DOCSLIB.ORG

ON the IMPORTANCE of BUCK's FASCIA TN the CASE of PENILE LANCER. Pr Of

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
ON the IMPORTANCE of BUCK's FASCIA TN the CASE of PENILE LANCER. Pr Of 1 ON THE IMPORTANCE OF BUCK'S FASCIA TN THE CASE OF PENILE LANCER. Pr of. Tokuji Ichikawa, M. D., and Assistant Koizo Shida A certain book tells of the important role which (Fig. I a). Buck's fascia plays in respect of the extravasation Buck's fascia originates as fascia of M. bulboca- of blood and urine on the occasion of injuries of vernosus and M. is hiocavernosus and its rear the penis. However, little has been written of the connects with the triangular ligament and, enveloping stand which Buck's fascia takes against the invasion corpora cavernosa and corpus spongiosum, its of neoplasm. front reaches the glans. The fasciculi of fiber which The corpora cavernosa penis which is wrapped constitutes Buck's fascia bisect themselves after by a dense tunica albuginea is surrounded by Buck's extending to the part of the glans, and one half of fascia, together with corpus mspongiosum urethrae. which end in corona glandis, but the other half, Outside of this fascia there lies dartos layer, enveloping corpora cavernosa, enter into the interior separated by fatty, loose connective tissues. of the glans (Fig. I a). And, on the side of urethra Tunica albuginea is a dense sheath consistin of it terminates in the region of frenulum entangled rich collagenous fiber, destitute of elastic fiber, and with the elastic fiber of the glans. Buck's fascia is made up of fasciculi of rich elastic In the region of penii shaft, the fascia is cons- fiber. And, dartos layer is composed of smooth picuous on the dorsum, but on the side of the urethra, muscle and elastic fiber, and amongst them, against it is less conspicuous. However, when it reaches the invasion of neoplasm., Buck's fascia is of prime the glans in its front the arrangement of the significance. This is because the elastic fiber consti- fasciculi of fiber becomes gradually disordered, tutes a powerful resistance against the invasion of and its anterior end is interlaced with the fibers of neoplasm. corpus cavernosum glandis. That is to day, Buck's In the interspace between each of the cavernous fascia, at the anterior end, that is, in the part of body, Buck's fascia and dartos layer, layer of loose the glans, is in a state of opening to corpus caver- connective tissue containing blood vessels and nosum glandis (Fig. I b). nerves, lies, which offers capital ground for the In most of the cases of carcinoma of the penis, proliferation of neoplasm. the carcinoma which developed in the cavernous Dartos layer, as above mentioned, lying between tissue of the glans is observed to soon make its the skin and Buck's fascia, forms the subcutaneous way through this aperture and invade into the connective tissue embracing circular elastic fiber connective tissue that lies between Buck's fascia and and smooth muscle, and it connects itself with tunica albuginea Fig. II a, b). Scarpa's fascia in the upper region, with Colles' Carcinoma is said to break through the extremity fascia in the lower region, with dartos muscle of of tunica albuginea and invade the interior of cor- the scrotum and the superficial fascia of the thigh, pora cavernosa. However, in the above case, we and its front ends in the part of collum glandis observed that carcinoma does not invade intIcaver- 2 nous tissue from the first, but invades into and deve. REFERENCES lops in layers of the loose connective tissues in (1) Braus, H., Anatomie des Menschen, Bd the interspace between Buck's fascia and tunica III, 1924. albuginea, and further breaks through tunica albu- (2) Hinman, F., The Principles ancL Practice ginea and invades into the cavernous tissue (Fig. II, of Urology, 1936. a, b.). (3) Matsui, T., Peniskrebs, Acta Dermatologica, The corpus spongiosum urethrae, although of the Vol. 37, 121--135, 183--216, 1941. same cavernous body, contains much more quantity (4) Mollendorff, W., Handbuch der mikrosko- of elastic fiber as compared with corpora cavernoua pischen Anatomie des Menschen, VII J2, penis and is but slightly invaded by carcinoma. 1930. We have experienced cases of highly developed (5) Lenowitz, H. & Graham, A. P., Carcinoma stage of carcinoma in which the interior is wholly of the Penis. J. Urol., Vol.56, Nr. 4, 458- occupied by carcinoma and the outer cover is also 484, 1946. in a state of carcinoinatous ulcer but is still barely (6) Tandler, J., Lehrbuch der systematischen enabled to maintain the shape of the penis owing Anatomic. Bd II, 1923, Leibzig. to the corpus spongiosum urethrae and Buck's fascia (7) Tobin, C. E., Benjamin, J. A. & Wells, J. being in sound condition. C., Continuity of the Fasciae lining the Cane lesion Abdomen, Pelvis and Spermatic Cord. Surg. Buck's fascia, thanks to its rich elastic fiber, Gyne. & Obst., Vol. 83, Nr. 575-596, offers strong resistance against the invasion of 1946. carcinoma, and the state of its arrangement has an (8) Wesson, M. B., The Value of Buck's and important significance as against the development Colles' Fasciae. J. Urol., Vol. 53, Nr. 2. and proliferation of carcinoma. 365-372, 1945. Fig Ia Fig Ib Fig ha Fig IIb B. Buck's fascia C. Carcinoma D. Dartos layer T. Tunica albuginea.
