Korean J Urol.  2015 Jul;56(7):515-518. 10.4111/kju.2015.56.7.515.

The incidence and histological characteristics of intratubular germ cell neoplasia in postpubertal cryptorchid testis

• Ryang SH
• Jung JH
• Eom M
• Song JM
• Chung HC
• Chae Y
• Lee CM
• Kim KJ

• KMID: 2160648
• DOI: http://doi.org/10.4111/kju.2015.56.7.515

Abstract

PURPOSE
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.
MATERIALS AND METHODS
Between January 2002 and August 2012, orchiectomy specimens from 31 postpubertalpatients (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.

Keyword

Cryptorchidism; Germ cell neoplasms; Puberty

MeSH Terms

Adolescent
Adult
Aged
Alkaline Phosphatase/metabolism
Biomarkers, Tumor/metabolism
Carcinoma in Situ/diagnosis/*etiology/pathology
Cryptorchidism/*complications/surgery
Disease Progression
Humans
Infertility, Male/etiology
Isoenzymes/metabolism
Male
Middle Aged
Neoplasms, Germ Cell and Embryonal/diagnosis/*etiology/pathology/prevention & control
Orchiectomy
Puberty
Retrospective Studies
Spermatogenesis
Testicular Neoplasms/diagnosis/*etiology/pathology/prevention & control
Young Adult
Alkaline Phosphatase
Biomarkers, Tumor
Isoenzymes

Figure

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  Fig. 1 The germ cells are positive with immunohistochemical staining of placental-like alkaline phosphatase (A) and Oct 3/4 (B) (×100).

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