Korean J Urol.  2013 Oct;54(10):718-720.

Missed Spermatic Cord Torsion in an Old Man

Affiliations
  • 1Department of Urology, Dankook University College of Medicine, Cheonan, Korea. hjh178@medimail.co.kr
  • 2Department of Pathology, Dankook University College of Medicine, Cheonan, Korea.

Abstract

The fate of testicular salvage in spermatic cord torsion depends on the duration of ischemia and the degree of torsion. Even though spermatic cord torsion (SCT) can occur at any age, it is rarely reported in older patients. If the physician does not pay close attention to this unusual situation, the lack of suspicion for SCT may result in a missed or delayed diagnosis. We report a very uncommon case of missed SCT occurring in a 63-year-old man.

Keyword

Age groups; Spermatic cord torsion; Testis

MeSH Terms

Delayed Diagnosis
Humans
Ischemia
Middle Aged
Spermatic Cord
Spermatic Cord Torsion
Testis

Figure

  • FIG. 1 (A) Gray-scale imaging demonstrates that the right testis shows a heterogeneous echotexture with thickening of the scrotal wall. A twisted cord structure (white arrows) is identified as an echogenic extratesticular mass. (B) Color Doppler ultrasonography shows the complete absence of detectable flow inside the right testis. T, testis.

  • FIG. 2 (A) Gross appearance of the specimen. The cord appears as a twisted breadstick within the thickened vaginalis. (B) Microscopic finding. Hemorrhagic testicular infarct of this case reveals typical coagulative necrosis of almost the entire seminiferous tubules in the background of stromal hemorrhage (H&E, ×100).


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