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Malignancy Yield of Testis Pathology in Older Boys and Adolescents with Cryptorchidism

医学 恶性肿瘤 病态的 外科 妇科 病理
作者
Rena Xu,Joseph W. McQuaid,Vera Paulson,Michael P. Kurtz,Tanya Logvinenko,Richard N. Yu,Richard S. Lee,Caleb P. Nelson
出处
期刊:The Journal of Urology [Lippincott Williams & Wilkins]
卷期号:207 (3): 694-700 被引量:10
标识
DOI:10.1097/ju.0000000000002345
摘要

No AccessJournal of UrologyPediatric Urology1 Mar 2022Malignancy Yield of Testis Pathology in Older Boys and Adolescents with CryptorchidismThis article is commented on by the following:Editorial CommentEditorial CommentEditorial Comment Rena Xu, Joseph W. McQuaid, Vera A. Paulson, Michael P. Kurtz, Tanya Logvinenko, Richard N. Yu, Richard S. Lee, and Caleb P. Nelson Rena XuRena Xu †Correspondence: Boston Children's Hospital, 300 Longwood Ave., Boston, Massachusetts 02115 telephone: 617-355-7796; FAX: 617-730-0474; E-mail Address: [email protected] http://orcid.org/0000-0002-0142-7589 Department of Urology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts Equal study contribution. More articles by this author , Joseph W. McQuaidJoseph W. McQuaid Department of Urology, University of Massachusetts Medical School, Worcester, Massachusetts Equal study contribution. More articles by this author , Vera A. PaulsonVera A. Paulson Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington More articles by this author , Michael P. KurtzMichael P. Kurtz Department of Urology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts More articles by this author , Tanya LogvinenkoTanya Logvinenko Department of Urology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts More articles by this author , Richard N. YuRichard N. Yu Department of Urology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts More articles by this author , Richard S. LeeRichard S. Lee Department of Urology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts More articles by this author , and Caleb P. NelsonCaleb P. Nelson Department of Urology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002345AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail 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. References 1. : Cryptorchidism and testicular cancer: separating fact from fiction. J Urol 2009; 181: 452. Link, Google Scholar 2. : Germ cell development in the postnatal testis: the key to prevent malignancy in cryptorchidism?Front Endocrinol (Lausanne) 2012; 3: 176. Google Scholar 3. : Age at surgery for undescended testis and risk of testicular cancer. N Engl J Med 2007; 356: 1835. Google Scholar 4. : Cryptorchidism: aspects of fertility and neoplasms. A study including data of 1,335 consecutive boys who underwent testicular biopsy simultaneously with surgery for cryptorchidism. Horm Res 2001; 55: 21. Google Scholar 5. : Prepubertal orchiopexy for cryptorchidism may be associated with lower risk of testicular cancer. J Urol 2007; 178: 1440. Link, Google Scholar 6. : The impact of age at orchiopexy on testicular cancer outcomes. World J Urol 2020; 38: 2531. Google Scholar 7. : Testicular neoplasia in cryptorchid boys at primary surgery: case series. BMJ 1999; 319: 888. Google Scholar 8. : Histopathological evaluation of orchiectomy specimens in 51 late postpubertal men with unilateral cryptorchidism. J Urol 2014; 192: 1183. Link, Google Scholar 9. : The incidence and histological characteristics of intratubular germ cell neoplasia in postpubertal cryptorchid testis. Korean J Urol 2015; 56: 515. Google Scholar 10. : Testicular biopsy in prepubertal boys: a worthwhile minor surgical procedure?Nat Rev Urol 2016; 13: 141. Google Scholar 11. : Prevalence of carcinoma in situ and other histopathological abnormalities in testes of men with a history of cryptorchidism. J Urol 1989; 142: 998. Link, Google Scholar 12. : Gonadal dysgenesis in disorders of sex development: diagnosis and surgical management. J Pediatr Urol 2016; 12: 411. Google Scholar 13. : Malignancy in disorders of sex development. Transl Androl Urol 2016; 5: 794. Google Scholar See Editorial on page 500. © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByWan J (2021) This Month in Pediatric UrologyJournal of Urology, VOL. 207, NO. 3, (489-489), Online publication date: 1-Mar-2022.Michaud J (2021) “Down or Out?”: How Should We Manage Adolescent Undescended Testes?Journal of Urology, VOL. 207, NO. 3, (500-501), Online publication date: 1-Mar-2022.Related articlesJournal of UrologyMar 1, 2022, 12:00:00 AMEditorial CommentJournal of UrologyMar 1, 2022, 12:00:00 AMEditorial CommentJournal of UrologyMar 1, 2022, 12:00:00 AMEditorial Comment Volume 207Issue 3March 2022Page: 694-700 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.Keywordstesticular neoplasmscryptorchidismorchiopexyMetricsAuthor Information Rena Xu Department of Urology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts †Correspondence: Boston Children's Hospital, 300 Longwood Ave., Boston, Massachusetts 02115 telephone: 617-355-7796; FAX: 617-730-0474; E-mail Address: [email protected] Equal study contribution. More articles by this author Joseph W. McQuaid Department of Urology, University of Massachusetts Medical School, Worcester, Massachusetts Equal study contribution. More articles by this author Vera A. Paulson Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington More articles by this author Michael P. Kurtz Department of Urology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts More articles by this author Tanya Logvinenko Department of Urology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts More articles by this author Richard N. Yu Department of Urology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts More articles by this author Richard S. Lee Department of Urology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts More articles by this author Caleb P. Nelson Department of Urology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts More articles by this author Expand All See Editorial on page 500. Advertisement PDF DownloadLoading ...
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