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Fibrous hamartoma of infancy masquerading as a rhabdomyosarcoma of the spermatic cord
71B
INTERNATIONAL ABSTRACTS
rigidity in gastroschisis may result from the trauma of labor and delivery, and that elective preterm section, as soon as lung maturity can be demonstrated, may substantially improve the ease of primary repair.--Prem Puri
GENITOURINARY TRACT Management of Mullerian Duct Remnants in the Male Patient.
M.L. Ritchey, R.C. Benson, S.A. Krarner, et al. J Uro1140:795-799, (October), 1988. Thirty-six patients were evaluated for mullerian duct remnants that were manifest in several forms. The most common type was an enlarged prostatic utricle communicating with the urethra (in 22 younger patients). This was associated with hypospadias or intersex disorders in >90% of the cases. A cystic mullerian duct remnant was the other configuration noted in 14 older patients who bad normal external genitalia and often presented with a rectal mass. The diagnostic evaluation consists of voiding cystourethrography, retrograde urethrography, and cystoscopy. Other useful imaging techniques are ultrasonography and computerized tomography. Careful delineation of the anatomy of the lower urinary and genital tracts will help to plan surgical therapy. Suprapubic excision was the most frequent operation, and it was successful in all 18 patients in whom it was performed.--George W. Holcomb, Jr Adherence of Bacteria to Human Foreskins. E.N. Fussell, M.B.
Kaack, R. Cherry, et al. J Urol 140:997-1001, (November), 1988. The mucosal surface of the human foreskin from newborns shows a propensity to be colonized by pathogenic bacteria. Bacteria with P fimbriae and type 1 fimbriae adhere. However, hydrophobic interaction as well as electrostatic charge appear to be as important in this adherence as fimbriae. Since bacterial adherence has been shown to precede urinary tract infection in female patients, it is assumed that this adherence to the foreskin in male patients also may be necessary before initiation of the disease. The high incidence of urinary tract infection in uncircumcised male patients combined with these findings of adherence of pathogenic bacteria to the mucosal surface of the foreskin would, thus, seem to be related. Thus, prevention of urinary tract infection and acute pyelonephritis in male neonates may require either circumcision or the prevention of bacterial adherence to the human foreskin.--George IV. Hotcomb, Jr
incidence was found to have increased from 11 cases to 43 cases by 1984. More than 90% of the cases were managed by general surgeons. The age range was nine days to 77 years, with 62% of cases occurring in patients 12 to 18 years of age. Torsion was more common in the colder months. When torsion was relieved within 12 hours of the onset of symptoms, only 4% of the affected testes were found to be nonviable. After this time, 75% of the patients required orchidectomy. The testicular salvage rate improved steadily over the years, probably reflecting a greater awareness of the condition with earlier referraL--John D. Orr Simple Cysts of the Testis in Children: Preoperative Diagnosis by Ultrasound and Excision With Testicular Preservation. V. Altadon-
na, H.M. Snyder Ill, H.K. Rosenberg, et al. 3 Urol 140:1505-1507, (December), 1988. Two children with simple cysts of the testis who were treated with excision and testicular preservation are reported. The authors report that, to their knowledge, both cases represent the first report of conservative surgery for these lesions in children. In one case, the diagnosis of a simple intratesticular cyst was made by ultrasound. The patient was followed conservatively until enlargement resulted in excision of the cyst with preservation of the gonad. In the other patient, the diagnosis was made intraoperatively, and simple excision of the lesion with testicular sparing was performed. High resolution real-time ultrasound should be performed routinely for all suspected testicular masses in children. Benign testicular tumors are more common than in adults, and ultrasound may permit the identification of lesions that can be excised with testicular preservation. Should the diagnosis of a simple, small intratesticular cyst be made by ultrasound, regular follow-up may be appropriate. Should enlargement occur, surgical excision can be performed with the possibility of gonadal preservation.--George W. Holcomb, Jr Fibrous Hamartoma of Infancy Masquerading as a Rhabdomyosarcoma of the Spermatic Cord. E.L. Ritchie, F. Gonzales-Crussi, and
M.R. Zaontz. J Urol 140:800-801, (October), 1988. Fibrous hamartoma of infancy is an uncommon nonmalignant fibroproliferative tumor found predominantly in the upper torso within the first 2 years of life. A case of fibrous hamartoma of infancy is described, which presented as a rapidly growing serotal mass clinically indistinguishable from a rhabdomyosarcoma of the spermatic cord. The clinical characteristics of this neoplasm as well as management are discussed.--George W. Holcomb, Jr
Plasma Testosterone in Preterm Infants With Cryptorchidism.
