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Xanthogranulomatous funiculitis and epididymo-orchitis in a tetraplegic patient.
Spinal Cord. 2000 Dec; 38(12):769-72.SC

Abstract

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+Show Affiliations

Regional Spinal Injuries Centre, Southport and Formby District General Hospital, Southport and Ormskirk Hospital NHS Trust, Southport, Merseyside PR8 6PN, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

11175379

Citation

Vaidyanathan, S, et al. "Xanthogranulomatous Funiculitis and Epididymo-orchitis in a Tetraplegic Patient." Spinal Cord, vol. 38, no. 12, 2000, pp. 769-72.
Vaidyanathan S, Mansour P, Parsons KF, et al. Xanthogranulomatous funiculitis and epididymo-orchitis in a tetraplegic patient. Spinal Cord. 2000;38(12):769-72.
Vaidyanathan, S., Mansour, P., Parsons, K. F., Singh, G., Soni, B. M., Subramaniam, R., Oo, T., & Sett, P. (2000). Xanthogranulomatous funiculitis and epididymo-orchitis in a tetraplegic patient. Spinal Cord, 38(12), 769-72.
Vaidyanathan S, et al. Xanthogranulomatous Funiculitis and Epididymo-orchitis in a Tetraplegic Patient. Spinal Cord. 2000;38(12):769-72. PubMed PMID: 11175379.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Xanthogranulomatous funiculitis and epididymo-orchitis in a tetraplegic patient. AU - Vaidyanathan,S, AU - Mansour,P, AU - Parsons,K F, AU - Singh,G, AU - Soni,B M, AU - Subramaniam,R, AU - Oo,T, AU - Sett,P, PY - 2001/2/15/pubmed PY - 2001/4/17/medline PY - 2001/2/15/entrez SP - 769 EP - 72 JF - Spinal cord JO - Spinal Cord VL - 38 IS - 12 N2 - 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. SN - 1362-4393 UR - https://www.unboundmedicine.com/medline/citation/11175379/Xanthogranulomatous_funiculitis_and_epididymo_orchitis_in_a_tetraplegic_patient_ L2 - http://dx.doi.org/10.1038/sj.sc.3101045 DB - PRIME DP - Unbound Medicine ER -