Histopathological evaluation of orchiectomy specimens in 51 late postpubertal men with unilateral cryptorchidism.
OBJECTIVE
We evaluate the histopathological features of uncorrected undescended testis presenting at a late postpubertal age.


METHODS
The study included 51 men (age 20 to 24 years) diagnosed with inguinal unilateral undescended testis found on routine examination for military recruits. None was evaluated or treated for undescended testis previously. All of the men had a normal contralateral testis and no other observed phenotypic alterations, and all had undergone unilateral orchiectomy. The surgical specimens were first examined histologically, and sections were additionally examined with immunohistochemical methods using antibodies against CD117 and OCT3/4 proteins to verify the presence of intratubular germ cell neoplasia.


RESULTS
Histopathology revealed the presence of germ cells at different maturation levels in 26 of 51 (51%) cases. There were 28 cases (55%) with different degrees of basal membrane thickening. A decrease in seminiferous tubule diameter was observed in 23 (45%) patients. Six patients (12%) had dystrophic calcification and 12 (24%) had Leydig cell hyperplasia. Although morphological evaluation did not show intratubular germ cell neoplasia in any patients, 1 with germ cells had positivity for OCT3/4 and CD117 staining. Therefore, 1 case out of 51 had diagnosed intratubular germ cell neoplasia.


CONCLUSIONS
There was a wide range of histopathological changes in undescended testis. Nearly half the patients may still have significant germ cell activity at a variety of maturation levels. The incidence of intratubular germ cell neoplasia was 2% in this group. Intratubular germ cell neoplasia may be overlooked with hematoxylin and eosin staining so immunohistochemical study should be added for evaluation.
Department of Urology, Hacettepe University School of Medicine, Ankara, Turkey.
Artan
A
Koni
Department of Pathology, Hacettepe University School of Medicine, Ankara, Turkey.
Havva Solak
HS
Ozseker
Department of Urology, Istanbul Memorial Hospital, Istanbul, Turkey.
Emre
E
Arpali
Department of Urology, Ankara Mevki Military Hospital, Ankara, Turkey.
Ercument
E
Kilinc
Department of Urology, Hacettepe University School of Medicine, Ankara, Turkey.
Hasan Serkan
HS
Dogan
Department of Pathology, Hacettepe University School of Medicine, Ankara, Turkey.
Aytekin
A
Akyol
Department of Urology, Hacettepe University School of Medicine, Ankara, Turkey.
Serdar
S
Tekgul
D000328:Adult; D003456:Cryptorchidism / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008889:Military Personnel; D050814:Octamer Transcription Factor-3 / Q000378:metabolism; D009919:Orchiectomy; D027701:Organic Cation Transport Proteins / Q000378:metabolism; D019009:Proto-Oncogene Proteins c-kit / Q000378:metabolism; D013737:Testis / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D013997:Time Factors; D055815:Young Adult; D000099254:Organic Cation Transporter 3
D050814:Octamer Transcription Factor-3; D027701:Organic Cation Transport Proteins; D019009:Proto-Oncogene Proteins c-kit; D000099254:Organic Cation Transporter 3; C494173:POU5F1 protein, human
cryptorchidism; germ cell and embryonal; neoplasms; testicular neoplasms