Cryptorchid Testicle Research Articles

Torsion of the cryptorchid testicle: A patent emergency, a latent diagnosis

Torsion of the cryptorchid testicle: A patent emergency, a latent diagnosis

Canine testicular tumors: An 11-year retrospective study of 358 cases in Moscow Region, Russia.

Background and Aim:Canine testicular tumors are among the most common reproductive tract tumors in male dogs and have been studied in many countries. However, to the best of our knowledge, studies with a large sample size have not been conducted in Russia. This study aimed to provide the latest information on the prevalence of canine testicular tumors in the Veterinary Oncology Scientific Center for Small Animals “Biocontrol” in Moscow, Russia, in 2010-2020 and the characteristics of the affected canine population.Materials and Methods:A retrospective review of patients and histological reports was collected and analyzed from 358 dogs with 447 testicular tumors within 11 years.Results:The mean age of the affected dogs was 10.4 years, whereas that of dogs with Sertoli cell tumors was 9.4 years p=0.009. This study includes mixed-breed dogs (18.4%), Yorkshire Terriers (8.8%), Labrador Retrievers (7.9%), Golden Retrievers (5.0%), and Fox Terriers (3.4%). The most common tumors were interstitial cell tumors (n=227, 50.8%). In contrast, 107 (23.9%) seminomas, 80 (17.9%) Sertoli cell tumors, 19 (7.4%) mixed germ cell-sex cord-stromal tumors, and 26 (7.6%) testicular tumors developed from cryptorchid testes, which included 16 (61.5%) Sertoli cell tumors, 10 (38.5%) seminomas, and no interstitial cell tumors.Conclusion:This study provides baseline information on the prevalence of canine testicular tumors in the described population, including the median age of each tumor type and overrepresented dog breeds. We further found that the most common scrotal testicular tumor was interstitial cell tumor, whereas Sertoli cell tumor was the most common in cryptorchid testicles.

Introducing a new scrotal orchiopexy technique: The fat anchor orchiopexy

Cryptorchidism is the most common congenital anomaly of the male genital tract. Cryptorchidism is associated with potentially serious consequences including reduced fertility, increases risk of cancer, susceptibility to torsion and traumatic injury, as well as future psychological problems related to an abnormal scrotal appearance. The mainstay of orchiopexy is to achieve an adequate tension-free and permanent scrotal fixation of the testis; one that prevents recurrent ascent. A number of suggestions have been made regarding keeping the testis in the scrotal position once it was brought down in the scrotum without tension. Several techniques for testicular fixation have been described to date; however, the optimal method remains controversial.We herein introduce a novel scrotal orchidopexy technique. This innovative fixation technique utilizes the sub-scrotal fat as a permanent anchor for fixing the low-lying cryptorchid testicle in the scrotum through a trans-scrotal incision. Therefore, the procedure was named “the fat anchor orchiopexy”. We believe our method will give better options for scrotal fixation especially in cases of low-lying cryptorchid testes. This article provides a detailed description of this new fixation technique.

Pathomorphological features of neoplasms of the testes of dogs

 The research was conducted to study the morphological, clinical, and macroscopic characteristics of the different histological types of canine testicular tumors. The material was obtained during a routine surgery for the removal of testicular tumors in dogs in clinics of veterinary medicine in Kyiv. Tumors were divided into sex cord-stromal tumors and germ cell tumors. Among the sex-cord stromal tumors recorded Leydig (interstitial) and Sertoli cell tumors. Macroscopic and histologic characteristics of canine interstitial (Leydig) cell tumor are described. It comprises 12% of all testicular tumors. Interstitial (Leydig) cell tumor has a slower growth compared to other testicular tumors, metastases are not observed. Half of the animals had no clinical signs. Most interstitial (Leydig) cell tumor go together with the pathology of adnexal structures. This is because Leydig cell tumor leads to increased levels of androgens. This fact may cause the pathology of adnexal structures. Neoplasms are recorded both on the right and the left testis. Leydig cell tumor was not related to the cryptorchid testicles. Mostly, tumors are regular oval, brown or gray color, different texture, and size with no signs of necrosis or ulceration. Macroscopic and histologic characteristics of malignant tumors of the testicle are described. A macroscopic picture was different and did not have clear meaning with the histological type of tumors. Microscopically a seminoma was characterized by the presence of layers of oval cells with the expressed grainy cytoplasm, surrounded by connective tissue, in which there was significant lymphoid infiltration. Leydig cell tumor is composed of cells that resemble Leydig cells and that are arranged into islands or tubular structures. The polygonal eosinophilic cells with granular or vacuolated, which contains lipids, were detected. Nuclei were a round mesh of chromatin and distinct nucleolus. Sometimes the large cells with 1, 2, or more nucleoli were noted. In Sertoli cell, tumor marked the various spectrum of cages from polygonal to prismatic sustenocytes.

