Acquired undescended testis.

We report an unusual case of a 22-year-old man who presented with the left testis spontaneously ascended to a non-scrotal position. The testis had been documented to be intrascrotal without any sign of up-migration when the man was 12 years old. On surgery, the cryptorchid testis was found to be located within the superficial inguinal pouch. The testis was atrophic with the spermatic cord too short. On dissection, a remnant string of the closed processus vaginalis was observed within the cord, and the distal end of the gubernaculum was abnormally attached to the fascia near inguinoscrotal junction. Histopathologic findings of the testis were that of the Sertoli-cell-only syndrome which may represent the end-stage of germinal cell hypoplasia, a pathologic sequela common in postpubertal undescended testis. We recommend 3 diagnostic criteria for the acquired undescended testis and emphasize that testicular descent should be confirmed in infancy and re-confirmed periodically through puberty by the health care physician. Our observations seem to support the theory that acquired undescended testis may be caused by a postnatal failure of the spermatic cord to elongate in proportion to somatic growth.