Load more

Recommended publications
  • Te2, Part Iii
    TERMINOLOGIA EMBRYOLOGICA Second Edition International Embryological Terminology FIPAT The Federative International Programme for Anatomical Terminology A programme of the International Federation of Associations of Anatomists (IFAA) TE2, PART III Contents Caput V: Organogenesis Chapter 5: Organogenesis (continued) Systema respiratorium Respiratory system Systema urinarium Urinary system Systemata genitalia Genital systems Coeloma Coelom Glandulae endocrinae Endocrine glands Systema cardiovasculare Cardiovascular system Systema lymphoideum Lymphoid system Bibliographic Reference Citation: FIPAT. Terminologia Embryologica. 2nd ed. FIPAT.library.dal.ca. Federative International Programme for Anatomical Terminology, February 2017 Published pending approval by the General Assembly at the next Congress of IFAA (2019) Creative Commons License: The publication of Terminologia Embryologica is under a Creative Commons Attribution-NoDerivatives 4.0 International (CC BY-ND 4.0) license The individual terms in this terminology are within the public domain. Statements about terms being part of this international standard terminology should use the above bibliographic reference to cite this terminology. The unaltered PDF files of this terminology may be freely copied and distributed by users. IFAA member societies are authorized to publish translations of this terminology. Authors of other works that might be considered derivative should write to the Chair of FIPAT for permission to publish a derivative work. Caput V: ORGANOGENESIS Chapter 5: ORGANOGENESIS
    [Show full text]
  • Vocabulario De Morfoloxía, Anatomía E Citoloxía Veterinaria
    Vocabulario de Morfoloxía, anatomía e citoloxía veterinaria (galego-español-inglés) Servizo de Normalización Lingüística Universidade de Santiago de Compostela COLECCIÓN VOCABULARIOS TEMÁTICOS N.º 4 SERVIZO DE NORMALIZACIÓN LINGÜÍSTICA Vocabulario de Morfoloxía, anatomía e citoloxía veterinaria (galego-español-inglés) 2008 UNIVERSIDADE DE SANTIAGO DE COMPOSTELA VOCABULARIO de morfoloxía, anatomía e citoloxía veterinaria : (galego-español- inglés) / coordinador Xusto A. Rodríguez Río, Servizo de Normalización Lingüística ; autores Matilde Lombardero Fernández ... [et al.]. – Santiago de Compostela : Universidade de Santiago de Compostela, Servizo de Publicacións e Intercambio Científico, 2008. – 369 p. ; 21 cm. – (Vocabularios temáticos ; 4). - D.L. C 2458-2008. – ISBN 978-84-9887-018-3 1.Medicina �������������������������������������������������������������������������veterinaria-Diccionarios�������������������������������������������������. 2.Galego (Lingua)-Glosarios, vocabularios, etc. políglotas. I.Lombardero Fernández, Matilde. II.Rodríguez Rio, Xusto A. coord. III. Universidade de Santiago de Compostela. Servizo de Normalización Lingüística, coord. IV.Universidade de Santiago de Compostela. Servizo de Publicacións e Intercambio Científico, ed. V.Serie. 591.4(038)=699=60=20 Coordinador Xusto A. Rodríguez Río (Área de Terminoloxía. Servizo de Normalización Lingüística. Universidade de Santiago de Compostela) Autoras/res Matilde Lombardero Fernández (doutora en Veterinaria e profesora do Departamento de Anatomía e Produción Animal.
