Title: Histopathological Spectrum of Lesions in Orchidectomy Specimens – A Clinicopathological Study in Tertiary Care Hospital

Authors: Syed Imtiyaz Hussain, Gulshan Akhter, Ruby Reshi, Suhail Farooq, Farooq Sideeq

 DOI: https://dx.doi.org/10.18535/jmscr/v6i12.122

Abstract

Background: Testicular Lesions are common in males of all age groups. The lesions range from Benign to malignant. The treatment is different for different histologic subtypes.

Objective: The aim of this study is to study the spectrum of testicular lesions in orchidectomy specimens and their clinical presentation.

Materials and Methods: This is a three and a half year retrospective study on hundred Orchidectomy cases from January 2015 to June 2018 conducted in the Post graduate department of Pathology Govt. Medical College Srinagar. Histopathological examination was done after routine processing and staining with Haematoxylin and Eosin.

Results: Non-neoplastic lesions of the testis are most common in the second decade of the life while malignancy is common in 3rd decade of life. The youngest patient was at one year and oldest was 76 years of age. Unilateral involvement is more common than the bilateral involvement; particularly right sided involvement is common than the left side involvement. Non-neoplastic lesions were (70%) were more common than the neoplastic lesions (30%) of testis. Out of non-neoplastic lesions, cryptorchid testis was most common findings (42.8%) followed by torsion and infarction (22.8%). Among the neoplastic lesions malignant lesions (56.6%) are more common than the benign lesions (43.3%). Out of all neoplastic lesions, mature teratoma is the most common finding (43.3%) in the present study.

Conclusion: Histopathology diagnosis is the golden standard tool despite various newer techniques as management is different for different lesions.

Keywords: Testicular Lesions, Orchidectomy.

References

  1. Goedegebuure PS, Liyanange U, Eberlein TJ. Tumor biology and tumor markers. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, editors. Townsend: Sabiston Textbook of Surgery. 17th ed. Philadelphia, PA: Elsevier, Saunders; 2004.
  2. Bray F, Richiardi L, Ekbom A, Pukkala E, Cuninkova M, Moller H. Trends in testicular cancer incidence and mortality in 22 European countries: continuing increase in incidence and decline in mortality. Int J Cancer 2006; 188:3099-111.
  3. Mulbright T,Berney DM. Testicular and paratesticular tumours. Sternbergs Diagnostic Surgical Pathology 2015; Vol. 2: 2175.
  4. Richiardi L, Bellocco R, Adami HO, Torrang A, Barlau L, Hakulinen T, et al. Testicular cancer incidence in eight European countries: secular and recent trends. Cancer Epidemiol Biomarkers Prev 2004;13:2157-66.
  5. Barney DM. Staging and classification of testicular tumours: pitfalls from macroscopy to diagnosis. J ClinPathol 2008;61:20–24.
  6. Park DS, Chung MK, Chung JI, Ahn HJ, Lee ES, Choi HY, et al. Histologic type, staging, and distribution of germ cell tumors in Korean adults. Urologic Oncology 2008 Nov-Dec;26(6):590-4.
  7. Haas GP, Shumaker BP, Cerny JC. High incidence of benign testicular tumors, J Urol. 1986, Dec; 136(6): 1219-1220.
  8. Kressel K, Schnel lD, Thon WF,et al.Benign testicular tumours:a case for testis preservation? Eur Urol. 1988; 15: 200-4.
  9. Robertson GS. Radical orchidectomy and benign testicular conditions.Br J Surg. 1995. Mar, 82(3): 342-345.
  10. Robson CJ, BruceAW. Testicular tumors; A Collective review from Canadian Academy of Urological surgeon; J.Urol; 1965; 94:440.
  11. Duncan W, Munro AJ. The management of testicular seminoma: Edinburgh 1970-1981. Br J Cancer. 1987;55(4):443-8.
  12. Reddy DB, Ranganayakamma I; Review of 56 cases of Testicular tumors; Indian J cancer; 1966; 3: 255-271.
  13. Moghe KV, Agrawal RV, Junnerkar RV, Testicular tumors; Indian J cancer; 1970: 90-97.
  14. Nayak BS. Why the left testis hangs at a lower level than the right? Medical Hypotheses. 2009 Aug; 73(2):269-70.
  15. Mylonas I, Schiessl B, Jeschke U, Vogl J, Makrigiannakis A, Kuhn C, et al. Expression of inhibin/activin subunits alpha (-alpha), beta A (-beta (A)) and beta B (-beta (B)) in placental tissue of normal and intrauterine growth restricted (IUGR) pregnancies. J Molecular Histol 2006 Jan;37(1-2):43-52.
  16. McGlynn KA,Graubard BI, KlebanoffMA et al.Risk factors for cryptorchism among populations at differing risks of testicular cancer. Int J Epidemiol.2006 Jun; 35(3): 787-795.
  17. Ferguson L, Agoulnik AI. Testicular cancer and cryptorchidism .Front Endocrinol (Lausanne).2013; 4: 32.
  18. Das P, Abhuja A, Datta Gupta S. Incidence, etiopathogenesis and pathological aspects of genitourinary tuberculosis in India: A journey restricted. Indian J. Urol 2008; 24: 356-361.
  19. Kapoor R, Ansari MS, Madhavi A, Gulia A. Clinical presentation and diagnostic approach in cases of genitourinary TB. Indian J Urol2008; 24: 401-405.
  20. Mostofi FK, Price EB Jr. Tumors of the male genital system. Atlas of Tumor Pathology, Fascicle 7, Series 2. Washington, DC: Armed Forces Institute of Pathology1973; p. 1186-200.
  21. Vural F, Cagirgan S, Saydam G, Hekimgil M, Soyer NA, Tombuloglu M. Primary testicular lymphoma. J Natl Med Assoc. 2007;99(11):1277-82.

Corresponding Author

Syed Imtiyaz Hussain

Senior Resident Postgraduate Department of Pathology, GMC Srinagar.190010, India