Skip to main content
Erschienen in: Journal of Medical Case Reports 1/2019

Open Access 01.12.2019 | Case report

Polyarteritis nodosa isolated to the testis and urinary bladder in the setting of cryptorchidism: a case report and literature review

verfasst von: Mohan Stewart, Greg Marcotte, Michael A. Seidman, Natasha Dehghan

Erschienen in: Journal of Medical Case Reports | Ausgabe 1/2019

Abstract

Background

Polyarteritis nodosa is a small vessel to medium vessel vasculitis that frequently presents with multi-organ involvement, but can sometimes be limited to single organs such as the testes. Patients often require treatment with glucocorticoids, plus or minus additional immunosuppressive therapy depending on the severity of the disease. We describe a rare case of polyarteritis nodosa involving the right testis and urinary bladder without other systemic features of vasculitis.

Case presentation

A previously healthy 54-year-old First Nations Canadian man presented with intermittent gross hematuria. He underwent surgical excision of his right testis for cryptorchidism and a transurethral resection of a bladder mass. Histology showed an active medium vessel vasculitis in both organs. On extensive clinical, laboratory, and radiographic review, he had no systemic features of vasculitis. On 2-year follow-up, he has not required any systemic therapy and has not developed further symptoms.

Conclusion

Single organ polyarteritis nodosa can sometimes be managed with surgical excision of the involved organ alone. Although our patient had two organs involved, we extrapolated the results of our literature search to guide his care. This case highlights the potential for surgical excision to cure polyarteritis nodosa despite the involvement of two organs in the absence of symptoms and signs of systemic vasculitis.
Hinweise

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Introduction

Polyarteritis nodosa (PAN) is a vasculitis characterized by necrotizing inflammation of medium and small arteries. It can affect many organ systems; most often, it affects the peripheral nerves, skin, gastrointestinal system, muscles, and kidneys. The disease often presents with multi-organ involvement, but cases of isolated organ involvement have been described [1, 2]. A detailed history and physical examination are required to identify features consistent with PAN, such as constitutional symptoms, skin lesions, abdominal pain, and peripheral neuropathy. Once PAN is suspected, a biopsy is usually required to confirm the diagnosis. If a biopsy is not possible, angiography is a reasonable alternative [1]. Treatment is based on the severity of illness and involved organs.
In general, cases of mild PAN can be treated with glucocorticoids alone. More severe cases necessitate the addition of immunosuppressive agents, such as cyclophosphamide. Isolated or single organ PAN can be managed by excision of the organ involved (for example, testis) and serial follow-up to ensure that systemic features do not develop [1, 2].
Our case report explores a rare case of PAN affecting both the testis and urinary bladder.

Case presentation

A previously healthy 54-year-old First Nations Canadian man presented with a several-month history of urinary retention and intermittent gross hematuria. In the course of his initial evaluation, he was found to have an enlarged prostate and was started on tamsulosin with improvement in his urinary symptoms. He noted the absence of his testicle on the right side for at least 30 years, consistent with cryptorchidism. He subsequently underwent cystoscopy, which demonstrated a superficial-appearing mass at the dome of his bladder. A radical right orchiectomy and transurethral resection of the bladder tumor (TURBT) were performed. Surprisingly, a pathologic examination revealed the presence of small and medium vessel vasculitis in both the urinary bladder and undescended testis (Fig. 1). There was no evidence of malignancy. He was referred to rheumatology for further evaluation.
An extensive review revealed no evidence of systemic vasculitis. He had no features of another underlying rheumatologic disorder. His investigations including basic blood work, C-reactive protein (CRP)/erythrocyte sedimentation rate (ESR), and antineutrophil cytoplasmic antibody (ANCA) were normal. Although antinuclear antibody (ANA) was positive (1:320), double-stranded deoxyribonucleic acid (DNA) (dsDNA) and extractable nuclear antigen (ENA) were negative and complements were normal. Rheumatoid factor (RF) was positive at 43 kU/L (reference range < 12 kU/L), but anti-cyclic citrullinated peptides (CCP) antibody was negative and our patient had no features of an inflammatory arthritis. Hepatitis B and C serologies were negative. A diagnosis of PAN was made. His testicular involvement and findings of active small and medium vessel vasculitis on urinary bladder and testis pathology were most consistent with this diagnosis. Given the lack of clinically apparent systemic vasculitis, no immunosuppressive therapy was initiated. Following his radical orchiectomy and TURBT, he had ongoing intermittent hematuria that was investigated with several repeat cystoscopies. An area of erythema was identified on one occasion. A repeat biopsy of the site demonstrated reactive changes and no evidence of vasculitis. A computed tomography (CT) angiogram was done of his abdomen and pelvis to evaluate the possibility of occult vessel involvement elsewhere, and was negative other than wall thickening and fat stranding noted at the anterior bladder. His symptoms have completely resolved following surgery and he has remained asymptomatic over the last 2 years.

