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      Tumor in undescended intrapelvic testis revealed by supraclavicular lymphadenopathy: a case report and literature review

      case-report

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          Abstract

          Background

          Testicular cancer is a rare disease. The incidence of testicular cancer in undescended testicles is of 3 to 48 times greater than in the general population. In the developed countries, the existence of undescended testicles in the adult population is rare, due to systematic practice of elective orchidopexy before the second year of life and orchiectomy in post adolescent males with undescended testicles. Despite these prevention measures, there are still some isolated cases of intra-abdominal testicular tumors in adults. We report a case of testicular cancer in cryptorchid testis revealed by supraclavicular lymphadenopathy.

          Case presentation

          We report a case of a 46 year old fertile man with a history of unilateral cryptorchidism who presented with a palpable left supraclavicular mass and absence of the right testicle. On investigations an intrapelvic testis tumor was diagnosed. Laparotomy and complete excision was carried out. The possible association between the undescended testis and cancer transformations is briefly discussed.

          Conclusion

          Testicular cancer in undescended testicles should not be ignored. Only early diagnosis and lower of testis in scrotumprevent such clinical forms.

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          Most cited references11

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          Testicular Cancer and Cryptorchidism

          Lydia Ferguson, Alexander Agoulnik (2013)
          The failure of testicular descent or cryptorchidism is the most common defect in newborn boys. The descent of the testes during development is controlled by insulin-like 3 peptide and steroid hormones produced in testicular Leydig cells, as well as by various genetic and developmental factors. While in some cases the association with genetic abnormalities and environmental causes has been shown, the etiology of cryptorchidism remains uncertain. Cryptorchidism is an established risk factor for infertility and testicular germ cell tumors (TGCT). Experimental animal models suggest a causative role for an abnormal testicular position on the disruption of spermatogenesis however the link between cryptorchidism and TGCT is less clear. The most common type of TGCT in cryptorchid testes is seminoma, believed to be derived from pluripotent prenatal germ cells. Recent studies have shown that seminoma cells and their precursor carcinoma in situ cells express a number of spermatogonial stem cell (SSC) markers suggesting that TGCTs might originate from adult stem cells. We review here the data on changes in the SSC somatic cell niche observed in cryptorchid testes of mouse models and in human patients. We propose that the misregulation of growth factors’ expression may alter the balance between SSC self-renewal and differentiation and shift stem cells toward neoplastic transformation.
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            Testicular cancer risk in boys with maldescended testis: a cohort study.

            A Giwercman, J Grindsted, B. Hansen … (1987)
            Testicular maldescent is considered as a predisposing condition for development of testicular malignancy. Male subjects with a history of cryptorchidism have been suggested by some authors to have a 40 to 50 times increased risk of testis cancer. However, the magnitude of this risk is a point of considerable disagreement. Therefore, we studied the records of 506 consecutive patients hospitalized for maldescended testis from January 1949 to December 1960. Testis cancer developed in 6 patients, which when compared to the 1.3 expectant Danish incidence rate, yielded a statistically significant relative risk of 4.7 (95 per cent confidence interval 1.7 to 10.2). Thus, our study confirmed that male subjects with a history of testicular maldescent have an increased risk for testis cancer, although the magnitude of this risk was lower than suggested previously.
            Article 0 comments Cited 23 times – based on 0 reviews     Review now
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              Cryptorchidism and testicular cancer.

              M A Batata, W Whitmore, F. Chu … (1980)
              An analysis of 125 patients with a history or clinical evidence of cryptorchidism and testicular germinal tumor treated at our hospital from 1934 to 1975 is presented. Cryptorchidism was corrected ipsilaterally or contralaterally in 83 patients with intrascrotal testis cancer when they were from 4 to 42 years old, either spontaneously (21 patients), by orchiopexy (51 patients) or by hormonal therapy (11 patients). Forty-two cryptorchid patients (uncorrected cases) presented with either ipsilateral inguinal (24 patients), abdominal (14 patients) or contralateral intrascrotal tumors (4 patients). Tumor histologic types on orchiectomy were pure seminoma in 54 patients, embryonal carcinoma in 35, teratocarcinoma in 33 and pure choriocarcinoma in 3. The 5-year survival rates were 60 per cent for the corrected cases and 63 per cent for the uncorrected cases according to cryptorchid state, and they were 78 per cent in patients with pure seminoma and 48 per cent in patients with other germinomas according to histologic type. The majority (58 of 73) of 5-year survivors received regional lymphatic irradiation, in 39 patients with pure seminoma, and/or systemic chemotherapy, in 19 patients with germinal carcinomas, with or without regional lymphadenectomy.
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                Author and article information

                Journal
                Journal ID (nlm-ta): BMC Res Notes
                Journal ID (iso-abbrev): BMC Res Notes
                Title: BMC Research Notes
                Publisher: BioMed Central
                ISSN (Electronic): 1756-0500
                Publication date Collection: 2013
                Publication date (Electronic): 26 April 2013
                Volume: 6
                Page: 166
                Affiliations
                [1 ]Department of urology, University Hospital Center Hassan II, Fes, Morocco
                [2 ]Faculté de médecine et de pharmacie de Fès, BP : 1893 –Km 2.200 Route de Sidi Harazem, FES, Morocco
                Article
                Publisher ID: 1756-0500-6-166
                DOI: 10.1186/1756-0500-6-166
                PMC ID: 3645951
                PubMed ID: 23622500
                SO-VID: 936ca8a5-fc64-4f71-963d-05e7c9191120
                Copyright © Copyright ©2013 Tazi et al.; licensee BioMed Central Ltd.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 24 August 2012
                Date accepted : 25 March 2013
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Medicine
                Keywords: supraclavicular lymphadenopathy,testicular tumor,cryptorchidism
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: supraclavicular lymphadenopathy, testicular tumor, cryptorchidism

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