Clinical presentation, management and follow-up of 83 patients with Leydig cell tumors of the testis: a prospective case-cohort study
AbstractSTUDY QUESTIONWhen should ‘not so rare’ Leydig cell tumors (LCTs) of the testis be suspected, diagnosed, and treated?SUMMARY ANSWERLCTs are more frequent than generally believed, are associated with male infertility, cryptorchidism and gynecomastia, and should be treated conservatively (in compliant patients) with active surveillance, which appears to be a safe alternative to surgical enucleation.WHAT IS KNOWN ALREADYIncreasing referrals for testicular imaging have led to an increase in findings of LCTs. The features and natural history of these tumors remain largely unknown, as the available studies are small and heterogeneous. LCTs were previously treated aggressively and follow-up data are lacking.STUDY DESIGN, SIZE, DURATIONA case-cohort study of consecutive patients diagnosed with LCTs over a 10-year period was prospectively enrolled from 2009 to 2018 and compared to matched cohorts of patients with seminomas or no testicular lesions screened in the same timeframe.PARTICIPANTS/MATERIALS, SETTING, METHODSOf the 9949 inpatients and outpatients referred for scrotal ultrasound, a total of 83 men with LCTs were included. Enrolled subjects underwent medical history and clinical examination and were asked to undergo routine blood tests, hormone investigations (FSH, LH, total testosterone, estradiol, inhibin B, sex hormone-binding globulin (SHBG), prolactin), and semen analysis. Patients who consented also underwent contrast-enhanced ultrasound, elastography,...
Publication date: Available online 14 May 2020Source: Seminars in Ultrasound, CT and MRIAuthor(s): Aishah Azam, Giles Rottenberg
Publication date: Available online 3 May 2020Source: Seminars in Ultrasound, CT and MRIAuthor(s): Essam Hashem, Sherif Elsobky, Mohamed Khalifa
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The objective is to determine the prevalence of levator ani muscle (LAM) avulsion using four-dimensional ultrasound in primiparous women after vaginal delivery and according to delivery mode.MethodsThis prospective, multicenter study included 322 women evaluated at 6 –12 months postpartum by four-dimensional transperineal ultrasound to identify levator ani muscle avulsion. The researcher who performed the ultrasound was blinded to all clinical data. Meaningful data about the birth were also recorded: mode of delivery, mother’s age and body mass index, durat ion of second stage, episiotomy, perineal tearing...
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