Testicular Teratoma in a Unilateral Right-Sided Abdominal Cryptorchid Horse

Background: Cryptorchidism is characterized by the incomplete descent of one or both testicles to the scrotum, being a hereditary alteration and frequently an unilateral condition. Besides the sexual and aggressive behaviour, the retained testicle is commonly located in abdominal cavity, being considered a risk factor for neoplasm development. The most common testicular neoplasm reported in mammalian species are Sertoli cell tumors, Leydig cell tumors, seminomas and teratomas. A presumptive diagnosis of testicular tumor can be achieved by ultrasonography, although the definitive diagnosis is obtained only by histopathology. In this report, we are presenting a of testicular teratoma in an unilateral abdominal cryptorchid horse. Case: A stallion, American Quarter Horse, 3 year-old, was attended and presented right testicle retained and a left testicle in the scrotum. Transrectal palpation was used to identify a round and firm structure, presumably the right testicle, lateral to the urinary bladder and located in the right side of the abdomen. Further, a transrectal ultrasound examination showed a complex, round mass with irregular edges containing both cystic and solid structures, hypoechoic fluid-filled cavities separated by linear hyperechoic septa. After a clinical examination, the animal was diagnosed with cryptorchidism and was submitted to orchiectomy and cryptorchidectomy by inguinal approach. Surgery was performed under general anesthesia and postoperative care included cold shower, anti-inflammatory and antibiotic therapy. Testicles were surgically removed and further sent for histopathological examination. The visual appearance of the right undescended testicle showed multiple round, cystic, and solid structures on outer surface, while the left descended testicle was apparently normal. The macroscopic evaluation showed that the affected testicle consisted of a firm to soft solid mass with multiple fluid-filled cystic areas. Microscopically, the testicular architecture was replaced by cysts, fibrous tissue, adipose tissue, glandular structures, and foci of calcification. The histology revealed that the retained testicle had a testicular teratoma. Discussion: Reproductive disorders are common in horses and represent a significant part of the equine practitioner routine. Equine cryptorchidism is the most common non-lethal developmental defect of stallions; Surgery is the best treatment, since this alteration is hereditary. Teratomas have been reported more often in cryptorchid testicles, being usually just diagnosed as an incidental finding during surgical procedure. Under field conditions, usually the testicles are not sent for histopathological evaluation and this fact can contribute to underdiagnoses. Ultrasonography allows clinicians to determine testis location as well as morphological changes in the testes, as well as to elaborate a presumptive diagnose of testicular neoplasm. Histopathology is the best exam to achieve definitive diagnoses in the presence of testicular alterations. In our report, diagnosis of testicular neoplasia was not made before surgery and testicular mass was an incidental finding during the pre-surgical examination. Before testicular enlargement or presence of testicular mass, neoplasia should be included in the differential diagnosis. In conclusion, although rare, teratoma should be included in differential diagnoses of retained testicles, especially those with morphological alterations.

Semenoma Originated from an Ectopic Testis

The authors report an observation of a meta static seminoma on an ectopic testicle in a 23 years old patient and discuss the epidemiological, diagnostic, therapeutic and evolutionary aspects of this entity. Clinical diagnosis is often difficult due to the diversity of clinical symptoms, the use of imaging, biological markers and percutaneous biopsyis essential to make the diagnosis. The anatomopathology and therapeutic aspects are similar to the testis in normal situations. Early diagnosis of these tumors involves the lowering of the cryptorchid testicles, because even if this lowering does not prevent the setumors, it allows better monitoring.

