title: The testicular regression syndrome--do remnants require routine excision?
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  Viable germ cells were found in 11% of examined remnants, which, in our opinion, justifies their removal.
authors.affiliation: Department of Paediatric Surgery, Alder Hey Children's NHS Foundation Trust, Liverpool, L12 2AP, UK. mibader@gmail.com
authors.forename: Mohammad I
authors.initials: MI
authors.lastname: Bader
authors.forename: Riyad
authors.initials: R
authors.lastname: Peeraully
authors.forename: Mohammed
authors.initials: M
authors.lastname: Ba'ath
authors.forename: Jo
authors.initials: J
authors.lastname: McPartland
authors.forename: Colin
authors.initials: C
authors.lastname: Baillie
mesh_terms: D000328:Adult; D000368:Aged; D003456:Cryptorchidism / Q000473:pathology / Q000601:surgery*; D004822:Epididymis / Q000473:pathology / Q000601:surgery*; D005854:Germ Cells / Q000473:pathology; D006801:Humans; D010535:Laparoscopy; D007985:Leydig Cells / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009919:Orchiectomy / Q000379:methods; D011230:Precancerous Conditions; D012671:Seminiferous Tubules / Q000473:pathology; D012708:Sertoli Cells / Q000473:pathology; D013577:Syndrome; D013737:Testis / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D013521:Urologic Surgical Procedures, Male / Q000379:methods*; D014649:Vas Deferens / Q000473:pathology / Q000601:surgery*