Discussion

To the best of our knowledge, this is the first case reported in the literature of PAN affecting both the bladder and testis in the absence of systemic involvement. Moreover, this is also the first case of PAN reported in the setting of cryptorchidism. We performed a literature search to find reports of patients with isolated testicular or bladder vasculitis and found 45 such cases (Table 1). The average age of presentation was 39 years (median, 36 years). Of the 45 cases, 39 had isolated testicular vasculitis and 6 had isolated bladder vasculitis. Most cases (34/45) had biopsies that were pathologically consistent with PAN.
Table 1
Summary of cases of isolated testicular or bladder vasculitis from literature search
Authors
Age/gender
Organ affected
Systemic symptoms
ANCA
ESR/CRP
Pathology
Systemic therapya
Persellin and Menke (1992) [3]
29/M
Testis
None
N/A
N/A
Necrotizing small and medium vessel vasculitis consistent with PAN
None (F/u 17 months)
Halim et al. (1994) [4]
71/M
Testis
None
Neg
Normal
Necrotizing granulomatous vasculitis
None (F/u 24 months)
Mukamel et al. (1995) [5]
28/M
Testis
None
N/A
Normal
Necrotizing small vessel vasculitis consistent with PAN
None (F/u 27 months)
Mukamel et al. (1995) [5]
35/M
Testis
None
N/A
Normal
Necrotizing vasculitis consistent with PAN
None (F/u 36 months)
Kessel et al. (2001) [6]
13.5/M
Testis
None
Neg
Elevated
Necrotizing small and medium vessel vasculitis consistent with PAN
None (F/u 24 months)
Hashiguchi et al. (2001) [7]
37/M
Testis
None
N/A
Normal
Necrotizing small and medium vessel vasculitis consistent with PAN
None (F/u 9 months)
Eilber et al. (2001) [8]
43/M
Testis
Fever, myalgia, and hematuria
N/A
Elevated
Necrotizing vasculitis consistent with PAN (cystoscopy normal)
Not reported (F/u unclear)
Fraenkel-Rubin et al. (2002) [9]
26/M
Testis
None
Neg
Normal
Necrotizing small and medium vessel vasculitis consistent with PAN
None (F/u 30 months)
Dotan et al. (2003) [10]
32/M
Testis
None
Neg
Normal
Necrotizing medium vessel vasculitis consistent with PAN
None (F/u 60 months)
Tanuma et al. (2003) [11]
40/M
Testis
None
N/A
Normal
Necrotizing small and medium vessel vasculitis consistent with PAN
None (F/u 22 months)
Fleischmann and Studer (2007) [12]
21/M
Testis
None
N/A
Normal
Necrotizing small and medium vessel vasculitis consistent with PAN
None (F/u 24 months)
Giannarini et al. (2009) [13]
36/M
Testis
None
Neg
Normal
Necrotizing medium vessel vasculitis consistent with PAN
None (F/u 60 months)
Atis et al. (2010) [14]
57/M
Testis
None
Neg
Normal
Necrotizing medium vessel vasculitis consistent with PAN
None (F/u unclear)
Saito et al. (2013) [15]
78/M
Testis
None
Neg
N/A
Necrotizing vasculitis of epididymis consistent with PAN
None (F/u 12 months)
Lintern et al. (2013) [16]
21/M
Testis
None
Neg
Normal
Necrotizing medium vessel vasculitis consistent with PAN
Not reported (F/u unclear)
Garg and Dawson (2015) [17]
36/M
Testis
None
Neg
N/A
Necrotizing small and medium vessel vasculitis consistent with PAN
None (F/u 3 months)
Dixit et al. (2017) [18]
84/M
Testis
None
Pos
Elevated
Non-granulomatous medium vessel vasculitis
Not reported (lost to follow-up)
Brimo et al. (2011) [19]
35/M
Testis
None
Neg
Normal
Necrotizing small and medium vessel vasculitis consistent with PAN
None (F/u unclear)
Brimo et al. (2011) [19]
31/M
Testis
None
Neg
Normal
Necrotizing small and medium vessel vasculitis consistent with PAN
None (F/u unclear)
Brimo et al. (2011) [19]
63/M
Testis
None
Neg
Normal
