A study on the relationship between adult testicular tumors, and undescended testis
Evin BÜYÜKÜNAL1, S.N. Cenk BÜYÜKÜNAL2
1İ.Ü Cerrahpaşa Tıp Fakültesi İç Hastalıkları Anabilim Dalı, Medikal Onkoloji Bilim Dalı, İstanbul
2İ.Ü Cerrahpaşa Tıp Fakültesi, Çocuk Cerrahisi Anabilim Dalı, Çocuk Ürolojisi Bilim Dalı, İstanbul
Keywords: Undescended testis, testicular malignancies, germ cell tumors, orchidopexy
Abstract
Aim: The aim of this study is to was to find out the incidence, and history of undescended in adult testicular malignancies in a large series of adult testis tumor and to obtain some practical implications.
Material and Methods: In this retrospective file-screening study, the history of undescended testis was investigated in a patient population mostly consisted of adult age group. In addition the age of the patient during orchiopexy, other coexisting testicular problems, the age of the patient when the testicular tumor had been observed, histologic type of the tumor, clinical stage of the tumor and survival rates were analyzed.
Results: A total of 137 patients aged between 15-70 (median age: 27) were investigated. In 6 of them history of undescended testis was detected. Five of these 6 patients had undergone delayed orchidopexy between 7-25 years of age. One of them had not had undergone orchidopexy until the age of 67. Among 137 cases, 4.4% of the patients had a history of undescended testis In all cases histopathology was reported as malignant germ cell tumor. All 5 patients were presented with local disease. The patient who did not have any orchiopexy until the age of 67 was presented with signs of systemic disease (lung metastasis). In 2 cases in addition to the history of undescended testis, signs of orchiepididymitis, and congenital ortchimegaly were detected All six patients survived without any evidence of disease using effective treatment protocols.
Conclusion: Based on the outcomes of this study, the possibility of developing malignancies increases among cases who had undergone delayed orcidopexy at advanced ages. Since this possibility is rare- not more than 1-2%- which can be associated with easily examined intrascrotal testis, and higher rates of survival from testicular malignancies, testicular orchiopexy can be thought as an alternative which can be applied for patients who presented during prepubertal period. However close follow-up with urologic exams until 3-4 decades is mandatory. Besides parents of the children, anmd the children themselves should be very well enlightened on this issue.