Kassir Radwan, Dubois Joelle, Berremila Sid-Ali, Baccot Sylviane, Boueil-Bourlier Alexia, Tiffet Olivier
Department of General Surgery, CHU Hospital, Jean Monnet University, Saint Étienne, France.
Department of General Surgery, CHU Hospital, Jean Monnet University, Saint Étienne, France.
Int J Surg Case Rep. 2014;5(7):416-8. doi: 10.1016/j.ijscr.2014.03.015. Epub 2014 Apr 16.
Cryptorchidism is characterized by the extra-scrotal position of the testis. The surgical community has little to no knowledge of cryptorchid testis in adults apart from of pediatric surgeons. Therefore, we sought to describe this unusual cause of inguinal hernia.
A 50-year-old man was referred with a inguinal hernia. Diagnosis of cryptorchidism was made during surgery, as the patient underwent an operation for repair of his left inguinal hernia. The testicle was non-viable and a left testicle was resected. Histopathology report confirmed a atrophic testis without testicular germ cell tumor (TGCT).
This is an extremely rare case of cryptorchidism revealed in an adult. The patient remained asymptomatic for 50 years. Most studies have concluded that there is a direct correlation between how long the testis was subjected to a cryptorchid position and TGCT incidence. The recommended age of surgical correction is before the age of 2 years. In our case, we did not find correlation between the time of surgery and risk of TGCT. Histopathology report confirmed the presence of leydig cells, seminiferous tubule and Sertoli cells without TGCT. Very little is known about link between cryptorchidism and TGCT. The correct diagnosis of inguinal hernia is usually made during an inguinal hernia repair.
The surgeon must always be alert to the possibility of cryptorchid testis during a surgical exploration of an inguinal hernia. In suspected cases, laparoscopy ultrasonographic, CT scan and laparoscopy evaluation may be helpful in diagnosing of this atypical inguinal hernia before surgery.
隐睾症的特征是睾丸位于阴囊外。除了小儿外科医生外，外科界对成人隐睾症知之甚少。因此，我们试图描述这种腹股沟疝的不寻常病因。
一名50岁男性因腹股沟疝前来就诊。在手术过程中诊断为隐睾症，当时患者接受了左侧腹股沟疝修补手术。睾丸已无活力，遂切除左侧睾丸。组织病理学报告证实为萎缩性睾丸，无睾丸生殖细胞肿瘤（TGCT）。
这是一例极为罕见的成人隐睾症病例。该患者50年来一直无症状。大多数研究得出结论，睾丸处于隐睾位置的时间长短与TGCT发病率之间存在直接关联。建议的手术矫正年龄在2岁之前。在我们的病例中，我们未发现手术时间与TGCT风险之间存在关联。组织病理学报告证实存在睾丸间质细胞、生精小管和支持细胞，无TGCT。关于隐睾症与TGCT之间的联系，人们知之甚少。腹股沟疝的正确诊断通常在腹股沟疝修补手术期间做出。
在对腹股沟疝进行手术探查时，外科医生必须始终警惕隐睾的可能性。在疑似病例中，腹腔镜超声、CT扫描和腹腔镜评估可能有助于在手术前诊断这种非典型腹股沟疝。