B.A. Baker, R.A. Morley, and A. Lucas. Arch Dis Child 63:11981120, (October), 1988. The authors had previously reported a high incidence of cryptorchidism in preterm babies at 18 months' corrected age, reaching an incidence of 19% in infants with a birth weight of <1,000 g. In this study, they looked at the plasma testosterone concentrations during the first 3 months postpartum in 21 preterm infants with cryptorchidism and in 21 controls. Ten subjects had bilateral and 11 had unilateral cryptorchidism. The index cases failed to show the normal rise in plasma testosterone in the second month found in controls. The authors postulate that there may be inadequate release of testosterone induced by maternal chorionic gonadotrophin in utero, and speculate that endocrine treatment or prophylaxis may be appropriate in this group of babies.--D.M. Burge Testicular Torsion in Bristol: A 25-Year Review. J.B. Anderson and R.C.N. Williamson. Br J Surg 75:988-992, (October), 1988.
Nine hundred seventy patients with torsion of the spermatic cord presenting between 1980 and 1984 were reviewed. The annual
The Use of Paraaxstrophy Flaps for Urethral Construction in Neonatal Girls With Classical Exstrophy. M.R. Spindel, B.H.
Winslow, and G.H. Jordan. J Urol 140:574-576, (September), 1988. Primary closure of classical exstrophy was performed with paraexstrophy skin flaps for urethral lengthening in four female neonates. In all cases, more than 2.0 cm of urethral length was achieved. Efficacy of bladder closure and subsequent bladder neck revision were enhanced by the use of these flaps. The technique of urethral construction is described and results discussed.--George W. Holcomb, Jr Prostatic Suppuration and Destruction in Patients With Myelodysplasia: A Newly Recognized Entity. G.F. Steinhardt. J Uro]
140:1002-1006, (November), 1988. Prostatic abscess is an unusual occurrence in the era of modern antibiotics. In five patients with myelodysplasia, extravasation of contrast material to the boundaries of the prostate was noted on
INTERNATIONAL ABSTRACTS
rigidity in gastroschisis may result from the trauma of labor and delivery, and that elective preterm section, as soon as lung maturity can be demonstrated, may substantially improve the ease of primary repair.--Prem Puri
GENITOURINARY TRACT Management of Mullerian Duct Remnants in the Male Patient.
M.L. Ritchey, R.C. Benson, S.A. Krarner, et al. J Uro1140:795-799, (October), 1988. Thirty-six patients were evaluated for mullerian duct remnants that were manifest in several forms. The most common type was an enlarged prostatic utricle communicating with the urethra (in 22 younger patients). This was associated with hypospadias or intersex disorders in >90% of the cases. A cystic mullerian duct remnant was the other configuration noted in 14 older patients who bad normal external genitalia and often presented with a rectal mass. The diagnostic evaluation consists of voiding cystourethrography, retrograde urethrography, and cystoscopy. Other useful imaging techniques are ultrasonography and computerized tomography. Careful delineation of the anatomy of the lower urinary and genital tracts will help to plan surgical therapy. Suprapubic excision was the most frequent operation, and it was successful in all 18 patients in whom it was performed.--George W. Holcomb, Jr Adherence of Bacteria to Human Foreskins. E.N. Fussell, M.B.
