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Malignancy in an Undescended Intra-abdominal Testis: a Single Institution Experience

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Abstract

Cryptorchidism is one of the most common congenital anomalies of the genitourinary tract, encountered in 1% of men. The cancer risk in an ectopic testis is 40 times higher than a scrotal testis. However, not much literature is available on the management of this rare presentation of testicular cancer. A retrospective analysis was conducted at our institute of patients who were diagnosed with carcinoma in an undescended intra-abdominal testis between 2014 and 2019. Patients with an intra-abdominal mass with an empty hemiscrotum/scrotum were included in the study. In all 10 patients were identified with a mean age of 32 years. Four patients were non-seminomatous germ cell tumors, and other 6 were seminomatous tumors. Five were in stage I, two in stage II, and three in stage III. Six patients received induction chemotherapy with bleomycin, etoposide, and cisplatin, and four had complete response. Five patients underwent laparoscopic excision, and five underwent open surgery. Two patients with bilateral (B/L) cryptorchidism underwent contralateral orchidopexy. Two patients with B/L intra-abdominal gonads and uterus underwent excision of the malignant testicular mass with removal of atrophic uterus and contralateral dysgenetic gonad. One patient developed peritoneal recurrence within 3 months of completion of surgery. Both recurrence-free and overall survival were 90% after a median follow-up of 35 months. Malignancy in an undescended intra-abdominal testis is a rare presentation of testicular cancer, diagnosis of which requires a sharp correlation between clinical and radiological findings. There management and prognosis remains similar to classical testicular cancer.

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References

  1. Fonkalsrud EW (1970) Current concepts in the management of the undescended testis. Surg Clin North Am 50:847

    Article  CAS  Google Scholar 

  2. Bani-Hani KE, Matani YS, Bani-Hani IH (2003) Cryptorchidism and testicular neoplasia. Saudi Med J 24:166–169

    PubMed  Google Scholar 

  3. Gill B, Kogan S (1997) Cryptorchidism. Current concepts. Pediatr Clin North Am 44:1211–1227

    Article  CAS  Google Scholar 

  4. Hutson J (2006) Undescended testis, torsion, and varicocele. In: Grosfeld J, O’Neill J, Coran A et al (eds) Pediatric surgery, 6th edn. Mosby Elsevier, Philadelphia, pp 1193–1205

    Chapter  Google Scholar 

  5. Batata MA, Chu FC, Hilaris BS, Whitmore WF, Golbey RB (1982) Testicular cancer in cryptorchids. Cancer 49:1023

    Article  CAS  Google Scholar 

  6. El Fouda M, Bazarbashi S, El Wishi A et al (2001) Germ cell tumors in undescended testis-prognostic factors and treatment outcome. J Egypt Natl Canc Inst 13:209–214

    Google Scholar 

  7. Amin MB, Edge SB, Greene FL (2018) AJCC cancer staging manual, 8th edn. American Joint Committee on Cancer, Chicago

    Google Scholar 

  8. Thorup J, Mclachlan R, Cortes D, Nation TR, Balic A, Southwell BR et al (2010) What is new in cryptorchidism and hypospadias – a critical review on the testicular dysgenesis hypothesis. J Pediatr Surg 45:2074–2086

    Article  Google Scholar 

  9. Rao AB (1969) Seminoma in undescended testes. Br J Urol 41:83–88

    Article  CAS  Google Scholar 

  10. Batata MA, Whinore WF Jr, Chu FCH et al (1980) Cryptorchidism and testicular cancer. J Urol 124:382–387

    Article  CAS  Google Scholar 

  11. Kulkarni JN, Kamat MR (1991) Tumors in undescended testis. J Surg Oncol 46:257

    Article  CAS  Google Scholar 

  12. Pettersson A, Richiardi L, Nordenskjold A, Kaijser M, Akre O (2007) Age at surgery for undescended testis and risk of testicular cancer. N Engl J Med 356:1835–1841

    Article  CAS  Google Scholar 

  13. Wood HM, Elder JS (2009) Cryptorchidism and testicular cancer: separating fact from fiction. J Urol 181:452–461

    Article  Google Scholar 

  14. Raina V, Shukla NK, Gupta NP, Deo S, Rath GK (1995) Germ cell tumours in uncorrected cryptorchid testis at Institute Rotary Cancer Hospital, New Delhi. Br J Cancer 71:380–382

    Article  CAS  Google Scholar 

  15. Miller FH, Whitney WS, Fitzgerald SW, Miller EI (1999) Seminomas complicating undescended intraabdominal testes in patients with prior negative findings from surgical exploration. AJR. 172:425–428

