Although late cases occur, the first year after SOT is the period of highest risk for histoplasmosis. In patients who survive the first month after diagnosis, treatment with an amphotericin formulation followed by an azole for 12 months is usually successful, with only rare relapse.
In this study, disease outcomes were generally favorable. Discontinuation of antifungal treatment after clinical response and an appropriate duration of therapy, probably at least 12 months, appears safe if pharmacologic immunosuppression has been held. Resumption of TNF-α blocker therapy also appears safe, assuming that the initial antifungal therapy was administered for 12 months.
Adenocarcinoma of the rete testis is a rare tumor. Histologic diagnosis is difficult, and in the past the tumor may have been incorrectly identified in a number of cases, leading to misleading information on the nature and behavior of this neoplasm. We present the case of a 39-year-old man with a long history of a small left hydrocele, who was lost to follow-up and presented again 2 years later with testicular discomfort. Sonographic findings were consistent with a testicular tumor. Histology confirmed low-grade adenocarcinoma of the rete testis, the first reported tumor of this grade. Previously reported cases of rete testis carcinoma are reviewed.
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