HF01-14 DESCENDING THROUGH THE HISTORY OF CRYPTORCHIDISM AND TESTICULAR TUMORS

Abstract

You have accessJournal of UrologyCME1 May 2022HF01-14 DESCENDING THROUGH THE HISTORY OF CRYPTORCHIDISM AND TESTICULAR TUMORS Alexis Steinmetz, Kit Yuen, David Diamond, and Ronald Rabinowitz Alexis SteinmetzAlexis Steinmetz More articles by this author , Kit YuenKit Yuen More articles by this author , David DiamondDavid Diamond More articles by this author , and Ronald RabinowitzRonald Rabinowitz More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002541.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: An appreciation for the association between aberrant testicular descent and testicular cancer has developed over the past two centuries. While the etiology is incompletely understood, cryptorchidism is a known risk factor for the development of testicular tumors—even in the contralateral descended testis. This report presents the history of the relationship between cryptorchidism and testis tumors. METHODS: The literature was reviewed for historical descriptions of cryptorchidism and testis tumors. RESULTS: While much of our understanding regarding testicular maldescent evolved over the last 200 years, cryptorchidism was described in the Mishnah, the 2nd century CE writing of Jewish oral law. Baron Albrecht von Haller identified the intra-abdominal location of the fetal testis in 1755. Seven years later, through postmortem dissection, John Hunter observed that testes descend during the 8th month of gestation. He also correctly hypothesized that testicles that failed to descend into the scrotum were intrinsically abnormal and that it was best to assist the testis in its passage. Surgical repair was attempted unsuccessfully in early 19th century Germany. James Adams and Thomas Curling are credited with the first orchidopexy on an infant in 1871 in London. Unfortunately, the patient developed a wound infection and died of sepsis. Using antiseptic technique, Thomas Annandale performed the first successful orchidopexy in Edinburgh in 1877. A growing appreciation of histological aberrations in the cryptorchid testis further supported the concept of surgical correction. In the US, Arthur Dean Bevan popularized the orchidopexy, reporting 400 orchidopexies with a 95% success rate in 1918. There were reports of carcinomas affecting undescended testes in the 1850s, and Max Schüller described their malignant potential in 1881. John Cunningham reported a testicular tumor following orchidopexy in 1921. Larger studies emerged by the 1940s documenting the increased incidence of testicular cancer in patients with cryptorchidism. It has since been established that approximately 10% of all germ cell tumors occur in maldescended testes. Early orchidopexy was initially believed to be beneficial by facilitating tumor detection, however more recent data have demonstrated that early repair reduces the risk of subsequent malignancy; histology worsens the longer the testis is undescended. The underlying mechanisms of increased tumorigenesis in this setting remain unclear. CONCLUSIONS: There is a rich history of the management of cryptorchidism and its relation to subsequent tumor formation. Source of Funding: N/A © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e216 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alexis Steinmetz More articles by this author Kit Yuen More articles by this author David Diamond More articles by this author Ronald Rabinowitz More articles by this author Expand All Advertisement PDF DownloadLoading ...