ПАТОМОРФОЛОГІЧНІ ОСОБЛИВОСТІ ЛЕЙДИГОМИ СОБАК

The research for the study of morphological, clinical and macroscopic characteristics of the different histological types of canine testicular tumors. Material was obtained during a routine surgery for the removal of testicular tumors in dogs in clinics of veterinary medicine in Kiev. Tumors were divided into sex-cord stromal tumors and germ cell tumors. Among the sex-cord stromal tumors recorded leydig (interstitial) and sertoli cell tumors. Macroscopical and histologic characteristics of canine interstitial (Leydig) cell tumor are described. It is 12.5% of all testicular tumors. The average age of dogs is 9 years. Largest share is breeds dog such as foxterriers and toyterriers. Interstitial (Leydig) cell tumor has a slower growth compared to other tumors the testicle, no metastases. Half the animals had no clinical signs. Mostinterstitial (Leydig) cell tumor go together with the pathology of adnexal structures. This is because Leydig cell tumor lead to increased levels of androgens. This fact may cause pathology of adnexal structures. Neoplasms are recorded both on the right and the left testis. Leydig cell tumor was not related to the cryptorchid testicles. Most tumors regular oval, brown or gray color, different texture and size with no signs of necrosis or ulceration. The average volume of tumors ranged from 2 to 20 cm2. Microscopically, the tumor is composed of cells that resemble Leydig cells and that are arranged into islands or tubular structures. Find polygonal eosinophilic cells with granular or vacuolated, which contains lipids. Nuclei were round mesh of chromatin and distinct nucleolus. Sometimes noted the large cells with 1, 2 or more nucleoli. In some cases, found elongated fusiform cells with small nuclei and granular eosinophilic cytoplasm. Tumor stroma characterized by calcification. Note mitotically active cells. Cysts lined by tumor cells are present in some tumors. Distinction between benign and malignant forms on purely histological criteria, in the absence of metastasis, often is difficult. Studies on the features of histological structure of testicular tumors will optimize the histological diagnosis of neoplasms.

Metastasis of sigmoid colon cancer in cryptorchid testis: report of a case.

Isolated testicular metastasis from colorectal cancer is considered an unusual event. In this case report we describe for the first time a metastasis from an adenocarcinoma of the sigmoid colon to a cryptorchid testis. The patient developed a painless testicular nodule three years after the diagnosis of primary sigmoid colon cancer. Recent reports have suggested that the incidence of genitourinary abnormalities in human males has increased over the past 50 years; in particular, cryptorchid testes increase the clinical risk factors for primary or metastatic testicular cancer. In conclusion, there should be awareness of the risk of metastasis of colorectal cancer to the testis in the workup of patients with testicular symptoms. Furthermore, patients with colorectal cancer and cryptorchidism should be managed with a single surgical intervention: when the primary colorectal tumor is removed, the cryptorchid testicle should also be removed to reduce the risk of late metastases.

Testicular Neoplasms in Dogs in Rio Grande do Sul, Brazil

Testicular Neoplasms in Dogs in Rio Grande do Sul, Brazil

Testicular ischaemic necrosis as a cause of equine cryptorchidism

SummaryCryptorchidism is a fairly common pathology presented to equine surgical facilities with the cryptorchid testicle most commonly located in the abdomen or ipsilateral inguinal canal. The causes of cryptorchidism are not known, but testicular abnormalities have been suggested. Monorchidism as a cause of maldescent of one or both testicles is rare and is hypothesised to be the result of a vascular insult, similar to testicular regression in man. This case report details laparoscopic abdominal exploration of a cryptorchid horse and identification of an abnormal testicular remnant affected by ischaemic necrosis.

High Undescended Testis Treatment with Distal Espermatic Vessel Ligation (Koff-Sethi Technique)

Objectives: To evaluate the results obtained with the technique of distal spermatic vessel ligation in children with upper or intra-abdominal undescended testis. Methods: Analysis of cryptorchid patients treated with Koff-Sethi technique for orquiopexy. Patient series: 15 children with uni- or bilateral cryptorchidism. Postoperative gonad viability was evaluated on the basis of clinical data, physical examination and testicular scintigraphy. Results: Mean age was 5.4 years. Cryptorchidism was unilateral in 10/15 (67%) patients and bilateral in 5/15 (33%). The total number of testicles operated was 25. Of these, 19/25 (76%) required ligation of the spermatic vessels performed according to the Koff-Sethi technique. Eighteen (98%) gonads remained well positioned in the scrotum and one remained in a high position. Late evaluation revealed that 14/19 (74%) testicles had normal consistency and volume upon palpation and 3/19 (16%) were atrophic. Two patients did not return for late reevaluation. Scintigraphy demonstrated good testicular perfusion in 14/17 (82%) gonads evaluated. The patient with bilateral ligation of the spermatic vessels had good perfusion in both gonads. Conclusions: Distal spermatic vessel ligation (Koff-Sethi technique) is safe and useful for the treatment of high cryptorchid testicles.

