Microsurgical Onco-Testicular Sperm Extraction in a Patient With Testicular Cancer and Congenital Unilateral Testicular Absence: A Case Report.

INTRODUCTION

Testicular cancer primarily affects men of reproductive age. Therefore, fertility preservation is important in managing testicular cancer. In patients with a solitary testis, oncological testicular sperm extraction (onco-TESE) is used to retrieve sperm from tumor-bearing testis.

CASE PRESENTATION: A 39-year-old man with congenital absence of the left testis presented with a 4-month history of progressive right testicular swelling. Laboratory tests showed elevated β-human chorionic gonadotropin and follicle-stimulating hormone concentrations, and ultrasonography showed a heterogeneous hypoechoic mass with microcalcifications. A seminal analysis showed azoospermia with AZFc partial deletion. Following orchiectomy, microsurgical onco-TESE was performed. Motile sperm were successfully retrieved from preserved seminiferous tubules. A pathological examination demonstrated a pure seminoma. In preserved seminiferous tubules, the Johnsen score was 9-10, and partial tubular hyalinization and microcalcifications were observed.

CONCLUSION

Microsurgical onco-TESE is for retrieving sperm in patients with testicular cancer with a solitary testis, even in the presence of impaired spermatogenesis.