Pathak Manish, Suchiang Biangchwadaka, Elhence Poonam, Saxena Rahul, Jadhav Avinash, Rathod Kirtikumar, Sinha Arvind
Department of Pediatric Surgery, All India Institute of Medical Sciences Jodhpur, Jodhpur, India.
Department of Pediatric Surgery, All India Institute of Medical Sciences Jodhpur, Jodhpur, India.
J Pediatr Urol. 2020 Oct;16(5):627-634. doi: 10.1016/j.jpurol.2020.07.011. Epub 2020 Jul 17.
To determine whether excising a testicular remnant or nubbin is necessary and perform a systematic review of the incidental ectopic adrenal cortical rest associated with undescended testis.
A retrospective analysis of impalpable undescended testis was carried out between May 2016 and June 2019. The demographic data, intra-operative findings and histopathological diagnosis were analyzed. In conjunction with this, systematic search of PUBMED and EMBASE database was performed by using the search terms "undescended testis" AND "ectopic adrenal tissue". Data was collected for demographic characteristics, size and appearance of ectopic adrenal cortical rest and histopathology. Quantitative data has been presented as medians. Categorical variables have been presented as percentages.
We encountered 43 cases of impalpable undescended testis, out of which, nubbins were identified in 9 cases. Incidence of EACT in nubbin and impalpable UDT was 2/9 (22.22%) and 2/43 (4.7%) respectively. None of the excised nubbin had germ cells. On Systematic review, EACT associated with UDT was seen in 90/2501 (3.6%), while its association with testicular nubbin has been reported only once before in a case report.
A testicular nubbin is a condition wherein no viable testicular tissue can be grossly identified in a case of impalpable testis. Even when germ cells are not found in the excised nubbin, the presence of ectopic adrenal cortical rest make them prone to later malignant transformation. Association of EACT with UDT has been consistently reported but there is scarcity of such documentation in association with testicular nubbin.
确定切除睾丸残端或小结节是否必要，并对与隐睾相关的偶然异位肾上腺皮质残余进行系统评价。
对2016年5月至2019年6月间不可触及的隐睾进行回顾性分析。分析人口统计学数据、术中发现及组织病理学诊断。与此同时，通过使用搜索词“隐睾”和“异位肾上腺组织”对PUBMED和EMBASE数据库进行系统检索。收集有关异位肾上腺皮质残余的人口统计学特征、大小、外观及组织病理学的数据。定量数据以中位数表示。分类变量以百分比表示。
我们遇到43例不可触及的隐睾病例，其中9例发现有小结节。小结节和不可触及的隐睾中异位肾上腺皮质组织（EACT）的发生率分别为2/9（22.22%）和2/43（4.7%）。切除的小结节中均无生殖细胞。系统评价显示，与隐睾相关的EACT在90/2501（3.6%）中可见，而其与睾丸小结节的关联此前仅在一篇病例报告中有过一次报道。
睾丸小结节是指在不可触及的睾丸病例中无法大体识别出有活力的睾丸组织的一种情况。即使在切除的小结节中未发现生殖细胞，但异位肾上腺皮质残余的存在使其易于发生后期恶性转化。EACT与隐睾的关联已有一致报道，但与睾丸小结节相关的此类文献较少。
