Volume 10, Number 2Case ReviewLeydig Cell Hyperplasia Revealed by GynecomastiaCase ReviewMohamed Jamal El FassiMoulay Hassan FarihMohamed Fadl TaziSoufiane MellasLeydig cell tumors are rare and represent 1% to 3% of all tumors of the testis. Leydig cell tumors affect males at any age, but there are 2 peak periods of incidence: between 5 and 10 years and between 25 and 35 years. Their main clinical presentation is a testicular mass associated with endocrinal manifestations that are variable according to age and appearance of the tumor. Our patient, a 17-year-old adolescent, presented with an isolated and painless hypertrophy of the right mammary gland. Clinical examination found gynecomastia and no testicular mass. Hormonal levels and tumor markers were normal. Testicular sonography showed an ovular and homogeneous right intratesticular mass 6 mm in diameter. We treated the patient with an inguinal right orchidectomy. The anatomopathological study found a nodule of Leydig cell hyperplasia. The patient recovered without recurrence at 8-month follow-up. The patient opted for mammoplasty 2 months after his orchidectomy rather than wait for the spontaneous gradual regression of his gynecomastia, which requires at least 1 year. Leydig cell hyperplasia manifests in the adult by signs of hypogonadism, most frequently gynecomastia. Although many teams prefer total orchidectomy because of the diagnostic difficulty associated with malignant forms, simple subcapsular orchidectomy should become the first-line treatment, provided it be subsequently followed by close surveillance, as it preserves maximum fertility, and these tumors usually resolve favorably. [Rev Urol. 2008:10(2):164-167]FertilityTesticular tumorLeydig cell hyperplasiaNonseminomatous germ celltumorsGynecomastia
Volume 11, Number 4Case ReviewConcurrent Bilateral Renal Angiomyolipoma and Renal Cell Carcinoma in a Patient With Tuberous Sclerosis ComplexAbdelhak KhalloukYounes AhallalMohamed Jamal El FassiMohamed Fadl TaziSoufiane MellasMbarek DoublaliRenal angiomyolipomas (AMLs) are often associated with tuberous sclerosis. These tumors are predominantly benign, although malignant forms do exist and are known to be associated with renal cell carcinoma. This case report describes a patient with tuberous sclerosis and massive bilateral AML. Total right nephrectomy was performed; histopathologic examination revealed the coexistence of AML and clear cell renal carcinoma in the same kidney. Because differentiation between renal cell carcinoma and AML with minimal or no fat component can be difficult, an accurate diagnosis is critical in the management of renal AML.[Rev Urol. 2009;11(4):216-218 doi: 10.3909/riu0436]© 2009 MedReviews®, LLCRenal cell carcinomaAngiomyolipomaTuberous sclerosis
Volume 13, Number 2Case ReviewIdiopathic Scrotal Calcinosis: A Non-Elucidated Pathogenesis and Its Surgical TreatmentAbdelhak KhalloukMohamed Jamal El FassiMoulay Hassan FarihOussama El YazamiMohamed Fadl TaziSoufiane MellasScrotal calcinosis (SC) is a rare, benign entity defined as the presence of multiple calcified nodules within the scrotal skin. In most cases, there are no associated symptoms. We report the case of 27-year-old man with a massive SC. Treatment was surgical with complete excision of the affected part of the scrotum wall. Histopathologically, there was no epithelial lining around the calcified nodules and no cystic structure. Therefore, our case was considered idiopathic SC [Rev Urol. 2011;13(2):95-97 doi: 10.3909/riu0481] © 2011 MedReviews®, LLCTreatmentCalcinosisIdiopathicScrotumSurgery