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

• Published in: Korean journal of urology Vol. 56; no. 7; pp. 515 - 518
• Main Authors: Ryang, Seung Hoon, Jung, Jae Hung, Eom, Minseob, Song, Jae Mann, Chung, Hyun Chul, Chae, Yunbyung, Lee, Chang Min, Kim, Kwang Jin
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Urological Association 01.07.2015
• Subjects: Adolescent; Adult; Aged; Alkaline Phosphatase - metabolism; Biomarkers, Tumor - metabolism; Carcinoma in Situ - diagnosis; Carcinoma in Situ - etiology; Carcinoma in Situ - pathology; Cryptorchidism - complications; Cryptorchidism - surgery; Disease Progression; Humans; Infertility, Male - etiology; Isoenzymes - metabolism; Male; Middle Aged; Neoplasms, Germ Cell and Embryonal - diagnosis; Neoplasms, Germ Cell and Embryonal - etiology; Neoplasms, Germ Cell and Embryonal - pathology; Neoplasms, Germ Cell and Embryonal - prevention & control; Orchiectomy; Original; Puberty; Retrospective Studies; Spermatogenesis; Testicular Neoplasms - diagnosis; Testicular Neoplasms - etiology; Testicular Neoplasms - pathology; Testicular Neoplasms - prevention & control; Young Adult; Puberty; Cryptorchidism; Germ cell neoplasms
• ISSN: 2005-6737; 2005-6745; 2005-6745
• DOI: 10.4111/kju.2015.56.7.515

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. 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. 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. Considering the risk of malignancy and low spermatogenesis, we should perform immunohistochemical stains and discuss preventative orchiectomy for the postpubertal cryptorchidism.