Non-necrotizing granulomatous vasculitis
None (F/u unclear)
Brimo et al. (2011) [19]
38/M
Testis
None
Neg
Normal
Necrotizing small and medium vessel vasculitis consistent with PAN
None (F/u unclear)
Brimo et al. (2011) [19]
38/M
Testis
N/A
N/A
N/A
Lymphocytic vasculitis
Not reported (F/u unclear)
Brimo et al. (2011) [19]
31/M
Testis
None
Neg
Normal
Necrotizing small and medium vessel vasculitis consistent with PAN
None (F/u unclear)
Brimo et al. (2011) [19]
53/M
Testis
None
Neg
Normal
Necrotizing small and medium vessel vasculitis consistent with PAN
None (F/u unclear)
Brimo et al. (2011) [19]
31/M
Testis
N/A
N/A
N/A
Necrotizing small and medium vessel vasculitis consistent with PAN
Not reported (F/u unclear)
Brimo et al. (2011) [19]
23/M
Testis
None
Neg
Normal
Necrotizing small and medium vessel vasculitis consistent with PAN
None (F/u unclear)
Brimo et al. (2011) [19]
40/M
Testis
N/A
N/A
N/A
Necrotizing small and medium vessel vasculitis consistent with PAN
Not reported (F/u unclear)
Brimo et al. (2011) [19]
34/M
Testis
N/A
N/A
N/A
Necrotizing granulomatous vasculitis
Not reported (F/u unclear)
Brimo et al. (2011) [19]
27/M
Testis
None
Neg
Normal
Necrotizing small and medium vessel vasculitis consistent with PAN
Prednisone (F/u unclear)
Brimo et al. (2011) [19]
20/Mb
Testis
Fever, night sweats
Pos
Elevated
Non-necrotizing granulomatous vasculitis
Prednisone, cyclophosphamide (F/u unclear)
Brimo et al. (2011) [19]
40/M
Testis
Fatigue
Neg
Elevated
Necrotizing small and medium vessel vasculitis consistent with PAN
Prednisone, MMF (F/u unclear)
Brimo et al. (2011) [19]
28/M
Testis
Fever, myalgia
Neg
Elevated
Necrotizing small and medium vessel vasculitis consistent with PAN
Prednisone, cyclophosphamide (F/u unclear)
Brimo et al. (2011) [19]
44/Mb
Testis
Fevers, sweats, weight loss
Neg
Elevated
Necrotizing small and medium vessel vasculitis consistent with PAN
Prednisone, cyclophosphamide (F/u unclear)
Brimo et al. (2011) [19]
38/Mb
Testis
None
Neg
Elevated
Necrotizing small and medium vessel vasculitis consistent with PAN
Prednisone (F/u unclear)
Brimo et al. (2011) [19]
34/M
Testis
N/A
Neg
Normal
Necrotizing small and medium vessel vasculitis consistent with PAN
Prednisone, cyclophosphamide (F/u unclear)
Pastor-Navarro et al. (2007) [20]
26/M
Testis
None
Neg
N/A
Necrotizing vasculitis consistent with PAN
Steroids (F/u 12 months)
Breuer et al. (2015) [21]
19/Mb
Testis
Erythema nodosum (8 years after initial episode of testicular symptoms)
N/A
Normal
Vasculitis with fibrinoid necrosis consistent with PAN
Prednisone, AZA, rituximab (F/u > 8 years)
Bhatia et al. (2018) [22]
52/M
Testis
None
Neg
Elevated
Necrotizing vasculitis consistent with PAN
Prednisone, cyclophosphamide, methotrexate (F/u 8 months)
Islam et al. (2018) [23]
41/M
Testis
Polyarthritis, weight loss, rash
Neg
N/A
Necrotizing vasculitis of medium and large vessels consistent with PAN
Steroids, methotrexate (F/u unclear)
Fischer et al. (1998) [24]
32/M
Bladder
None
Neg
Elevated
Necrotizing vasculitis of the medium-sized arteries consistent with PAN. Positive for hepatitis B surface antigen immunostaining
TURBT, steroids (F/u 18 months)
Fischer et al. (1998) [24]
61/F
Bladder
None
Neg
N/A
Small vessel vasculitis
Steroids, cyclophosphamide (F/u 12 months)
Katz et al. (2005) [25]
59/M
Bladder
Fatigue, sweats, weight loss
Neg
Elevated
Necrotizing vasculitis of small and large vessels
Prednisolone (F/u 3 months)
Becker et al. (2008) [26]
53/M
Bladder
None
Neg
Elevated
Necrotizing vasculitis of small vessels
