Peno-scrotal limphedema with giant hydrocele - surgical treatment particularities
Identifieur interne : 004097 ( Pmc/Curation ); précédent : 004096; suivant : 004098Peno-scrotal limphedema with giant hydrocele - surgical treatment particularities
Auteurs : Dan Mischianu ; Ioan Florescu ; Victor Madan ; Cristian Iatagan ; Ovidiu Bratu ; Anca Oporan ; C. GiubleaSource :
- Journal of Medicine and Life [ 1844-122X ] ; 2009.
Abstract
The necessity for complex and multidisciplinary approach of “border” surgical pathology has unanimously been agreed upon for such a long period of time, its advantages becoming even more obvious in rare, particular cases.
We report the case of a 39 year-old man diagnosed with lymphangiomatosis back in his childhood. He is admitted with a giant pseudotumoral scrotal mass presenting an important scrotal enlargement (40/35 cm).
Physical examination, blood tests, ultrasound, IVP, abdominal and chest CT, psychiatric and plastic surgery evaluation established the diagnosis: peno-scrotal lymphedema with gigantic hydrocele and depressive disorder. Taking into account the important enlargement of the scrotum associated with the alteration of the local skin, we decided to form a mixed surgical team: urology - plastic and reconstructive surgery.
We performed bilateral surgical therapy of hydrocele with partial excision and eversion of sac edges, excision of peno-scrotal skin and subcutaneous tissue surplus. At the end we made a reconstruction by using a partial-thickness graft from the normal skin of the left thigh.
Spinal anaesthesia was sufficient in order to perform a qualitative complex surgery. Intra and postoperative course was uneventful with minimal blood loss.
Rare cases like this one clearly reveal the advantages of a multidisciplinary surgical team by combining usual surgical procedures from different specialities that could lead to spectacular results.
Url:
PubMed: 20108494
PubMed Central: 5051485
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hydrocele - surgical treatment particularities
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<author><name sortKey="Mischianu, Dan" sort="Mischianu, Dan" uniqKey="Mischianu D" first="Dan" last="Mischianu">Dan Mischianu</name>
<affiliation><nlm:aff id="A1">“Dr. Carol Davila” Central Military Emergency Hospital - Department of Urology</nlm:aff>
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<author><name sortKey="Florescu, Ioan" sort="Florescu, Ioan" uniqKey="Florescu I" first="Ioan" last="Florescu">Ioan Florescu</name>
<affiliation><nlm:aff id="A1">“Dr. Carol Davila” Central Military Emergency Hospital - Department of Urology</nlm:aff>
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<author><name sortKey="Madan, Victor" sort="Madan, Victor" uniqKey="Madan V" first="Victor" last="Madan">Victor Madan</name>
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<author><name sortKey="Oporan, Anca" sort="Oporan, Anca" uniqKey="Oporan A" first="Anca" last="Oporan">Anca Oporan</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Peno-scrotal limphedema with giant
hydrocele - surgical treatment particularities
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<author><name sortKey="Mischianu, Dan" sort="Mischianu, Dan" uniqKey="Mischianu D" first="Dan" last="Mischianu">Dan Mischianu</name>
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<author><name sortKey="Florescu, Ioan" sort="Florescu, Ioan" uniqKey="Florescu I" first="Ioan" last="Florescu">Ioan Florescu</name>
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<author><name sortKey="Madan, Victor" sort="Madan, Victor" uniqKey="Madan V" first="Victor" last="Madan">Victor Madan</name>
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<author><name sortKey="Iatagan, Cristian" sort="Iatagan, Cristian" uniqKey="Iatagan C" first="Cristian" last="Iatagan">Cristian Iatagan</name>
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<author><name sortKey="Bratu, Ovidiu" sort="Bratu, Ovidiu" uniqKey="Bratu O" first="Ovidiu" last="Bratu">Ovidiu Bratu</name>
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<author><name sortKey="Oporan, Anca" sort="Oporan, Anca" uniqKey="Oporan A" first="Anca" last="Oporan">Anca Oporan</name>
<affiliation><nlm:aff id="A2">“D. Bagdasar” Hospital - Department of Plastic and Reconstructive Surgery</nlm:aff>
</affiliation>
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<author><name sortKey="Giublea, C" sort="Giublea, C" uniqKey="Giublea C" first="C" last="Giublea">C. Giublea</name>
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<series><title level="j">Journal of Medicine and Life</title>
<idno type="ISSN">1844-122X</idno>
<idno type="eISSN">1844-3117</idno>
<imprint><date when="2009">2009</date>
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<front><div type="abstract" xml:lang="en"><p><bold>Introduction</bold>
:</p>
<p>The necessity for complex and multidisciplinary approach of “border” surgical pathology has unanimously been agreed upon for such a long period of time, its advantages becoming even more obvious in rare, particular cases.</p>
<p><bold>Patients and methods</bold>
:</p>
<p>We report the case of a 39 year-old man diagnosed with lymphangiomatosis back in his childhood. He is admitted with a giant pseudotumoral scrotal mass presenting an important scrotal enlargement (40/35 cm).</p>
<p>Physical examination, blood tests, ultrasound, IVP, abdominal and chest CT, psychiatric and plastic surgery evaluation established the diagnosis: peno-scrotal lymphedema with gigantic hydrocele and depressive disorder. Taking into account the important enlargement of the scrotum associated with the alteration of the local skin, we decided to form a mixed surgical team: urology - plastic and reconstructive surgery.</p>
