[Cryptorchidism and cancer].

OBJECTIVES

To demonstrate the presence of neoplasic degeneration within non descended testicles and the effect that late orchydopexy could have in the increased incidence.

METHODS

We review the medical records of 22 patients with the diagnosis of malignant testicular tumor cared for at the Department of Urology of the Hospital CQ D Comandante M. Fajardo between 1982 and 2004, looking for history of cryptorchidism, age at the time of orchydopexy (if carried out), histological diagnosis and stage, and post operative outcome. We include one case which did not belong to this series because it was not reported previously.

RESULTS

Four patients with history of cryptorchidism were found, the youngest was 12 years old and the time of orchydopexy and the oldest 57. All cases of testicles outside the scrotum at the time of diagnosis were seminomas. The only case with successful orchydopexy presented teratocarcinoma and died before two years from orchiectomy. All cases of seminoma received radiotherapy and are disease-free with negative tumor markers.

CONCLUSIONS

Cryptorchid testicles operated after the age of two years only provide hormonal supply adequate for development of secondary sexual features but not fertility, so that in unilateral cases late orchydopexy would only help to detect neoplasic degeneration before the appearance of pain or symptoms from metastases. If there are not important psychological or cosmetic reasons orchiectomy should be the first therapeutic option for adult's cryptorchidism.