TURBT, prednisone, cyclophosphamide (F/u 1 month)
Kassir et al. (2013) [27]
31/M
Bladder
Fever
N/A
Elevated
Non-granulomatous, small and medium vessel thrombotic vasculitis
TURBT (F/u 9 months)
Fall et al. (2018) [28]
45/M
Bladder
None
Neg
Normal
Fibrinoid degeneration with neutrophil infiltration into vessel walls consistent with vasculitis
TURBT, Prednisone, AZA (F/u 60 months)
ANCA antineutrophil cytoplasmic antibody, AZA azathioprine, CRP C-reactive protein, ESR erythrocyte sedimentation rate, F female, F/u follow-up, M male, MMF mycophenolate mofetil, N/A not applicable, Neg negative, PAN polyarteritis nodosa, Pos positive, TURBT transurethral resection of bladder tumor
a All patients with isolated testicular vasculitis underwent orchiectomy
b These patients went on to develop systemic vasculitis or persistent mild cutaneous vasculitis
For the patients with isolated testicular vasculitis in whom treatment information was available, most (21/32) were treated with surgical excision alone with no reported cases of emergent systemic disease over a mean follow-up of 29 months (median, 24 months). Of the 11 patients who were treated with surgical excision as well as glucocorticoids +/− additional immunosuppressive therapy, 8/11 had evidence of more systemic illness at disease onset (for example, elevated CRP/ESR or constitutional symptoms) (Fig. 2). It is unclear what prompted treatment in the other three cases. Three patients were treated with glucocorticoids alone. Eight patients were treated with glucocorticoids in conjunction with at least one other immunosuppressive therapy [1923]. Of those eight, four were treated with steroids and cyclophosphamide and the other four were treated with steroids in conjunction with cyclophosphamide and methotrexate, mycophenolate mofetil, methotrexate alone, or azathioprine and rituximab.
Of the 11 patients with isolated testicular vasculitis who received systemic therapy, three went on to develop systemic vasculitis [19] and one patient had persistent episodes of mild cutaneous vasculitis [21]. All four patients had evidence of more systemic disease on initial presentation.
Six patients who had isolated bladder vasculitis were included in our literature review. Four of the patients had evidence of more systemic illness at disease onset. The patients who did not have any systemic features underwent either a TURBT as well as therapy with prednisone and azathioprine, or treatment with steroids and cyclophosphamide without surgical excision [24, 28]. Of the other four patients, one underwent TURBT alone [27], two underwent TURBT as well as systemic therapy [24, 26], and one received prednisolone alone [25]. All six patients had no evidence of emergent systemic vasculitis over a mean follow-up of 17.2 months (median, 10.5 months).
It appears from the result of our literature review that patients who present with isolated testicular vasculitis and no evidence to suggest more systemic disease do not go on to develop systemic vasculitis after orchiectomy, regardless of whether or not they receive concomitant immunosuppressive therapy. Therefore, orchiectomy alone in isolated testicular vasculitis seems to be a reasonable therapeutic approach. There were only six patients with isolated bladder vasculitis, and one of them underwent TURBT alone with no emergent systemic illness. We used these findings to guide our management of a patient with PAN affecting both the right testis and urinary bladder.

