Cases reported "Cryptorchidism"

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1/6. Multinucleated spermatogonia in cryptorchid boys: a possible association with an increased risk of testicular malignancy later in life?

    At birth, undescended testes contain germ cells, but after 1 year of life, a reduced number of germ cells is generally found. Microlithiasis and carcinoma-in-situ-testis occur in cryptorchid boys. Multinucleated germ cells, including at least 3 nuclei in the cell, exist in impaired spermatogenesis and in the senescent testis. AIM OF THE STUDY: We investigated whether multinucleated spermatogonia were present in undescended testes of cryptorchid boys, and if such a pattern is associated with special clinical features. RESULTS: Multinucleated spermatogonia occurred in 13/168 (8%) of 163 consecutive cryptorchid boys, who underwent surgery for cryptorchidism with simultaneous testicular biopsy showing seminiferous tubules. The patients with multinucleated spermatogonia more often exhibited a normal germ cell number (Fisher's exact test, p<0.0005), and were younger at surgery (Mann Whitney, p<0.005) than the rest of the patients. Before surgery, 3 patients underwent treatment with erythropoietin because of renal failure. An intra-abdominal testis underwent clipping and division of the spermatic vessels, and a biopsy at final surgery 7 months later, exhibited multinucleated spermatogonia. In 1 case the undescended testicular position, a fixed retraction, was acquired after surgery for an inguinal hernia. Multinucleated spermatogonia were found in cases of carcinoma-in situ-testis in 2 cryptorchid boys. No case of multinucleated germ cells appeared in our normal material. CONCLUSION: Multinucleated spermatogonia are a further abnormality present in cryptorchidism. The cryptorchid boys with multinucleated spermatogonia in general exhibited rather many germ cells. This feature may be associated with an increased risk of testicular malignancy later in life, and we propose a careful follow up regime in these cases including ultrasound examination and a testicular biopsy in cases of symptoms or clinical findings.
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ranking = 1
keywords = seminiferous tubule, tubule
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2/6. Testicular tumour with features of sex cord tumor with annular tubules associated with cryptorchidism and infertility--a case report.

    sex cord tumor with annular tubules (SCTAT) is a rare tumor seen in the ovary usually associated with peutz-jeghers syndrome. Testicular SCTAT are more infrequent and only four such cases have been reported in the literature. A 28-year-male presented with infertiliy. He had a history of orchiopexy 10 years back for right-sided inguinal testes. A right testicular biopsy done to investigate the cause of infertility revealed testicular atrophy with a focus suspicious of SCTAT. The right-sided orchiectomy revealed two firm nodules of 0.5 and 0.2 cms of SCTAT and sertoli cell nodule (SCN) respectively on microscopy. He did not have any features of Peutz-Jeghers or any other dysgenetic syndrome. He is asymptomatic after follow up of 26 months. This is the fifth case of testicular SCTAT and the first with SCN.
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ranking = 0.010037452792643
keywords = tubule
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3/6. leydig cells within the aspermatogenic seminiferous tubules.

    Cells identical to leydig cells were found within a peritubular boundary layer and even inside a basal lamina of seminiferous tubules in three male patients (two with inguinal cryptorchism and one with infertility). The seminiferous tubules of all patients showed a moderate to marked thickening of the boundary layer and a complete loss of spermatogenic cells. The "ectopic leydig cells" were characterized by the presence of Reinke crystals or an extensively developed smooth endoplasmic reticulum. These cells were believed to have differentiated in situ from myoid cells within the boundary layer and also to have invaded from the interstitial tissue in the form of mature leydig cells. The occurrence of ectopic leydig cells appeared to parallel the extent of loss of the sertoli cells and also that of the thickening of the boundary layer. The functional significance of the ectopic occurrence might be implicated in the impaired spermatogenesis.
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ranking = 6
keywords = seminiferous tubule, tubule
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4/6. Testicular microlithiasis in 2 children with bilateral cryptorchidism.

    Testicular microlithiasis, associated with bilateral cryptorchidism, is studied in 2, 6-year-old children. In case 1 autopsy revealed that 60 per cent of the seminiferous tubules contained completely calcified microliths. Similar mineralized concretions also were found in different areas of the cerebrum and cerebellum. In the testicular biopsy obtained from case 2, 30 per cent of the seminiferous tubules contained microliths showing different degrees of calcification. The study of such calcifications supports the hypothesis that the mineralization process occurs according to the following stages: 1) accumulation of cellular debris in the tubular lumen, 2) deposit of concentric rings of glycoprotein material surrounding the central core and 3) calcification of the glycoprotein lamellar material. The presence of similar concretion in the nervous system as well as the lung in other reported cases suggests that microlithiasis could be a systemic disease.
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ranking = 2
keywords = seminiferous tubule, tubule
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5/6. Incipient germ cell tumor in a cryptorchid testis.

    A 13-year-old male who had bilateral cryptorchid testes since birth underwent testicular biopsies and subsequent left orchiectomy following a diagnosis of malignant germ cell tumor. No tumor mass was noted although the malignant cells were seen within the seminiferous tubules and the interstitium. Five recorded cases of in-situ or incipient germ cell neoplasms of the testes are reviewed; three were infertile, another had a cryptorchid testis, and the fifth was both infertile and cryptorchid. Two of these patients have developed frank carcinoma, which would suggest that the process represents an early phase of invasive germ cell neoplasia.
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ranking = 1
keywords = seminiferous tubule, tubule
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6/6. Hormone profiles and testicular histology in cryptorchid boys with marker chromosome.

    Hormone profiles and testicular histology were studied in two cryptorchid boys with marker chromosome. plasma testosterone levels were abnormally low in both cases. plasma levels of gonadotropins and prolactin were within normal ranges in case 1, but case 2 showed decreased concentration of plasma gonadotropins and normal level of plasma prolactin. The administration of LH-RH induced low response of plasma gonadotropins in case 1 and exaggerated response in case 2. The response of plasma testosterone to the administration of hCG was poor in both cases. Testicular histology showed maturation arrest and reduction of tubular diameter and leydig cells per seminiferous tubules in both cases. Although testicular histology in these cases were similar to those in prepubertal or pubertal boys with cryptorchidism, hormonal disturbances were more severe. It would appear that marker chromosome enhances hormonal alterations.
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ranking = 1
keywords = seminiferous tubule, tubule
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