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June 17, 1974

Benign Neural Invasion in Vasitis Nodosa

Author Affiliations

Howard University College of Medicine Washington, DC

JAMA. 1974;228(12):1519. doi:10.1001/jama.1974.03230370017004

To the Editor.—  Complications of a carefully performed, elective vasectomy are infrequent.1

Report of a Case.—  A 36-year-old man underwent bilateral vasectomy for voluntary sterilization in August 1972. He was readmitted in March 1974 for reconstruction of vasa deferentia. A sperm count done prior to admission was zero. A vasovasostomy was performed. One of the segments excised appeared to be firm and nodular, measuring 0.3×0.4×0.2 cm. Microscopically, sections through this segment showed the eccentrically located remnants of the original vas lumen, surrounded by hyperplastic smooth muscle. There were innumerable ductules in the muscle wall lined with small, cuboidal, epithelial cells having frequently hyperchromatic nuclei, with prominent nucleoli. The resemblance of these structures to metastatic alveolar adenocarcinoma of the prostate was remarkable. However, some of the acini contained spermatozoa. Spermatozoa had also extravasated into the wall, inciting a heavy cellular reaction. Nerve bundles in the vasal wall were invaded by