Conclusion

This case summarizes the current literature regarding the treatment of isolated testicular or bladder vasculitis. Our findings support withholding immunosuppressive therapy after surgical excision in these patients if there is no evidence of more systemic disease at onset. While single organ PAN has been treated in the past with surgical excision, there is a lack of data regarding treatment of PAN involving two organs, with no other systemic features. We extrapolated the results of our literature review to guide the management of a patient who presented with PAN affecting both the urinary bladder and right testis. He underwent radical right orchiectomy and TURBT, with no systemic therapy. On 2-year follow-up, he has not developed any systemic PAN symptoms. The risk of developing future extratesticular and extravesicular involvement appears to be low.

Acknowledgements

Not applicable.
The patient involved in the case report gave consent to participate prior to inclusion in the manuscript. As per the University of British Columbia Clinical Research Ethics Board guidelines, individual case reports do not require ethics review. More information is available at https://​ethics.​research.​ubc.​ca/​ore/​ubc-clinical-research-ethics-general-guidance-notes section 4.4.2.
Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.

Competing interests

The authors declare that they have no competing interests.
Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://​creativecommons.​org/​licenses/​by/​4.​0/​), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://​creativecommons.​org/​publicdomain/​zero/​1.​0/​) applies to the data made available in this article, unless otherwise stated.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Unsere Produktempfehlungen

e.Med Interdisziplinär

Kombi-Abonnement

Für Ihren Erfolg in Klinik und Praxis - Die beste Hilfe in Ihrem Arbeitsalltag

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf SpringerMedizin.de.

© Springer Medizin

Bis 11. April 2024 bestellen und im ersten Jahr 50 % sparen!

e.Med Allgemeinmedizin

Kombi-Abonnement

Mit e.Med Allgemeinmedizin erhalten Sie Zugang zu allen CME-Fortbildungen und Premium-Inhalten der allgemeinmedizinischen Zeitschriften, inklusive einer gedruckten Allgemeinmedizin-Zeitschrift Ihrer Wahl.

© Springer Medizin

Bis 11. April 2024 bestellen und im ersten Jahr 50 % sparen!