    Article  CAS  Google Scholar 

  16. Hutson JM, Li R, Southwell BR, Petersen BL, Thorup J, Cortes D (2013) Germ cell development in the postnatal testis: the key to prevent malignancy in cryptorchidism? Front Endocrinol (Lausanne) 3:176

    Article  Google Scholar 

  17. Nef S, Parada LF (2000) Hormones in male sexual development. Genes Dev 14:3075–3086

    Article  CAS  Google Scholar 

  18. Islam SR, Rahman S, Sarkar S, Paul D (2018) Intra-abdominal testicular tumour--a case report. Arch Surg Clin Res 2:025–028

    Article  Google Scholar 

  19. Harland SJ, Cook PA, Fossa SD, Horwich A, Mead GM, Parkinson MC (1998) Intratubular germ cell neoplasia of the contralateral testis in testicular cancer: defining a high risk group. J Urol 160:1353–1357

    Article  CAS  Google Scholar 

  20. Skakkebaek NE, Berthelsen JG, Muller J (1982) Carcinoma-in-situ of the undescended testis. Urol Clin North Am 9:377–385

    CAS  PubMed  Google Scholar 

  21. Swerdlow AJ, Higgins CD, Pike MC (1997) Risk of testicular cancer in cohort of boys with cryptorchidism. BMJ. 314:1507–1511

    Article  CAS  Google Scholar 

  22. Myrup C, Schnack TH, Wohlfahrt J (2007) Correction of cryptorchidism and testicular cancer. N Engl J Med 357(8):825–827 author reply 825–827

    Article  CAS  Google Scholar 

  23. Horwich A (1995) Testicular cancer. In: Horwich A (ed) Oncology—a multidisciplinary textbook. Chapman and Hall, London, pp 485–498

    Google Scholar 

  24. Slowikowska-Hilczer J, Romer TE, Kula K (2003) Neoplastic potential of germ cells in relation to disturbances of gonadal organogenesis and changes in karyotype. J Androl 24:270–278

    Article  Google Scholar 

  25. Carmignani L, Morabito A, Gadda F, Bozzini G, Rocco F, Colpi GM (2005) Prognostic parameters in adult impalpable ultrasonographic lesions of the testicle. J Urol 174:1035–1038

    Article  Google Scholar 

  26. Shrestha B, Baidya JL (2009) Unresolved abdominal mass. Kathmandu Univ Med J 7(25):82–85

    CAS  Google Scholar 

  27. Sandikci F, Cimen S, Cimen SG, Imamoglu GI, Han U, Kokurcan A, Baylan B, Goktug G, Imamoglu A (2018) Bilateral intraabdominal testicular tumor: case report. Int J Surg Case Rep 49:102–105

    Article  Google Scholar 

  28. Sarma D, Barua SK, Rajeev TP, Baruah SJ (2013) Role of primary chemotherapy in management of large tumors of undescended testis: our experience. Urol Ann 5:179–182

    Article  CAS  Google Scholar 

  29. Kulkarni JN, Desai SM, Phadke GK, Tongaonkar HB (1996) Improved management of abdominal undescended testicular tumors with bulky confluent retroperitoneal nodal metastases. J Urol 156:1341–1344

    Article  CAS  Google Scholar 

  30. Cary C, Masterson TA, Bihrle R, Foster RS (2015) Contemporary trends in postchemotherapy retroperitoneal lymph node dissection: additional procedures and perioperative complications. Urol Oncol 33(9):389.e15–389.389

    Article  Google Scholar 

  31. Thyavihally Y, Sengar M, Mahanthshetty U et al (2008) Management of germ cell tumors in undescended testis: a single institute series. Urology. 72(suppl 5A):S33

    Google Scholar 

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Correspondence to Rakesh Sharma.

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The data of the present study were collected in the course of common clinical practice, and accordingly, the signed informed consent was obtained from each patient for any surgical and clinical procedure. The study protocol was in accordance with the ethical standards of the institutional research committee and the 1964 Helsinki Declaration and its later amendments. Because this was a retrospective study, formal consent for this study is not required and no approval of the institutional research committee was needed.

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Gupta, V., Giridhar, A., Sharma, R. et al. Malignancy in an Undescended Intra-abdominal Testis: a Single Institution Experience. Indian J Surg Oncol 12, 133–138 (2021). https://doi.org/10.1007/s13193-020-01262-9

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  • DOI: https://doi.org/10.1007/s13193-020-01262-9

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