Epidermoid Cyst of the Testis 5-Year Follow-Up Results in Adults

Background: In this study, we aimed to share our experiences in patients with epidermoid cyst of the testis. We report the demographic and clinical characteristics and the long term results in patients with epidermoid cysts. Materials and Methods: Thirteen patients with epidermoid cyst of the testis treated between June 2000 and January 2018 were retrospectively evaluated. Ten patients with available data were included in the study. Patients’ age, scrotal localization of symptoms, physical examination findings, serum tumor marker levels, pathology results and follow-up periods were recorded. Results: The current cohort consisted of 10 patients. The mean age at diagnosis was 29.7 years (range, 20 to 53 years). Eighty percent of the lesions were localized to the left hemiscrotum and 20% to the right hemiscrotum. One patient had a history of unilateral undescended testis. Serum tumor markers were normal in all patients. The mean scrotal mass lesion volume at diagnosis was 28 mm3 (range, 13 to 51 mm3). The mean follow-up period was 66.9 months (range, 12 to 216 months). Conclusions: Epidermoid cyst of the testis should be kept in mind, particularly in patients with lesions negative for tumor markers and radiological findings typical of epidermoid cysts. Annual follow-up is not required.

Mean Platelet Volume as an Inflammation Marker, Possible Biomarker of Tumor Detection in Prostate Biopsy

Background: In the diagnosis of prostatic diseases, the need for markers other than prostate specific antigen (PSA) has been increasing in recent years. So, we aimed to determine the predictive value, the neutrophil lymphocyte ratio, platelet-to-lymphocyte ratio and mean platelet volume before prostate biopsy in predicting the results of pathology. Transrectal ultrasound-guided biopsy of the prostate was performed because of high PSA values and compared values of these parameters to predict of pathology results. Methods: 2715 patients who underwent 10 - 12 quadrant transrectal ultrasound-guided prostate biopsies between January 2008 and January 2018 have been evaluated retrospectively. Patients were divided into groups according to the biopsy pathology results by benign (group 1), atypical small acinar proliferation (ASAP) (group 2) and prostate cancer (group 3). A total of 204 patients who were benign prostate hyperplasia in 71 patients (34.8%), atypical small acinar proliferation in 80 (39.21%) and prostate adenocarcinoma (PCa) in 53 patients (25.98%) were included in the study by systematic sampling. Before the biopsy total PSA (tPSA), free PSA (fPSA), rate of percentage of free to total prostate specific antigen (f/tPSA) rate, PSA density (PSA-D), white blood cell (WBC) count, blood neutrophil count (NC), blood lymphocyte count (LC), neutrophil lymphocyte ratio (NLR), mean platelet volume (MPV), platelet count (PLT) and platelet-to-lymphocyte ratio (PLR) were measured and compared in all groups. Differences in continuous variables were assessed using the ANOVA. Logistic regression was used to analyze the linear relationship between predictive variables and pathology results. P < 0.05 was considered statistically significant. Results: NLR and PLR values were lower in group 1 than group 2 and were found statistically significant between in group 1 and group 2 (p: 0.03 and p: 0.02, respectively). MPV value was found 1.7 times higher in patients who were diagnosed with ASAP pathology than those with benign pathologies. Although there was statistically significant increase in MPV values in logistic regression results, no statistically significant diagnostic value was found. In addition MPV value was found 0.5 times higher in patients who were diagnosed patients with ASAP than prostate cancer group. ROC analysis showed that the optimal threshold was 7.65 femtoliter (sensitivity: 51%;specificity: 30%) and was found to be a statistically significant diagnostic value to distinguish groups 2 and 3. The lowest value of MPV was found in group 3. Conclusions: In cases where the PSA value is insufficient in predicting the pathology result, the effect of NLR, PLR and MPV on differential diagnosis can be kept in mind. While NLR and PLR are more useful in the diagnosis of ASAP, MPV is more effective in the diagnosis of malignancy.