Literatur
1.
Zurück zum Zitat Pipitone N, Salvarani C. Polyarteritis Nodosa. In: Dammacco F, Ribatti D, Vacca A, editors. Systemic Vasculitides: Current Status and Perspectives. Cham: Springer International Publishing; 2016. p. 189–96.CrossRef Pipitone N, Salvarani C. Polyarteritis Nodosa. In: Dammacco F, Ribatti D, Vacca A, editors. Systemic Vasculitides: Current Status and Perspectives. Cham: Springer International Publishing; 2016. p. 189–96.CrossRef
2.
Zurück zum Zitat Hernández-Rodríguez J, Hoffman GS. Updating single-organ vasculitis. Curr Opin Rheumatol. 2012;24(1):38–45.CrossRef Hernández-Rodríguez J, Hoffman GS. Updating single-organ vasculitis. Curr Opin Rheumatol. 2012;24(1):38–45.CrossRef
3.
Zurück zum Zitat Persellin ST, Menke DM. Isolated polyarteritis nodosa of the male reproductive system. J Rheumatol. 1992;19(6):985–8.PubMed Persellin ST, Menke DM. Isolated polyarteritis nodosa of the male reproductive system. J Rheumatol. 1992;19(6):985–8.PubMed
4.
Zurück zum Zitat Halim A, Neild GH, Levine T, Shaw PJ. Isolated necrotizing granulomatous vasculitis of the epididymis and spermatic cords. World J Urol. 1994;12(6):357–8.CrossRef Halim A, Neild GH, Levine T, Shaw PJ. Isolated necrotizing granulomatous vasculitis of the epididymis and spermatic cords. World J Urol. 1994;12(6):357–8.CrossRef
5.
Zurück zum Zitat Mukamel E, Abarbanel J, Savion M, Konichezky M, Yachia D, Auslaender L. Testicular mass as a presenting symptom of isolated polyarteritis nodosa. Am J Clin Pathol. 1995;103(2):215–7.CrossRef Mukamel E, Abarbanel J, Savion M, Konichezky M, Yachia D, Auslaender L. Testicular mass as a presenting symptom of isolated polyarteritis nodosa. Am J Clin Pathol. 1995;103(2):215–7.CrossRef
6.
Zurück zum Zitat Kessel A, Toubi E, Golan TD, Toubi A, Mogilner JG, Jaffe M. Isolated epididymal vasculitis. Isr Med Assoc J. 2001;3(1):65–6.PubMed Kessel A, Toubi E, Golan TD, Toubi A, Mogilner JG, Jaffe M. Isolated epididymal vasculitis. Isr Med Assoc J. 2001;3(1):65–6.PubMed
7.
Zurück zum Zitat Hashiguchi Y, Matsuo Y, Torii Y, Kajiwara T, Kayajima T, Irie K, et al. Polyarteritis nodosa of the epididymis. Abdom Imaging. 2001;26(1):102–4.CrossRef Hashiguchi Y, Matsuo Y, Torii Y, Kajiwara T, Kayajima T, Irie K, et al. Polyarteritis nodosa of the epididymis. Abdom Imaging. 2001;26(1):102–4.CrossRef
8.
Zurück zum Zitat Eilber KS, Freedland SJ, Rajfer J. Polyarteritis nodosa presenting as hematuria and a testicular mass. J Urol. 2001;166(2):624.CrossRef Eilber KS, Freedland SJ, Rajfer J. Polyarteritis nodosa presenting as hematuria and a testicular mass. J Urol. 2001;166(2):624.CrossRef
9.
Zurück zum Zitat Fraenkel-Rubin M, Ergas D, Sthoeger ZM. Limited polyarteritis nodosa of the male and female reproductive systems: diagnostic and therapeutic approach. Ann Rheum Dis. 2002;61(4):362–4.CrossRef Fraenkel-Rubin M, Ergas D, Sthoeger ZM. Limited polyarteritis nodosa of the male and female reproductive systems: diagnostic and therapeutic approach. Ann Rheum Dis. 2002;61(4):362–4.CrossRef
10.
Zurück zum Zitat Dotan ZA, Laufer M, Heldenberg E, Langevitz P, Fridman E, Duvdevani M, et al. Isolated testicular polyarteritis nodosa mimicking testicular neoplasm-long-term follow-up. Urology. 2003;62(2):352.CrossRef Dotan ZA, Laufer M, Heldenberg E, Langevitz P, Fridman E, Duvdevani M, et al. Isolated testicular polyarteritis nodosa mimicking testicular neoplasm-long-term follow-up. Urology. 2003;62(2):352.CrossRef
