Document Detail


Xanthogranulomatous funiculitis and epididymo-orchitis in a tetraplegic patient.
MedLine Citation:
PMID:  11175379     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY DESIGN: A case report of xanthogranulomatous funiculitis and epididymo-orchitis. Xanthogranulomatous inflammation is an uncommon, non-neoplastic process characterised by destruction of tissue, which is replaced by a striking cellular infiltrate of lipid-laden macrophages.
CASE REPORT: A 21-year male sustained complete tetraplegia at C-6 level, after a fall in 1998. The neuropathic bladder was managed with an indwelling urethral catheter. He had many unsuccessful trials of micturition. Sixteen months after the cervical injury, he noticed swelling of the left side of the scrotum following removal of a blocked catheter. He was prescribed antibacterial therapy. Four weeks later, physical examination revealed a hard and irregular swelling encompassing the testis, epididymis and spermatic cord. The clinical diagnosis was epididymo-orchitis progressing to pyocele. Through a scrotal incision, the swollen testis, epididymis and diseased segment of the spermatic cord were removed en masse. Histopathology showed extensive areas of necrosis, with xanthogranulomatous inflammation in the spermatic cord and to a lesser extent in the testis/epididymis.
CONCLUSION: Repeated episodes of high-pressure urinary reflux along the vas deferens during dyssynergic voiding, and subsequent interstitial extravasation of urine together with chronic, low-grade, suppurative infection possibly led to development of xanthogranulomatous inflammation in the testis and the epididymis. Since tissue destruction is a feature of xanthogranulomatous inflammation, the definite and curative treatment is either complete (or, where applicable, partial) excision of the affected organ in most of the cases.
Authors:
S Vaidyanathan; P Mansour; K F Parsons; G Singh; B M Soni; R Subramaniam; T Oo; P Sett
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Spinal cord     Volume:  38     ISSN:  1362-4393     ISO Abbreviation:  Spinal Cord     Publication Date:  2000 Dec 
Date Detail:
Created Date:  2001-02-22     Completed Date:  2001-04-12     Revised Date:  2011-06-06    
Medline Journal Info:
Nlm Unique ID:  9609749     Medline TA:  Spinal Cord     Country:  England    
Other Details:
Languages:  eng     Pagination:  769-72     Citation Subset:  IM    
Affiliation:
Regional Spinal Injuries Centre, Southport and Formby District General Hospital, Southport and Ormskirk Hospital NHS Trust, Southport, Merseyside PR8 6PN, UK.
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MeSH Terms
Descriptor/Qualifier:
Adult
Epididymis / pathology,  surgery,  ultrasonography
Epididymitis / etiology*,  pathology,  surgery
Humans
Male
Orchitis / etiology*,  pathology,  surgery
Pyelonephritis, Xanthogranulomatous / pathology
Quadriplegia / complications*
Spermatic Cord / pathology*,  surgery
Spinal Cord Injuries / complications*
Testis / pathology,  surgery,  ultrasonography
Urinary Bladder, Neurogenic / complications*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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