Abstract

OJEDA FIORE, Hugo et al. Bilateral cryptorchidism and testicular cancer. A case report. An. Fac. Cienc. Méd. (Asunción) [online]. 2008, vol.41, n.3, pp.38-42. ISSN 1816-8949.

Introduction: Cryptorchidism or non descended testicles (NDT) is the most frequent malformation that affects the male external genitals and the most known etiologic factor of testicular cancer. The recommended surgical treatment in adult is the orchiectomies since orchydopexy doesn´t prevent cancer. Objectives: To show the relation between cryptorchidism in adults and testicular cancer. To determine the most adequate conduct in the presence of this two entities. Material and Method: Descriptive retrospective. A brief bibliographical revision of the theme. Case presentation: A male patient with past history of bilateral cryptorchidism, that consults for a mass and pain in hypogastrium. Both ultrasonography and computed tomography inform a retroperitoneal tumour and absence of the right kidney. The tumoral markers are in normal levels. He is subjected to surgery with excision of both testicles. The anatomopathology inform reveals the diagnosis of seminoma in the tumoral gland and atrophy in the other. He receives adjuvant with chemotherapy. He presents good evolution and good answer to the treatment with a follow up of 10 months until the date, with absent of illness. Discussion: Cryptorchidism is a frequent entity in pediatric clinic, generally is unilateral. When it is bilateral it can go with others genitourinary malformations, and between this, the renal agenesis. The orchydopexy doesn't decrease the risk of malignancy of the gland, but improves the prognosis because permits an earlier diagnoses and only has the possibility of preserve the fertility if it is realized before the 2 years old. The election treatment in adults is the orchiectomy by conventional or laparoscopic surgery. The diagnosis of testicular cancer is clinical and can support in complementary studies such as ultrasonography, computed tomography or tumoral markers that are not conclusive but provide orientation of the extension and histological variety respectively. The seminoma is the most frequent tumour. Radiotherapy and chemotherapy can be used according the histology and the stage. The prognosis also depends of these factors. Conclusion: The NDT is a factor for the development of testicular cancer. Its bilateralism sometimes goes with others malformations, so those must be looked for. The diagnosis is clinical. In case of it doesn't find the localization of the gland the imaging studies offer an important help. The tumoral markers in normal levels don't discard the illness. The basic treatment of the NDT such as the testicular cancer is the excision, having possibilities for adjuvant.

Keywords : Cryptorchidism; bilateral; kidney agenesis; testicular cancer.

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