Malignancy Yield of Testis Pathology in Older Boys and Adolescents with Cryptorchidism. Issue 3 (18th March 2022)

• Record Type: Journal Article
• Authors: Xu, Rena; McQuaid, Joseph W.; Paulson, Vera A.; Kurtz, Michael P.; Logvinenko, Tanya; Yu, Richard N.; Lee, Richard S.; Nelson, Caleb P.
• Is Part Of: Journal of urology. Volume 207:Issue 3(2022)
• Page Start: 694
• Page End: 700
• Publication Date: 2022-03-18
• Subjects: cryptorchidism -- testicular neoplasms -- orchiopexy; Genitourinary organs -- Periodicals; Urology -- Periodicals; Urology -- Periodicals; Urologie -- Périodiques; Urologie; 616.6
• DOI: 10.1097/JU.0000000000002345
• Languages: English
• ISSNs: 0022-5347

Abstract

Abstract : Purpose: We performed a retrospective, single-institution study to characterize the pathological findings of testis tissue specimens from older boys and adolescents with cryptorchidism. Materials and Methods: With institutional review board approval, pathology reports were obtained for testicular specimens from patients age 10 years or older at a pediatric hospital from 1994 to 2016. Reports were excluded if they lacked clinical records, lacked testicular parenchyma, were from a descended testis or were from a patient with differences of sexual development. Variables of interest included age, testis location, procedure and pathological findings. Presence of malignancy among intra-abdominal versus extra-abdominal undescended testes was compared using Fisher's Exact Test. Results: Seventy-one patients met inclusion criteria. The median age was 15.3 years (range 10.1–27.7). None had a history of testicular malignancy. Forty-five unilateral orchiectomies, 22 unilateral orchiopexies with biopsy and 4 bilateral procedures were performed. Seventeen testes (22.7%) were intra-abdominal, 42 (56.0%) were in the inguinal canal, 9 (12.0%) were at the external inguinal ring, 3 (4.0%) were in the superficial inguinal pouch and 4 (5.3%) were in the scrotum. Malignancy was detected in 2/71 patients (2.8%). By location, 2/16 patients (12.5%) with intra-abdominal testis and 0/55 patients (0%) with extra-abdominal testis demonstrated malignancy (p=0.048). Conclusions: Among males with cryptorchidism ages 10 years and older without differences of sexual development, 2/16 patients with intra-abdominal testis and 0/55 patients with extra-abdominal testis demonstrated malignancy. In older boys and adolescents, orchiectomy or biopsy is indicated for intra-abdominal testes but may not be necessary for extra-abdominal undescended testes.