Testicular volume and testicular atrophy index as predictors of functionality of unilaterally cryptorchid testis.

ABSTRACTGoal:The goal of this study was to determine relationship between the sensitivity and specificity of testicular volume (TV) and testicular atrophy index (TAI) in the indirect assessment of functional ability of cryptorchid testicles.Material and Methods:The study included sixty children with unilateral cryptorchidism who were treated surgically at the Clinic of Pediatric Surgery, Clinical Center University of Sarajevo. We evaluated the correlation of the size of cryptorchid testicles with its locations in various age groups.Results:The results showed a significant decrease in TV and TAI in the all cryptorchid groups after the sixth month of age compared with the same parameters in control group (p<0.001). It is also determined a strong correlation between the TV and TAI of cryptorchid testicles with its locations in various age groups.Conclusion:Our results showed that the average volume of cryptorchid testicles decreased after the sixth month as well as that the reduction of testicular size correlated with increasing distance of cryptorchid testicles from the scrotum.

Unusual Locations of Hydatidosis: Cryptorchid Testicle and Peritoneum

Hydatid cyst is a parasitic infection due to the larval stage of the tapeworm Echinococcus. It most commonly involves the liver and lung. Location at unusual sites in the body can have atypical presentations and poses a diagnostic challenge. Herein, the authors report a new case of hydatid disease involving the peritoneum and the tunica vaginalis of a cryptorchid testicle in a 57-year-old patient. They conclude that hydatid disease should be kept in mind when a cystic lesion in encountered in the testicle or the peritoneum in endemic areas.

Magnetic Resonance Imaging for Locating Nonpalpable Undescended Testicles: A Meta-analysis

Preoperative imaging techniques may guide management of nonpalpable, cryptorchid testicles. We evaluated conventional MRI for identifying and locating nonpalpable testicles in prepubescent boys via meta-analysis. Databases including Medline were searched from 1980 to February 2012. Eligible studies included ≥10 boys with cryptorchidism/suspected cryptorchidism and reported data on testicular presence/absence and position (abdominal, inguinal, or scrotal) as determined by imaging and surgery. Two investigators independently reviewed studies against inclusion criteria. We captured the number of testicles that were correctly and incorrectly identified and located, relative to surgically verified status, and estimated sensitivity and specificity by using a random-effects model. Eight unique prospective case series included 171 boys with 193 nonpalpable testicles (22 with bilateral testicles). Surgery identified 158 testicles (81.9%) present and 35 absent. MRI correctly identified testicles with an estimated median sensitivity of 0.62 (95% Bayesian credible interval [BCI]: 0.47-0.77) and a specificity of 1.0 (95% BCI: 0.99-1.0). MRI located intraabdominal testicles with a sensitivity of 0.55 (95% BCI: 0.09-1.0) and inguino-scrotal testicles with a sensitivity of 0.86 (95% BCI: 0.67-1.0). We were not able to obtain estimates for MRI sensitivity or specificity for locating atrophied testicles. The estimated specificity for location-specific testicles reached almost 100%. Conventional MRI has low sensitivity for estimating the population sensitivity for identifying the presence of nonpalpable cryptorchid testicles. When testicles are identified, MRI is poor at locating both atrophied and intraabdominal testicles but performs modestly well in locating those in the inguino-scrotal regions.

Role of laparoscopy in the management of impalpable testis in children: a study in Bangladesh

Introduction : Treatment of the cryptorchid testicle is justified due to the increased risk of infertility and malignancy as well as the risk of testicular trauma and psychological stigma on patients and their parents. Approximately 20% of cryptorchid testicles are impalpable. In these cases, the laparoscopic technique is the method of choice for diagnosis and treatment. Materials and Methods : From 1 April 2009 to 31 October 2010, 37 testicles of 30 patients were submitted to diagnostic laparoscopy for impalpable testes. This was a prospective study seeking the diagnostic accuracy and therapeutic outcomes of use of laparoscopy in impalpable testes. Age, operative techniques, complications, the cosmetic aspect and outcomes were also recorded. Results : Mean age was 6.64 ± 3.96 years and 23% cases were bilateral. Twenty-one cases had primary orchiopexy, 9 had 1st stage Fowler- Stephens (FS) procedure, 3 had 2nd stage FS, 13 cases needed inguinal exploration and there was one vanishing testicles. Average operating time was 40 min for diagnostic laparoscopy, 90 min for unilateral and 120 min for the bilateral cases. Two of the patients had late postoperative complications e.g. one uretereral obstruction and one recurrence. Conclusions : In pediatric age group, the laparoscopic approach is safe and feasible. The purpose of study is to see whether the laparoscopic procedure presents excellent results in terms of diagnosis and therapy of the impalpable testis. DOI: http://dx.doi.org/10.11593/bje.2013.0101.0005 Bangladesh Journal of Endosurgery Vol.1(1) January 2013: 16-20