    [Show full text]
  • The Reproductive System
    27 The Reproductive System PowerPoint® Lecture Presentations prepared by Steven Bassett Southeast Community College Lincoln, Nebraska © 2012 Pearson Education, Inc. Introduction • The reproductive system is designed to perpetuate the species • The male produces gametes called sperm cells • The female produces gametes called ova • The joining of a sperm cell and an ovum is fertilization • Fertilization results in the formation of a zygote © 2012 Pearson Education, Inc. Anatomy of the Male Reproductive System • Overview of the Male Reproductive System • Testis • Epididymis • Ductus deferens • Ejaculatory duct • Spongy urethra (penile urethra) • Seminal gland • Prostate gland • Bulbo-urethral gland © 2012 Pearson Education, Inc. Figure 27.1 The Male Reproductive System, Part I Pubic symphysis Ureter Urinary bladder Prostatic urethra Seminal gland Membranous urethra Rectum Corpus cavernosum Prostate gland Corpus spongiosum Spongy urethra Ejaculatory duct Ductus deferens Penis Bulbo-urethral gland Epididymis Anus Testis External urethral orifice Scrotum Sigmoid colon (cut) Rectum Internal urethral orifice Rectus abdominis Prostatic urethra Urinary bladder Prostate gland Pubic symphysis Bristle within ejaculatory duct Membranous urethra Penis Spongy urethra Spongy urethra within corpus spongiosum Bulbospongiosus muscle Corpus cavernosum Ductus deferens Epididymis Scrotum Testis © 2012 Pearson Education, Inc. Anatomy of the Male Reproductive System • The Testes • Testes hang inside a pouch called the scrotum, which is on the outside of the body
    [Show full text]
  • Adipose Tissue-Derived Stem Cell-Seeded Small Intestinal Submucosa for Tunica Albuginea Grafting and Reconstruction
    Adipose tissue-derived stem cell-seeded small intestinal submucosa for tunica albuginea grafting and reconstruction Limin Maa,b,1, Yijun Yanga,1, Suresh C. Sikkaa,c, Philip J. Kadowitzc, Louis J. Ignarrod, Asim B. Abdel-Mageeda,c,2, and Wayne J. G. Hellstroma,2,3 Departments of aUrology and cPharmacology, Tulane University Health Sciences Center, New Orleans, LA 70112; bDepartment of Urology, Ninth People’s Hospital Affiliated with Medical College of Shanghai, Jiaotong University, Shanghai 200011, China; and dDepartment of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California, Los Angeles Center for the Health Sciences, Los Angeles, CA 90095 Edited by Solomon H. Snyder, The Johns Hopkins University School of Medicine, Baltimore, MD, and approved December 13, 2011 (received for review August 29, 2011) Porcine small intestinal submucosa (SIS) has been widely used in cell transplantation has been demonstrated in vascular (6) and car- tunica albuginea (TA) reconstructive surgery. Adipose tissue-derived tilage reconstruction (7) and in restoring immune response and stem cells (ADSCs) can repair damaged tissue, augment cellular hematopoiesis (8). In vivo scaffold-based studies further expanded differentiation, and stimulate release of multiple growth factors. the use of MSCs in new bone formation (9). The aim of this rat study was to assess the feasibility of seeding With the development of tissue engineering, cell-seeded acellu- ADSCs onto SIS grafts for TA reconstruction. Here, we demonstrate lar matrix
    [Show full text]
  • Ultrasonography of the Scrotum in Adults
    University of Massachusetts Medical School eScholarship@UMMS Radiology Publications and Presentations Radiology 2016-07-01 Ultrasonography of the scrotum in adults Anna L. Kuhn University of Massachusetts Medical School Et al. Let us know how access to this document benefits ou.y Follow this and additional works at: https://escholarship.umassmed.edu/radiology_pubs Part of the Male Urogenital Diseases Commons, Radiology Commons, Reproductive and Urinary Physiology Commons, Urogenital System Commons, and the Urology Commons Repository Citation Kuhn AL, Scortegagna E, Nowitzki KM, Kim YH. (2016). Ultrasonography of the scrotum in adults. Radiology Publications and Presentations. https://doi.org/10.14366/usg.15075. Retrieved from https://escholarship.umassmed.edu/radiology_pubs/173 Creative Commons License This work is licensed under a Creative Commons Attribution-Noncommercial 3.0 License This material is brought to you by eScholarship@UMMS. It has been accepted for inclusion in Radiology Publications and Presentations by an authorized administrator of eScholarship@UMMS. For more information, please contact [email protected]. Ultrasonography of the scrotum in adults Anna L. Kühn, Eduardo Scortegagna, Kristina M. Nowitzki, Young H. Kim Department of Radiology, UMass Memorial Medical Center, University of Massachusetts Medical Center, Worcester, MA, USA REVIEW ARTICLE Ultrasonography is the ideal noninvasive imaging modality for evaluation of scrotal http://dx.doi.org/10.14366/usg.15075 abnormalities. It is capable of differentiating the most important etiologies of acute scrotal pain pISSN: 2288-5919 • eISSN: 2288-5943 and swelling, including epididymitis and testicular torsion, and is the imaging modality of choice Ultrasonography 2016;35:180-197 in acute scrotal trauma. In patients presenting with palpable abnormality or scrotal swelling, ultrasonography can detect, locate, and characterize both intratesticular and extratesticular masses and other abnormalities.