Kaack, R. Cherry, et al. J Urol 140:997-1001, (November), 1988. The mucosal surface of the human foreskin from newborns shows a propensity to be colonized by pathogenic bacteria. Bacteria with P fimbriae and type 1 fimbriae adhere. However, hydrophobic interaction as well as electrostatic charge appear to be as important in this adherence as fimbriae. Since bacterial adherence has been shown to precede urinary tract infection in female patients, it is assumed that this adherence to the foreskin in male patients also may be necessary before initiation of the disease. The high incidence of urinary tract infection in uncircumcised male patients combined with these findings of adherence of pathogenic bacteria to the mucosal surface of the foreskin would, thus, seem to be related. Thus, prevention of urinary tract infection and acute pyelonephritis in male neonates may require either circumcision or the prevention of bacterial adherence to the human foreskin.--George IV. Hotcomb, Jr
incidence was found to have increased from 11 cases to 43 cases by 1984. More than 90% of the cases were managed by general surgeons. The age range was nine days to 77 years, with 62% of cases occurring in patients 12 to 18 years of age. Torsion was more common in the colder months. When torsion was relieved within 12 hours of the onset of symptoms, only 4% of the affected testes were found to be nonviable. After this time, 75% of the patients required orchidectomy. The testicular salvage rate improved steadily over the years, probably reflecting a greater awareness of the condition with earlier referraL--John D. Orr Simple Cysts of the Testis in Children: Preoperative Diagnosis by Ultrasound and Excision With Testicular Preservation. V. Altadon-
na, H.M. Snyder Ill, H.K. Rosenberg, et al. 3 Urol 140:1505-1507, (December), 1988. Two children with simple cysts of the testis who were treated with excision and testicular preservation are reported. The authors report that, to their knowledge, both cases represent the first report of conservative surgery for these lesions in children. In one case, the diagnosis of a simple intratesticular cyst was made by ultrasound. The patient was followed conservatively until enlargement resulted in excision of the cyst with preservation of the gonad. In the other patient, the diagnosis was made intraoperatively, and simple excision of the lesion with testicular sparing was performed. High resolution real-time ultrasound should be performed routinely for all suspected testicular masses in children. Benign testicular tumors are more common than in adults, and ultrasound may permit the identification of lesions that can be excised with testicular preservation. Should the diagnosis of a simple, small intratesticular cyst be made by ultrasound, regular follow-up may be appropriate. Should enlargement occur, surgical excision can be performed with the possibility of gonadal preservation.--George W. Holcomb, Jr Fibrous Hamartoma of Infancy Masquerading as a Rhabdomyosarcoma of the Spermatic Cord. E.L. Ritchie, F. Gonzales-Crussi, and
M.R. Zaontz. J Urol 140:800-801, (October), 1988. Fibrous hamartoma of infancy is an uncommon nonmalignant fibroproliferative tumor found predominantly in the upper torso within the first 2 years of life. A case of fibrous hamartoma of infancy is described, which presented as a rapidly growing serotal mass clinically indistinguishable from a rhabdomyosarcoma of the spermatic cord. The clinical characteristics of this neoplasm as well as management are discussed.--George W. Holcomb, Jr
Plasma Testosterone in Preterm Infants With Cryptorchidism.
B.A. Baker, R.A. Morley, and A. Lucas. Arch Dis Child 63:11981120, (October), 1988. The authors had previously reported a high incidence of cryptorchidism in preterm babies at 18 months' corrected age, reaching an incidence of 19% in infants with a birth weight of <1,000 g. In this study, they looked at the plasma testosterone concentrations during the first 3 months postpartum in 21 preterm infants with cryptorchidism and in 21 controls. Ten subjects had bilateral and 11 had unilateral cryptorchidism. The index cases failed to show the normal rise in plasma testosterone in the second month found in controls. The authors postulate that there may be inadequate release of testosterone induced by maternal chorionic gonadotrophin in utero, and speculate that endocrine treatment or prophylaxis may be appropriate in this group of babies.--D.M. Burge Testicular Torsion in Bristol: A 25-Year Review. J.B. Anderson and R.C.N. Williamson. Br J Surg 75:988-992, (October), 1988.
Nine hundred seventy patients with torsion of the spermatic cord presenting between 1980 and 1984 were reviewed. The annual
The Use of Paraaxstrophy Flaps for Urethral Construction in Neonatal Girls With Classical Exstrophy. M.R. Spindel, B.H.
Winslow, and G.H. Jordan. J Urol 140:574-576, (September), 1988. Primary closure of classical exstrophy was performed with paraexstrophy skin flaps for urethral lengthening in four female neonates. In all cases, more than 2.0 cm of urethral length was achieved. Efficacy of bladder closure and subsequent bladder neck revision were enhanced by the use of these flaps. The technique of urethral construction is described and results discussed.--George W. Holcomb, Jr Prostatic Suppuration and Destruction in Patients With Myelodysplasia: A Newly Recognized Entity. G.F. Steinhardt. J Uro]
140:1002-1006, (November), 1988. Prostatic abscess is an unusual occurrence in the era of modern antibiotics. In five patients with myelodysplasia, extravasation of contrast material to the boundaries of the prostate was noted on