Yolk sac tumor in a patient with transverse testicular ectopia

Yi-Ping Zhu,Guo-Hai Shi,Ding-Wei Ye,Wen-Jun Xiao,Shi-Lin Zhang

doi:10.1186/1477-7819-9-91

Abstract

Transverse testicular ectopia (TTE) is a rare anomaly in which both testes descend through a single inguinal canal. We report a case of yolk sac tumor in the ectopic testis of a patient with TTE. A 24-year-old man presented to our hospital with a left inguinal-mass, right cryptorchidism and elevated alpha-fetoprotein (AFP). A left herniotomy 3 years earlier demonstrated both testes in the left scrotum, one above another positionally. Four months ago, a left scrotal mass appeared and radical orchiectomy of both testes revealed testicular yolk sac tumor of the ectopic testis. An enlarging left inguinal-mass appeared 2 months ago and he was referred to our hospital. Laboratory data showed an elevation of AFP (245.5 ng/ml) and a 46 XY karyotype. He underwent bilateral retroperitoneal lymph node dissection and simultaneous left inguinal mass dissection. Histopathologic examination revealed a diagnosis of recurrent yolk sac tumor in the left inguinal mass. The retroperitoneal lymph node was not enlarged and, on histopathology, was not involved. The patient has now been followed up for 8 months without evidence of biochemical or radiological recurrence.

Highlights

Transverse testicular ectopia (TTE), named crossed testicular ectopia, is a rare anomaly in which both testes descend through a single inguinal canal while the opposite inguinal canal and hemiscrotum are empty
We report a case of yolk sac tumor in the ectopic testis of a patient with TTE
TTE has been classified into three types on the basis of associated anomalies: (1) associated with inguinal hernia alone (40% to 50%); (2) associated with persistent or rudimentary müllerian duct structures (30%); Figure 2 Both spermatic cords were found to descend through the left internal inguinal ring

Summary

Background

Transverse testicular ectopia (TTE), named crossed testicular ectopia, is a rare anomaly in which both testes descend through a single inguinal canal while the opposite inguinal canal and hemiscrotum are empty. We report a case of yolk sac tumor in the ectopic testis of a patient with TTE. Case Presentation A 24-year-old man, who had fathered a child, presented to our hospital with a left inguinal-mass (Figure 1), right cryptorchidism and elevated alpha-fetoprotein (AFP) (245.5 ng/ml, normal 0.6 to 6.7 ng/ml). He had no family history of persistent Mullerian duct syndrome or testicular tumors. Bilateral spermatic cords were found to descend through the left internal inguinal ring (Figure 2) and no persistent Mullerian duct structures were observed. Histopathologic examination revealed a diagnosis of yolk sac tumor in the recurrent left inguinal mass at the spermatic residual end (Figure 3). He was followed for 8 months without evidence of biochemical or radiological recurrence

Discussion

Findings

Conclusion

Von Lenhossek MN