title: A rare variant of inguinal hernia: Cryptorchid testis at the age of 50 years. Etiopathogenicity, prognosis and management.
abstract: BACKGROUND
  Cryptorchidism is characterized by the extra-scrotal position of the testis. The surgical community has little to no knowledge of cryptorchid testis in adults apart from of pediatric surgeons. Therefore, we sought to describe this unusual cause of inguinal hernia.
  
  
  METHODS
  A 50-year-old man was referred with a inguinal hernia. Diagnosis of cryptorchidism was made during surgery, as the patient underwent an operation for repair of his left inguinal hernia. The testicle was non-viable and a left testicle was resected. Histopathology report confirmed a atrophic testis without testicular germ cell tumor (TGCT).
  
  
  CONCLUSIONS
  This is an extremely rare case of cryptorchidism revealed in an adult. The patient remained asymptomatic for 50 years. Most studies have concluded that there is a direct correlation between how long the testis was subjected to a cryptorchid position and TGCT incidence. The recommended age of surgical correction is before the age of 2 years. In our case, we did not find correlation between the time of surgery and risk of TGCT. Histopathology report confirmed the presence of leydig cells, seminiferous tubule and Sertoli cells without TGCT. Very little is known about link between cryptorchidism and TGCT. The correct diagnosis of inguinal hernia is usually made during an inguinal hernia repair.
  
  
  CONCLUSIONS
  The surgeon must always be alert to the possibility of cryptorchid testis during a surgical exploration of an inguinal hernia. In suspected cases, laparoscopy ultrasonographic, CT scan and laparoscopy evaluation may be helpful in diagnosing of this atypical inguinal hernia before surgery.
authors.affiliation: Department of General Surgery, CHU Hospital, Jean Monnet University, Saint Étienne, France. Electronic address: Radwankassir42@hotmail.Fr.
authors.forename: Radwan
authors.initials: R
authors.lastname: Kassir
authors.affiliation: Department of General Surgery, CHU Hospital, Jean Monnet University, Saint Étienne, France.
authors.forename: Joelle
authors.initials: J
authors.lastname: Dubois
authors.affiliation: Department of Pathology, CHU Hospital, Jean Monnet University, Saint Etienne, France.
authors.forename: Sid-Ali
authors.initials: SA
authors.lastname: Berremila
authors.affiliation: Department of General Surgery, CHU Hospital, Jean Monnet University, Saint Étienne, France.
authors.forename: Sylviane
authors.initials: S
authors.lastname: Baccot
authors.affiliation: Department of General Surgery, CHU Hospital, Jean Monnet University, Saint Étienne, France.
authors.forename: Alexia
authors.initials: A
authors.lastname: Boueil-Bourlier
authors.affiliation: Department of General Surgery, CHU Hospital, Jean Monnet University, Saint Étienne, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Tiffet
keywords: Cryptorchid testis; Histology; Inguinal hernia; Prognosis; Surgery