    [Show full text]
  • Morphological Analysis of the Elastic and Collagen Ibers in the Ram Penis1
    Pesq. Vet. Bras. 38(11):2159-2165, novembro 2018 DOI: 10.1590/1678-5150-PVB-5325 Original Article /Morphophysiology ISSN 0100-736X (Print) ISSN 1678-5150 (Online) Morfofisiologia PVB-5325 MF Morphological analysis of the elastic and collagen �ibers in the ram penis1 Bruno Cesar Schimming2* and Gustavo N. Moraes3 ABSTRACT.- Schimming B.C. & Moraes G.N. 2018. Morphological analysis of the elastic and collagen �ibers in the ram penis. Pesquisa Veterinária Brasileira 38(11):2159-2165. 18618-970, Brazil. E-mail: [email protected] Departamento de Anatomia, Universidade Estadual Paulista, Cx. Postal 510, Botucatu, SP The penis represents the organ of the male’s copulation. It is essential to know the Morphological analysis of the elastic and reproductive biology and the morphology of the reproductive organs to increase animal production. In order to contribute to this knowledge and provides information on the ram collagen �ibers in the ram penis reproductive morphology, the purpose of this work was to describe the distribution, based on light microscopy, of the collagen and elastic fibers in the ram penis. For that, were collected transverse fragments of the penis (root, sigmoid flexure, body and glans) of seven rams. The specimens were fixed in paraformaldehyde for 24h and destined for the histological pênis de ovinos]. routine. The extracellular matrix of the ram penis was composed of collagen and elastic [Análise morfológica de fibras elásticas e colágenas no fibers. The penis was enveloped by the tunica albuginea, consisting essentially of collagen Schimming B.C. & Moraes G.N. 2159- fibers, which were arranged in two layers: an outer longitudinal and an inner circular.
    [Show full text]
  • Anatomy and Physiology of Erection: Pathophysiology of Erectile Dysfunction
    International Journal of Impotence Research (2003) 15, Suppl 7, S5–S8 & 2003 Nature Publishing Group All rights reserved 0955-9930/03 $25.00 www.nature.com/ijir Chapter 2 Anatomy and Physiology of erection: pathophysiology of erectile dysfunction Reporters and participants of the 1st Latin American Dysfunction Consensus Meeting International Journal of Impotence Research (2003) 15, Suppl 7, S5–S8. doi:10.1038/sj.ijir.3901127 Anatomy deep dorsal vein, the circumflex veins, the emissary veins, the cavernous veins and the crural veins). The lacunar spaces drain into small venules, which flow The penis, the male genital organ, has two func- together into a subalbugineal plexus, which in turn, tions: sexual and urinary. It is located above the emerges as emissary veins4,5 (Figure 1). scrotum, and it is linked to the pubic symphysis by two ligaments. It has a three-cylinder shape, integrated by two CROSS-SECTIONAL SECTION OF THE PENIS vascular tissue bodies (corpora cavernosa) (CC) and Superficial dorsal vein the corpus spongiosum (CS). The CCs have two Dorsal artery of penis Dorsal nerve of portions: a fixed posterior one, or perineal, and one penis that is anterior or free. At its base, the ischiopubic Deep dorsal vein Colles’ fascia rami are fixed, surrounded by the ischiocavernous muscles. The CS, in turn, stems from the perineum, Buck’s fascia Circumflex Vein surrounded by the bulbocavernous muscle. The Corpus urethra runs most of its length. At the distal end, cavernosum Tunica albuginea the CS dilates into a structure known as glans, Cavernous artery where the urethra opens to the outside of the Corpus spongiosum Urethral artery body through the meatus.1,2 Urethra Adapted and Modified from the 2ndBrazilian Consensus on Erectile Dysfunction2 The penis has an epidermal layer, underneath which is located the superficial fascia (Colles’), Figure 1 Cross-sectional section of the penis.
