The testicular regression syndrome—do remnants require routine excision?

Abstract Aim Excision of testicular remnants is debatable in the scenario where hypoplastic vas and vessels can be seen entering a closed internal ring during laparoscopy for impalpable testes. We aimed to establish how frequently excised remnants have identifiable testicular tissue and, hence, mali...

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Bibliographic Details
Published in:Journal of pediatric surgery 2011-02, Vol.46 (2), p.384-386
Main Authors: Bader, Mohammad I, Peeraully, Riyad, Ba'ath, Mohammed, McPartland, Jo, Baillie, Colin
Format: Article
Language:English
Subjects:
Adult
Aged
Cryptorchidism - pathology
Cryptorchidism - surgery
Epididymis - pathology
Epididymis - surgery
Germ Cells - pathology
Humans
Laparoscopy
Leydig Cells - pathology
Male
Malignancy potential
Middle Aged
Orchiectomy - methods
Pediatrics
Precancerous Conditions
Seminiferous Tubules - pathology
Sertoli Cells - pathology
Surgery
Syndrome
Testicular regression syndrome
Testicular remnant
Testis - pathology
Testis - surgery
Treatment Outcome
Urologic Surgical Procedures, Male - methods
Vas Deferens - pathology
Vas Deferens - surgery
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Summary:Abstract Aim Excision of testicular remnants is debatable in the scenario where hypoplastic vas and vessels can be seen entering a closed internal ring during laparoscopy for impalpable testes. We aimed to establish how frequently excised remnants have identifiable testicular tissue and, hence, malignant potential. Methods This study is a retrospective review of all excised testicular remnants in children with impalpable testis. Specimens that were excised for indications other than testicular regression syndrome were excluded. Pathology reports of excised specimens were reviewed, and the presence of multiple histologic features was noted. Histologic confirmation of testicular/paratesticular tissue required the presence of 1 or more of the following: seminiferous tubules, germ cells, Sertoli cells, Leydig cells, vas deferens, or epididymal structures. Malignancy potential was defined by the presence of germ cells or seminiferous tubules. All patients with seminiferous tubules were further examined by a single histopathologist. Results A total of 208 testicular remnants from 206 children were excised over the 11-year period (1999-2009). Histologic evidence confirmed excision of testicular/paratesticular tissue in 180 cases (87%). Seminiferous tubules were noted in 27 (15%), and germ cells were present in 19 (11%) cases. Conclusion Viable germ cells were found in 11% of examined remnants, which, in our opinion, justifies their removal.
ISSN:0022-3468
1531-5037
DOI:10.1016/j.jpedsurg.2010.11.018