11.
Zurück zum Zitat Tanuma Y, Oda T, Yokoo A, Ito S, Takeuchi K. Recurrent polyarteritis nodosa limited to the testis. J Urol. 2003;170(5):1953.CrossRef Tanuma Y, Oda T, Yokoo A, Ito S, Takeuchi K. Recurrent polyarteritis nodosa limited to the testis. J Urol. 2003;170(5):1953.CrossRef
12.
Zurück zum Zitat Fleischmann A, Studer UE. Isolated polyarteritis nodosa of the male reproductive system associated with a germ cell tumor of the testis: a case report. Cardiovasc Pathol. 2007;16(6):354–6.CrossRef Fleischmann A, Studer UE. Isolated polyarteritis nodosa of the male reproductive system associated with a germ cell tumor of the testis: a case report. Cardiovasc Pathol. 2007;16(6):354–6.CrossRef
13.
Zurück zum Zitat Giannarini G, Pomara G, Moro U, Mogorovich A, Fabris FM, Morelli G, et al. Isolated polyarteritis nodosa of the genitourinary tract presenting with severe erectile dysfunction: a case report with long-term follow-up. J Sex Med. 2009;6(4):1189–93.CrossRef Giannarini G, Pomara G, Moro U, Mogorovich A, Fabris FM, Morelli G, et al. Isolated polyarteritis nodosa of the genitourinary tract presenting with severe erectile dysfunction: a case report with long-term follow-up. J Sex Med. 2009;6(4):1189–93.CrossRef
14.
Zurück zum Zitat Atis G, Memis OF, Güngör HS, Arikan O, Saglican Y, Caskurlu T. Testicular polyarteritis nodosa mimicking testicular neoplasm. ScientificWorldJournal. 2010;10:1915–8.CrossRef Atis G, Memis OF, Güngör HS, Arikan O, Saglican Y, Caskurlu T. Testicular polyarteritis nodosa mimicking testicular neoplasm. ScientificWorldJournal. 2010;10:1915–8.CrossRef
15.
Zurück zum Zitat Saito K, Washino S, Hirai M, Matuzaki A, Nokubi M, Terai C, et al. A case of isolated polyarteritis nodosa appeared in bilateral epididymides with asynchronous onset. Nihon Hinyokika Gakkai Zasshi Jpn J Urol. 2013;104(1):22–5. Saito K, Washino S, Hirai M, Matuzaki A, Nokubi M, Terai C, et al. A case of isolated polyarteritis nodosa appeared in bilateral epididymides with asynchronous onset. Nihon Hinyokika Gakkai Zasshi Jpn J Urol. 2013;104(1):22–5.
16.
Zurück zum Zitat Lintern N, Johnson NR, Mckenzie I, Martin B. Testicular Vasculitis - Literature Review and Case Report in Queensland. Curr Urol. 2013;7(2):107–9.CrossRef Lintern N, Johnson NR, Mckenzie I, Martin B. Testicular Vasculitis - Literature Review and Case Report in Queensland. Curr Urol. 2013;7(2):107–9.CrossRef
17.
Zurück zum Zitat Garg K, Dawson L. Single organ variant of polyarteritis nodosa in epididymis. J Cancer Res Ther. 2015;11(3):662.CrossRef Garg K, Dawson L. Single organ variant of polyarteritis nodosa in epididymis. J Cancer Res Ther. 2015;11(3):662.CrossRef
18.
Zurück zum Zitat Dixit A, Hague C, Bicknell S. Testicular Vasculitis: A Sonographic and Pathologic Diagnosis. Case Rep Radiol. 2017;2017:1–4.CrossRef Dixit A, Hague C, Bicknell S. Testicular Vasculitis: A Sonographic and Pathologic Diagnosis. Case Rep Radiol. 2017;2017:1–4.CrossRef
19.
Zurück zum Zitat Brimo F, Lachapelle J, Epstein JI. Testicular vasculitis: a series of 19 cases. Urology. 2011;77(5):1043–8.CrossRef Brimo F, Lachapelle J, Epstein JI. Testicular vasculitis: a series of 19 cases. Urology. 2011;77(5):1043–8.CrossRef
20.
