Histological features of the testicular nubbin in the vanishing testis: Is surgical exploration necessary?
- 정원호; 박철희; 김천일; 김병훈; 하지용
- Alternative Author(s)
- Jung, Won Ho; Park, Choal Hee; Kim, Chun Il; Kim, Byung Hoon; Ha, Ji Yong
- Publication Year
- INTRODUCTION & OBJECTIVES: Vanished testis syndrome is identified in up to 35% of cases of
nonpalpable testis. It seems that this syndrome is a common phenomenon; however, the optimal
management of this condition remains unclear. We reviewed histopathological studies of the testicular
nubbins associated with the vanishing testis syndrome, and determined whether surgical removal is
indicated based on the histological findings.
MATERIAL & METHODS: Between Jan. 1996 and Dec. 2015, a testicular nubbin consistent with a
vanishing testis was excised in 62 patients. We reviewed the medical records, operative summaries,
surgical pathology reports and slides. We also noted whether the testis was palpable or nonpalpable and
whether laparoscopy had been done before inguinal exploration. The microscopic slides were examined
in each cases.
RESULTS: The ages of patients ranged from 6 months to 35 years. On physical examination, no
palpable testis was found in the scrotum in 48 patients. In 12 patients, there was a small palpable nodule
thought to be a testis, 3 of which were within the inguinal canal. The surgical approach was via an
inguinal incision in 58 patients. The 4 patients underwent laparoscopy followed by inguinal exploration.
Of the explorations, 45 were on the left and 15 on the right, 2 patients underwent bilateral exploration. All
62 cases had fibrosis; calcifications were present in 25 and hemosiderin deposits in 28. An epididymis
was present in 4 (6.5%) and vas deferens in 49 (79.1%) cases. Recognizable testicular elements
(Seminiferous tubules) were present in 7 (11.2%) nubbin. The 5 (8%) with seminiferous tubules had
germ cells identified (Fig. 1). No recognizable Leydig cells were present in the stroma surrounding the
seminiferous tubules. In all cases, intratubular germ cell neoplasia (ITGCN) was not present.
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