Xanthogranulomatous funiculitis and epididymo-orchitis in a tetraplegic patient

Xanthogranulomatous funiculitis and epididymo-orchitis in a tetraplegic patient

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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. SIMILAR CONTENT BEING VIEWED BY OTHERS THE SURGICAL MANAGEMENT OF PENILE OLEOGRANULOMA: CASE SERIES Article 14 October 2023 NEPHROGENIC METAPLASIA IN A FEMALE PERSON WITH SPINAL CORD INJURY: CHRONIC IRRITATION CAUSED BY FOLEY BALLOON WAS AGGRAVATED BY A LARGE UTERINE FIBROID PRESSING UPON THE BLADDER WALL FOR SEVERAL YEARS: A CASE REPORT Article 09 May 2022 A CONTEMPORARY ASSESSMENT OF THE EVALUATION AND MANAGEMENT OF PATIENTS PRESENTING TO A TERTIARY MEDICAL CENTER WITH PEYRONIE’S DISEASE Article 19 July 2023 ARTICLE PDF AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Regional Spinal Injuries Centre, Southport and Formby District General Hospital, Southport and Ormskirk Hospital NHS Trust, Southport, PR8 6PN, Merseyside, UK S Vaidyanathan, G Singh, BM Soni, T Oo & P Sett * Department of Cellular Pathology, Southport and Formby District General Hospital, Southport and Ormskirk Hospital NHS Trust, Southport, PR8 6PN, Merseyside, UK P Mansour * Department of Radiology, Southport and Formby District General Hospital, Southport and Ormskirk Hospital NHS Trust, Southport, PR8 6PN, Merseyside, UK R Subramaniam * Department of Urology, Royal Liverpool University Hospital, Prescot Street, Liverpool, L7 8XP, UK KF Parsons Authors * S Vaidyanathan View author publications You can also search for this author inPubMed Google Scholar * P Mansour View author publications You can also search for this author inPubMed Google Scholar * KF Parsons View author publications You can also search for this author inPubMed Google Scholar * G Singh View author publications You can also search for this author inPubMed Google Scholar * BM Soni View author publications You can also search for this author inPubMed Google Scholar * R Subramaniam View author publications You can also search for this author inPubMed Google Scholar * T Oo View author publications You can also search for this author inPubMed Google Scholar * P Sett View author publications You can also search for this author inPubMed Google Scholar RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Vaidyanathan, S., Mansour, P., Parsons, K. _et al._ Xanthogranulomatous funiculitis and epididymo-orchitis in a tetraplegic patient. _Spinal Cord_ 38, 769–772 (2000). https://doi.org/10.1038/sj.sc.3101045 Download citation * Published: 12 January 2001 * Issue Date: 01 December 2000 * DOI: https://doi.org/10.1038/sj.sc.3101045 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content: Get shareable link Sorry, a shareable link is not currently available for this article. Copy to clipboard Provided by the Springer Nature SharedIt content-sharing initiative KEYWORDS * xanthogranulomatous inflammation * spinal cord injury * funiculitis * epididymo-orchitis * neuropathic bladder

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. SIMILAR CONTENT BEING VIEWED BY OTHERS THE SURGICAL MANAGEMENT OF PENILE OLEOGRANULOMA: CASE SERIES Article 14 October 2023 NEPHROGENIC METAPLASIA IN A


FEMALE PERSON WITH SPINAL CORD INJURY: CHRONIC IRRITATION CAUSED BY FOLEY BALLOON WAS AGGRAVATED BY A LARGE UTERINE FIBROID PRESSING UPON THE BLADDER WALL FOR SEVERAL YEARS: A CASE REPORT


Article 09 May 2022 A CONTEMPORARY ASSESSMENT OF THE EVALUATION AND MANAGEMENT OF PATIENTS PRESENTING TO A TERTIARY MEDICAL CENTER WITH PEYRONIE’S DISEASE Article 19 July 2023 ARTICLE PDF


AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Regional Spinal Injuries Centre, Southport and Formby District General Hospital, Southport and Ormskirk Hospital NHS Trust, Southport, PR8 6PN,


Merseyside, UK S Vaidyanathan, G Singh, BM Soni, T Oo & P Sett * Department of Cellular Pathology, Southport and Formby District General Hospital, Southport and Ormskirk Hospital NHS


Trust, Southport, PR8 6PN, Merseyside, UK P Mansour * Department of Radiology, Southport and Formby District General Hospital, Southport and Ormskirk Hospital NHS Trust, Southport, PR8 6PN,


Merseyside, UK R Subramaniam * Department of Urology, Royal Liverpool University Hospital, Prescot Street, Liverpool, L7 8XP, UK KF Parsons Authors * S Vaidyanathan View author publications


You can also search for this author inPubMed Google Scholar * P Mansour View author publications You can also search for this author inPubMed Google Scholar * KF Parsons View author


publications You can also search for this author inPubMed Google Scholar * G Singh View author publications You can also search for this author inPubMed Google Scholar * BM Soni View author


publications You can also search for this author inPubMed Google Scholar * R Subramaniam View author publications You can also search for this author inPubMed Google Scholar * T Oo View


author publications You can also search for this author inPubMed Google Scholar * P Sett View author publications You can also search for this author inPubMed Google Scholar RIGHTS AND


PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Vaidyanathan, S., Mansour, P., Parsons, K. _et al._ Xanthogranulomatous funiculitis and epididymo-orchitis in a


tetraplegic patient. _Spinal Cord_ 38, 769–772 (2000). https://doi.org/10.1038/sj.sc.3101045 Download citation * Published: 12 January 2001 * Issue Date: 01 December 2000 * DOI:


https://doi.org/10.1038/sj.sc.3101045 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content: Get shareable link Sorry, a shareable link is not


currently available for this article. Copy to clipboard Provided by the Springer Nature SharedIt content-sharing initiative KEYWORDS * xanthogranulomatous inflammation * spinal cord injury *


funiculitis * epididymo-orchitis * neuropathic bladder