    [Show full text]
  • Scrotal Dartos-Fascio-Myo-Cutaneous Flaps for Penis
    CASE REPORT – OPEN ACCESS International Journal of Surgery Case Reports 28 (2016) 300–302 Contents lists available at ScienceDirect International Journal of Surgery Case Reports journal homepage: www.casereports.com Scrotal dartos-fascio-myo-cutaneous flaps for penis elongation after catastrophic iatrogenic skin shaft sub-amputation: A case of recovery using an extremely adaptable flap ∗ Alessandro Innocenti (MD) , Sara Tanini (MD), F. Mori (MD), D. Melita (MD), M. Innocenti (Prof.) Plastic and Reconstructive Microsurgery, Careggi Universital Hospital, Florence, Italy a r t i c l e i n f o a b s t r a c t Article history: INTRODUCTION: Genitalia are linked to self-esteem and male sexual identity, especially among young Received 15 July 2016 men, who sometimes require a surgical procedure to acquire more confidence. Among the surgical pro- Received in revised form 5 October 2016 cedures requested for aesthetical purposes, circumcision is one of the most popular. Although it can be Accepted 6 October 2016 considered to be a simple surgical practice, it may cause severe complications such as penile skin necrosis. Available online 15 October 2016 PRESENTATION OF CASE: We report a case of a catastrophic situation after a circumcision performed on a 27-year-old HIV positive man resulted in a drastic reduction in the length of the penile shaft due Keywords: to extensive skin loss; this was subsequently restored using dartos-fascio-myo-cutaneous flaps. Primary Penis healing occurred in 10 days. No infection, dehiscence or flap ischemia were reported. Donor site morbidity Penile reconstruction was minimal. An adequate aesthetical appearance and satisfactory functional results were obtained.
    [Show full text]
  • Skin Grafting for Penile Skin Loss
    Demzik et al. Plast Aesthet Res 2020;7:52 Plastic and DOI: 10.20517/2347-9264.2020.93 Aesthetic Research Review Open Access Skin grafting for penile skin loss Alysen Demzik1, Charles Peterson2, Bradley D. Figler1 1Department of Urology, University of North Carolina-Chapel Hill, Chapel Hill, NC 27599, USA. 2University of North Carolina School of Medicine, Chapel Hill, NC 27599, USA. Correspondence to: Dr. Bradley D. Figler, Department of Urology, University of North Carolina-Chapel Hill, 2105 Physician’s Office Building, 170 Manning Drive, Chapel Hill, NC 27599, USA. E-mail: [email protected] How to cite this article: Demzik A, Peterson C, Figler BD. Skin grafting for penile skin loss. Plast Aesthet Res 2020;7:52. http://dx.doi.org/10.20517/2347-9264.2020.93 Received: 24 Apr 2020 First Decision: 11 Aug 2020 Revised: 1 Sep 2020 Accepted: 17 Sep 2020 Published: 12 Oct 2020 Academic Editor: Marlon E. Buncamper Copy Editor: Cai-Hong Wang Production Editor: Jing Yu Abstract Penile skin grafting is an effective technique for managing skin deficiency resulting from a variety of causes. A thorough understanding of penile anatomy and the pathophysiology of the underlying condition being treated are essential. We provide an overview of penile anatomy as well as the pathophysiology of conditions that may lead to penile skin deficiency, as a result of either the underlying condition or its management. The conditions discussed include lichen sclerosus, buried penis, hidradenitis suppurativa, lymphedema, necrotizing fasciitis, cancer, and trauma. We also discuss surgical technique for penile skin grafting with an emphasis on technical considerations unique to the penis.
