Xu Rena, McQuaid Joseph W, Paulson Vera A, Kurtz Michael P, Logvinenko Tanya, Yu Richard N, Lee Richard S, Nelson Caleb P
Department of Urology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
Department of Urology, University of Massachusetts Medical School, Worcester, Massachusetts.
J Urol. 2022 Mar;207(3):694-700. doi: 10.1097/JU.0000000000002345. Epub 2021 Nov 18.
We performed a retrospective, single-institution study to characterize the pathological findings of testis tissue specimens from older boys and adolescents with cryptorchidism.
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.
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).
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.
我们进行了一项回顾性单机构研究，以描述年龄较大的男孩和青少年隐睾症患者睾丸组织标本的病理结果。
经机构审查委员会批准，获取了1994年至2016年一家儿科医院10岁及以上患者睾丸标本的病理报告。如果报告缺乏临床记录、缺乏睾丸实质、来自下降的睾丸或来自性发育异常的患者，则将其排除。感兴趣的变量包括年龄、睾丸位置、手术和病理结果。使用Fisher精确检验比较腹内型与腹外型隐睾中恶性肿瘤的存在情况。
71例患者符合纳入标准。中位年龄为15.3岁（范围10.1 - 27.7岁）。均无睾丸恶性肿瘤病史。进行了45例单侧睾丸切除术、22例单侧睾丸固定术加活检和4例双侧手术。17个睾丸（22.7%）位于腹腔内，42个（56.0%）位于腹股沟管，9个（12.0%）位于腹股沟外环，3个（4.0%）位于腹股沟浅袋，4个（5.3%）位于阴囊。71例患者中有2例（2.8%）检测到恶性肿瘤。按位置划分，16例腹内型睾丸患者中有2例（12.5%）出现恶性肿瘤，55例腹外型睾丸患者中0例（0%）出现恶性肿瘤（p = 0.048）。
在年龄10岁及以上、无性发育异常的隐睾男性中，16例腹内型睾丸患者中有2例出现恶性肿瘤，55例腹外型睾丸患者中0例出现恶性肿瘤。对于年龄较大的男孩和青少年，腹内型睾丸需进行睾丸切除术或活检，但腹外型隐睾可能无需如此。