<p>We performed bilateral surgical therapy of hydrocele with partial excision and eversion of sac edges, excision of peno-scrotal skin and subcutaneous tissue surplus. At the end we made a reconstruction by using a partial-thickness graft from the normal skin of the left thigh.</p>
<p><bold>Results</bold>
:</p>
<p>Spinal anaesthesia was sufficient in order to perform a qualitative complex surgery. Intra and postoperative course was uneventful with minimal blood loss.</p>
<p><bold>Conclusion</bold>
:</p>
<p>Rare cases like this one clearly reveal the advantages of a multidisciplinary surgical team by combining usual surgical procedures from different specialities that could lead to spectacular results.</p>
</div>
</front>
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<author><name sortKey="Emiroglu, M" uniqKey="Emiroglu M">M Emiroglu</name>
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<author><name sortKey="He, W" uniqKey="He W">W He</name>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Med Life</journal-id>
<journal-id journal-id-type="iso-abbrev">J Med Life</journal-id>
<journal-id journal-id-type="publisher-id">JMedLife</journal-id>
<journal-title-group><journal-title>Journal of Medicine and Life</journal-title>
</journal-title-group>
<issn pub-type="ppub">1844-122X</issn>
<issn pub-type="epub">1844-3117</issn>
<publisher><publisher-name>Carol Davila University Press</publisher-name>
<publisher-loc>Romania</publisher-loc>
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</journal-meta>
<article-meta><article-id pub-id-type="pmid">20108494</article-id>
<article-id pub-id-type="pmc">5051485</article-id>
<article-id pub-id-type="publisher-id">JMedLife-02-72</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>General Articles</subject>
</subj-group>
</article-categories>
<title-group><article-title>Peno-scrotal limphedema with giant
hydrocele - surgical treatment particularities
</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Mischianu</surname>
<given-names>Dan</given-names>
</name>
<xref ref-type="aff" rid="A1">*</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Florescu</surname>
<given-names>Ioan</given-names>
</name>
<xref ref-type="aff" rid="A1">*</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Madan</surname>
<given-names>Victor</given-names>
</name>
<xref ref-type="aff" rid="A1">*</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Iatagan</surname>
<given-names>Cristian</given-names>
</name>
<xref ref-type="aff" rid="A1">*</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Bratu</surname>
<given-names>Ovidiu</given-names>
</name>
<xref ref-type="aff" rid="A1">*</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Oporan</surname>
<given-names>Anca</given-names>
</name>
<xref ref-type="aff" rid="A2">**</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Giublea</surname>
<given-names>C</given-names>
</name>
<xref ref-type="aff" rid="A2">**</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>*</label>
“Dr. Carol Davila” Central Military Emergency Hospital - Department of Urology</aff>
<aff id="A2"><label>**</label>
“D. Bagdasar” Hospital - Department of Plastic and Reconstructive Surgery</aff>
<author-notes><corresp><bold>Correspondence to:</bold>
Victor Madan,
“Dr. Carol Davila” Clinical Military Emergency Hospital Bucharest, Department of Urology,
134 Calea Plevnei, Bucharest, Romania
E-mail: victmad@yahoo.com
</corresp>
</author-notes>
<pub-date pub-type="ppub"><season>Jan-Mar</season>
<year>2009</year>
</pub-date>
<volume>2</volume>
<issue>1</issue>
<fpage>72</fpage>
<lpage>75</lpage>
<permissions><copyright-statement>©Carol Davila University Press
</copyright-statement>
<copyright-year>2009</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/2.0/"><license-p>This is
an open-access article distributed under the terms of the Creative
Commons Attribution License, which permits unrestricted use,
distribution, and reproduction in any medium, provided the original work
is properly cited.</license-p>
</license>
</permissions>
<abstract><p><bold>Introduction</bold>
:</p>
<p>The necessity for complex and multidisciplinary approach of “border” surgical pathology has unanimously been agreed upon for such a long period of time, its advantages becoming even more obvious in rare, particular cases.</p>
<p><bold>Patients and methods</bold>
:</p>
<p>We report the case of a 39 year-old man diagnosed with lymphangiomatosis back in his childhood. He is admitted with a giant pseudotumoral scrotal mass presenting an important scrotal enlargement (40/35 cm).</p>
<p>Physical examination, blood tests, ultrasound, IVP, abdominal and chest CT, psychiatric and plastic surgery evaluation established the diagnosis: peno-scrotal lymphedema with gigantic hydrocele and depressive disorder. Taking into account the important enlargement of the scrotum associated with the alteration of the local skin, we decided to form a mixed surgical team: urology - plastic and reconstructive surgery.</p>
<p>We performed bilateral surgical therapy of hydrocele with partial excision and eversion of sac edges, excision of peno-scrotal skin and subcutaneous tissue surplus. At the end we made a reconstruction by using a partial-thickness graft from the normal skin of the left thigh.</p>
<p><bold>Results</bold>
:</p>
<p>Spinal anaesthesia was sufficient in order to perform a qualitative complex surgery. Intra and postoperative course was uneventful with minimal blood loss.</p>
<p><bold>Conclusion</bold>
:</p>
<p>Rare cases like this one clearly reveal the advantages of a multidisciplinary surgical team by combining usual surgical procedures from different specialities that could lead to spectacular results.</p>
</abstract>
</article-meta>
</front>
</pmc>
</record>
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