Zurück zum Zitat Pastor-Navarro H, Broseta-Viana L, Donate-Moreno MJ, Pastor-Guzmán JM, Lorenzo-Romero JG, Segura-Martín M, et al. Isolated testicular polyarteritis nodosa. Urology. 2007;70(1):178.e7–8.CrossRef Pastor-Navarro H, Broseta-Viana L, Donate-Moreno MJ, Pastor-Guzmán JM, Lorenzo-Romero JG, Segura-Martín M, et al. Isolated testicular polyarteritis nodosa. Urology. 2007;70(1):178.e7–8.CrossRef
21.
Zurück zum Zitat Breuer GS, Reinus K, Nesher G, Munter G. Recurrent Unilateral Orchitis as a Presenting Symptom of Polyarteritis Nodosa. Isr Med Assoc J. 2015;17(9):585–6.PubMed Breuer GS, Reinus K, Nesher G, Munter G. Recurrent Unilateral Orchitis as a Presenting Symptom of Polyarteritis Nodosa. Isr Med Assoc J. 2015;17(9):585–6.PubMed
22.
Zurück zum Zitat Bhatia S, Herrera Hernandez LP, Kamboj AK, Rieck KM. Isolated Polyarteritis Nodosa Presenting as Bilateral Testicular Swelling. Am J Med. 2018;131(2):e55–6.CrossRef Bhatia S, Herrera Hernandez LP, Kamboj AK, Rieck KM. Isolated Polyarteritis Nodosa Presenting as Bilateral Testicular Swelling. Am J Med. 2018;131(2):e55–6.CrossRef
23.
Zurück zum Zitat Islam N, Sinha D, Ghosh P, Datta C, Chatterjee U. Orchitis: An unusual presentation of polyarteritis nodosa. Indian J Pathol Microbiol. 2018;61(4):600.CrossRef Islam N, Sinha D, Ghosh P, Datta C, Chatterjee U. Orchitis: An unusual presentation of polyarteritis nodosa. Indian J Pathol Microbiol. 2018;61(4):600.CrossRef
24.
Zurück zum Zitat Fischer AH, Wallace VL, Keane TE, Clarke HS. Two cases of vasculitis of the urinary bladder: diagnostic and pathogenetic considerations. Arch Pathol Lab Med. 1998;122(10):903–6.PubMed Fischer AH, Wallace VL, Keane TE, Clarke HS. Two cases of vasculitis of the urinary bladder: diagnostic and pathogenetic considerations. Arch Pathol Lab Med. 1998;122(10):903–6.PubMed
25.
Zurück zum Zitat Katz DJ, Sengupta S, Snow RM. Isolated vasculitis of the bladder. Urology. 2005;65(4):797.CrossRef Katz DJ, Sengupta S, Snow RM. Isolated vasculitis of the bladder. Urology. 2005;65(4):797.CrossRef
26.
Zurück zum Zitat Becker A, Astroza G, Quezada N, Riaño C, Urrutia J, Guzman S. Isolated manifestation of necrotizing vasculitis of the bladder: a case report. Urol. 2008;47(10):1347–9.CrossRef Becker A, Astroza G, Quezada N, Riaño C, Urrutia J, Guzman S. Isolated manifestation of necrotizing vasculitis of the bladder: a case report. Urol. 2008;47(10):1347–9.CrossRef
27.
Zurück zum Zitat Kassir R, Mouracade P, Barabino G, Peoc’h M, Cuilleron M, Gigante M. Vasculitis of the bladder: An extremely rare case report. Int J Surg Case Rep. 2013;4(9):782–4.CrossRef Kassir R, Mouracade P, Barabino G, Peoc’h M, Cuilleron M, Gigante M. Vasculitis of the bladder: An extremely rare case report. Int J Surg Case Rep. 2013;4(9):782–4.CrossRef
28.
Zurück zum Zitat Fall M, Höper L, Kåbjörn-Gustafsson C, Trysberg E. Isolated vasculitis of the urinary bladder: a note on diagnosis and prognosis. Scand J Urol. 2018;8:1–2. Fall M, Höper L, Kåbjörn-Gustafsson C, Trysberg E. Isolated vasculitis of the urinary bladder: a note on diagnosis and prognosis. Scand J Urol. 2018;8:1–2.
Metadaten
Titel
Polyarteritis nodosa isolated to the testis and urinary bladder in the setting of cryptorchidism: a case report and literature review
verfasst von
Mohan Stewart
Greg Marcotte
Michael A. Seidman
Natasha Dehghan
Publikationsdatum
01.12.2019
Verlag
BioMed Central
Erschienen in
Journal of Medical Case Reports / Ausgabe 1/2019
Elektronische ISSN: 1752-1947
DOI
https://doi.org/10.1186/s13256-019-2172-y

Weitere Artikel der Ausgabe 1/2019

Journal of Medical Case Reports 1/2019 Zur Ausgabe