title: The incidence and histological characteristics of intratubular germ cell neoplasia in postpubertal cryptorchid testis.
abstract: OBJECTIVE
  It is well known that testicular germ cell tumors arise with increased frequency in patients with cryptorchidism. In addition, intratubular germ cell neoplasia (ITGCN) is a precursor lesion to testicular germ cell tumor. Approximately 50% of patients with ITGCN will develop an invasive of testicular germ cell tumors within 5 years. Therefore, we evaluated that the incidence of ITGCN in postpubertal cryptorchidism.
  
  
  METHODS
  Between January 2002 and August 2012, orchiectomy specimens from 31 postpubertal patients (aged 12 or over) with cryptorchid testis were reviewed. The specimens were evaluated for ITGCN using immunohistochemical stains of placental-like alkaline phosphatase and Oct 3/4 with routine hematoxylin-eosin stain. Additionally, the degree of spermatogenesis was assessed using the Johnsen score.
  
  
  RESULTS
  Mean age was 34 years (range, 17 to 74 years) at surgery. All patients were diagnosed as unilateral cryptorchidism. One patient (3.2%) of 20-year-old had ITGCN in surgical specimen with all positive markers. Histological assessment of spermatogenesis showed that mean Johnsen score was 3.42 (range, 1 to 9). Majority of patients (27 of 31) presented impaired spermatogenesis with low Johnsen score lesser than 5.
  
  
  CONCLUSIONS
  Considering the risk of malignancy and low spermatogenesis, we should perform immunohistochemical stains and discuss preventative orchiectomy for the postpubertal cryptorchidism.
authors.affiliation: Department of Urology, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Seung Hoon
authors.initials: SH
authors.lastname: Ryang
authors.affiliation: Department of Urology, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Jae Hung
authors.initials: JH
authors.lastname: Jung
authors.affiliation: Department of Pathology, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Minseob
authors.initials: M
authors.lastname: Eom
authors.affiliation: Department of Urology, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Jae Mann
authors.initials: JM
authors.lastname: Song
authors.affiliation: Department of Urology, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Hyun Chul
authors.initials: HC
authors.lastname: Chung
authors.affiliation: Department of Urology, Cheongju St. Mary's Hospital, Cheongju, Korea.
authors.forename: Yunbyung
authors.initials: Y
authors.lastname: Chae
authors.affiliation: Department of Urology, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Chang Min
authors.initials: CM
authors.lastname: Lee
authors.affiliation: Department of Urology, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Kwang Jin
authors.initials: KJ
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000378:metabolism; D002278:Carcinoma in Situ / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D003456:Cryptorchidism / Q000150:complications* / Q000601:surgery; D018450:Disease Progression; D006801:Humans; D007248:Infertility, Male / Q000209:etiology; D007527:Isoenzymes / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009373:Neoplasms, Germ Cell and Embryonal / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000517:prevention & control; D009919:Orchiectomy; D011627:Puberty; D012189:Retrospective Studies; D013091:Spermatogenesis; D013736:Testicular Neoplasms / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000517:prevention & control; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D007527:Isoenzymes; C055791:germ-cell AP isoenzyme; D000469:Alkaline Phosphatase
keywords: Cryptorchidism; Germ cell neoplasms; Puberty