Adrenocortical carcinoma (ACC) is a rare and lethal disease with a poor prognosis. This study aims to share our 41-year experience as a referral center, focusing on identifying risk factors associated with ACC mortality. Our retrospective analysis included a cohort of 150 adult patients with ACC in all stage categories, treated between 1981 and 2022. Tumor hormonal hypersecretion was observed in 78.6% of the patients, and the median age of diagnosis was 40 years. The majority presented as European Network for the Study of Adrenal Tumors (ENSAT) III or IV (22.9% and 31.2%, respectively), and the overall mortality rate was 54.6%. Independent predictors of death were elevated secretion of cortisol (HR = 2.0), androstenedione (HR = 2.2), estradiol (HR = 2.8), 17-OH progesterone (HR = 2.0), and 11-deoxycortisol (HR = 5.1), higher Weiss (HR = 4.3), modified Weiss (HR = 4.4), and Helsinki scores (HR = 12.0), advanced ENSAT stage (HR = 27.1), larger tumor size (HR = 2.7), higher Ki-67 percentage (HR = 2.3), and incomplete surgical resection (HR = 2.5). Mitosis greater than 5/50 high-power field (HR = 5.6), atypical mitosis (HR = 2.3), confluent necrosis (HR = 15.4), venous invasion (HR = 2.8), and capsular invasion (HR = 2.4) were also identified as independent predictors of death. Knowing the risk factors for ACC's mortality may help determine the best treatment option.

Background: Chronic scrotal content pain (CSCP) is a challenging clinical condition, often undiagnosed, and marked by persistent or intermittent pain that may be localized or generalized and significantly affect quality of life. Wallerian degeneration, an inflammatory process involving axonal degeneration, may underlie the mechanism. While bacterial infections are recognized contributors to CSCP, the role of viral infections is less understood. Methods: We systematically searched PubMed, MEDLINE, and Web of Science for studies reporting associations between viral infections and scrotal or testicular pain. Of 142 identified records, 61 met the inclusion criteria and were analyzed qualitatively. Results: Our review assesses whether testicular or epididymal viral infections might contribute to CSCP. The literature points to a possible link, though definitive histopathological evidence remains scarce. Tissue biopsies may provide greater diagnostic clarity and inform treatment decisions. Conclusions: Additional research is needed to understand how viral infections affect testicular function, semen quality, and fertility, to improve patient outcomes globally.

Medical education often provides limited exposure to urology, despite the growing prevalence of urological conditions. To address this gap, the Urological Medical Student Interest Group (UMSIG) was established in 2006. This study aimed to evaluate the educational and professional impact of UMSIG participation among its current and former members. An electronic survey was distributed to 226 former and current UMSIG members between December 2023 and February 2024, collecting data on demographics, motivations for joining, perceptions of UMSIG activities, and influence on career decisions. Quantitative data were analyzed using descriptive statistics. We received 111 responses (49.1 % response rate). The primary motivations for joining UMSIG included a desire to deepen urology knowledge (77.5 %) and recommendations from peers (56.8 %). Most respondents (71.2 %) reported that UMSIG enhanced their urology education beyond the standard curriculum through practical experiences. Participation also had impact on career trajectories: 52.0 % of non-urologists indicated that UMSIG influenced their current specialty, while 78.6 % of urologists cited it as a decisive factor in their choice of specialization. Overall satisfaction was high, with a median rating of 9/10, and 55.9 % considered UMSIG superior to other medical student interest groups. Participation in UMSIG provided a valuable supplement to formal medical education by offering practical clinical experience and research opportunities. The program influenced participants' career decisions, reinforcing interest in urology and related surgical fields. These findings underscore the important role of structured extracurricular programs in medical education, particularly in specialties with limited curricular presence.