Cystic Rete Testis in a 3-Year-Old Gypsy Vanner Colt: A Case Report

A 3-year-old Gypsy Vanner colt was presented at the Auburn University College of Veterinary Medicine for castration. The left testicle of the horse was present within the scrotum, but neither the right testicle nor the epididymis was found during external palpation of the right inguinal ring. Removal of the retained testicle by a routine inguinal approach by traction on the gubernaculum and dilation of the internal inguinal ring was not possible. During a parainguinal approach to the abdomen, an enlarged cystic testicle was discovered. Histopathologic diagnosis was cystic rete testis. This case report stresses the importance of preoperative ultrasonographic assessment of cryptorchid testicles to decrease surgical time.

Metastasis of Sigmoid Colon Cancer in Cryptorchid Testis: Report of a Case

Isolated testicular metastasis from colorectal cancer is considered an unusual event. In this case report we describe for the first time a metastasis from an adenocarcinoma of the sigmoid colon to a cryptorchid testis. The patient developed a painless testicular nodule three years after the diagnosis of primary sigmoid colon cancer. Recent reports have suggested that the incidence of genitourinary abnormalities in human males has increased over the past 50 years; in particular, cryptorchid testes increase the clinical risk factors for primary or metastatic testicular cancer. In conclusion, there should be awareness of the risk of metastasis of colorectal cancer to the testis in the workup of patients with testicular symptoms. Furthermore, patients with colorectal cancer and cryptorchidism should be managed with a single surgical intervention: when the primary colorectal tumor is removed, the cryptorchid testicle should also be removed to reduce the risk of late metastases.

Splenogonadal fusion and testicular cancer: case report and review of the literature

A 36 year-old man after tests for assessing male infertility was diagnosed with primary infertility, bilateral cryptorchidism, nonobstructive azoospermia and discontinuous splenogonadal fusion. Carcinoma in situ was found in his left testicle, which was intraabdominal and associated with splenogonadal fusion. To our knowledge, this is the fourth case of splenogonadal fusion associated with testicular cancer reported. One should always bear in mind the possibility of this association for the left cryptorchid testicle.

개 세르토리세포종 케이스에서 면역조직화학적 마커를 통한 진단

Sertoli cell tumor (SCT) of the testicle arises from the supporting cells within the seminiferous tubules. SCT is common in dogs, especially in cryptorchid testicles, but also has been reported in the stallion, ram, cat, and bull. Sertoli cell tumor sample was collected from 7-years male german shepherd. In this study, SCT arose from one testicle. Sample size is approximately 1.7 cm in diameter and it has a round form. In the microscopic, cells within the tumor variably resemble Sertoli cells (SCs) that normally populate the seminiferous tubules and interstitial area. There is abundant stroma of dense, mature fibrous connective tissue in SCT. In the immunohistochemical staining, cytokeratin AE1/AE3 was not expressed in the control and SCT. S-100 protein was expressed by SCs, germ cells and fibrous connective tissue of SCT. Melan A was expressed by leydig cells (LCs) of SCT. A study by using S-100 and melan A in canine SCT was almost never carried out. S-100 and melans A is considered to suggest for diagnosis and pathogenesis of canine SCTs. Inhibin-alpha and Vimentin were well known as the marekers of SCTs. Also, they were expressed by Sertoli cells and LSs of SCT in this study.

Cryptorchid Testicular Torsion

Torsion of the testicle is a well-recognized urological emergency. Torsion of the cryptorchid testicle, however, is described in the urology literature, but not well recognized in the emergency department. We discuss a case of a torsed cryptorchid testicle and review the pathophysiology, imaging modalities, and prognosis.