War Surgery and Medicine
CHAPTER 24 — Diseases of the Testes
Diseases of the Testes
THESE consisted of inflammatory and malignant conditions. Of the inflammatory there were cases of gonococcal, BCC, and also tubercular epididymitis. The gonococcal cases were infrequent, due to greatly improved treatment by the sulphonamides and later penicillin. BCC infection rarely occurred and the cases were difficult to diagnose. Tubercular epididymitis was seen in Egypt, sometimes in a very acute form rendering diagnosis at times difficult. It was more common in the Maori troops. The ligature of the vas on the healthy side to prevent spread of the infection was a matter of considerable importance from the pension point of view.
Malignant tumours were infrequent, but different types were seen:
Ectopic testis removed two years previously in a Maori, recent development of very large lumbar glands of uniform elastic consistency— ‘seminoma’.
Slight enlargement right testis noted about a year. Development of large, very hard, somewhat irregular swelling in opposite side of abdomen, probably in lumbar glands, X-rays showed cannon ball metastases in the lung. Section after orchidectomy showed cystic teratoma with both adeno and squamous carcinoma.
Chorion-epithelioma of the testis. Orchidectomy was carried out, but he developed widespread metastases, including one on the skin over the shoulder region. He died in New Zealand some months later.
Several cases of seminoma were seen and operated on. The provision of deep X-ray treatment was difficult, especially in Italy, and normally the patients were evacuated to New Zealand for X-ray treatment as soon as possible following orchidectomy. In Egypt deep X-ray was arranged at the Egyptian Civil Hospital in Cairo.
Diagnosis for cases evacuated to New Zealand from 2 NZEF, 1940–45, were: epididymitis tubercular, 15; epididymitis nonspecific, 1; carcinoma testis, 2; teratoma testis, 2; seminoma testis, 3; neoplasm testis, 1; and chorion-epithelioma testis, 1.