    [Show full text]
  • Genitourinary Grossing Guidelines Specimen Type: PENECTOMY Note
    Genitourinary Grossing Guidelines Specimen Type: PENECTOMY Note: Although penectomy may be performed for conditions ranging from elective transsexual surgery to gangrene or cancer, most resections are performed for squamous cell carcinoma. Important: These are uncommon specimens and should be photographed (outer surface as well as the cut surfaces of the specimen). Procedure: 1. Identify the shaft, glans, and foreskin (if present). Identify dorsal and ventral surface (urethra is located at the ventral aspect). Measure dimensions of specimen (i.e., size of glans, length and thickness of foreskin, length and diameter/circumference of shaft). 2. Examine the surfaces of the penis for lesions or tumors. a. Most squamous cell carcinomas arise from the mucosa of the glans, and from the undersurface of the foreskin (prepuce). b. Retract the foreskin and examine the recesses of the coronal sulcus. c. Describe any externally evident lesions/tumor including size, demarcation, color, growth pattern, consistency, contour, location, distance from the skin resection margin, and other characteristics such as pigmentation/ lack of pigmentation, ulceration, or necrosis. d. Photograph the outer surface of the specimen. 3. After photographing the specimen, ink the skin margin and shaft margin (en face margin including urethra, periurethral tissue, and corpora cavernosa). 4. Take margins: a. If the tumor is > 1cm from the margin, take a complete shaved section of the shaft margin, submitting it in more than one cassette if necessary. b. If the tumor is <1cm from the margin, submit a perpendicular (radial) including the tumor and the margin. 5. Place a probe in the urethra and bivalve the specimen longitudinally along the probe into left and right halves.
    [Show full text]
  • Nomina Histologica Veterinaria, First Edition
    NOMINA HISTOLOGICA VETERINARIA Submitted by the International Committee on Veterinary Histological Nomenclature (ICVHN) to the World Association of Veterinary Anatomists Published on the website of the World Association of Veterinary Anatomists www.wava-amav.org 2017 CONTENTS Introduction i Principles of term construction in N.H.V. iii Cytologia – Cytology 1 Textus epithelialis – Epithelial tissue 10 Textus connectivus – Connective tissue 13 Sanguis et Lympha – Blood and Lymph 17 Textus muscularis – Muscle tissue 19 Textus nervosus – Nerve tissue 20 Splanchnologia – Viscera 23 Systema digestorium – Digestive system 24 Systema respiratorium – Respiratory system 32 Systema urinarium – Urinary system 35 Organa genitalia masculina – Male genital system 38 Organa genitalia feminina – Female genital system 42 Systema endocrinum – Endocrine system 45 Systema cardiovasculare et lymphaticum [Angiologia] – Cardiovascular and lymphatic system 47 Systema nervosum – Nervous system 52 Receptores sensorii et Organa sensuum – Sensory receptors and Sense organs 58 Integumentum – Integument 64 INTRODUCTION The preparations leading to the publication of the present first edition of the Nomina Histologica Veterinaria has a long history spanning more than 50 years. Under the auspices of the World Association of Veterinary Anatomists (W.A.V.A.), the International Committee on Veterinary Anatomical Nomenclature (I.C.V.A.N.) appointed in Giessen, 1965, a Subcommittee on Histology and Embryology which started a working relation with the Subcommittee on Histology of the former International Anatomical Nomenclature Committee. In Mexico City, 1971, this Subcommittee presented a document entitled Nomina Histologica Veterinaria: A Working Draft as a basis for the continued work of the newly-appointed Subcommittee on Histological Nomenclature. This resulted in the editing of the Nomina Histologica Veterinaria: A Working Draft II (Toulouse, 1974), followed by preparations for publication of a Nomina Histologica Veterinaria.
    [Show full text]
  • Orchiectomy (Neoplastic)
    Genitourinary Grossing Guidelines Specimen Type: ORCHIECTOMY (for TUMOR) Note: Radical orchiectomy is the unilateral removal of testis, epididymis and spermatic cord for the surgical treatment of malignancy, usually germ cell tumors. The goal of pathologic evaluation is to determine the type and extent of malignancy. Note: - Prior to sectioning the testis, it is best to obtain sections of the spermatic cord to avoid contamination by testicular tumor, which is often loose and friable. - Shave the spermatic cord margin while the specimen is fresh (tissue retracts after fixation and this section will be difficult to take). - After fixation, submit representative cross-sections of proximal, mid, and distal spermatic cord (be clear in cassette summary as to the designation of location on cord, such as “base of cord [nearest testis proper]”). Procedure: 1. Weigh and measure the specimen. 2. Measure testis and the length and diameter of spermatic cord. 3. Ink the entire surfaces of spermatic cord and testis. 4. Shave the resection margin of spermatic cord (including blood vessels and vas deferens) while specimen is FRESH. 5. Section the spermatic cord longitudinally, look for tumor spread along the cord. 6. Submit representative mid and base of spermatic cord before cutting the testis 7. Bisect the testis and epididymis along the longitudinal axis of the epididymis and through the rete testis, identify the tumor, and photograph one half of the specimen or both halves. 8. Serially section the testis at 3 mm intervals parallel or perpendicular to the first plane. 9. Describe the tumor: a. Size in 3 dimensions, demarcation, number b.
    [Show full text]