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The vanishing testis: a histomorphologic and clinical assessment
Tatjana Antic1, Elizabeth M Hyjek, Jerome B Taxy
1Department of Pathology, The University of Chicago, IL 60637, USA.
American Journal of Clinical Pathology
|November 19, 2011
Summary
Vanishing testis syndrome, characterized by absent palpable gonads in cryptorchidism patients, involves testicular remnants. Histological analysis reveals fibrosis, calcifications, and hemosiderin deposits, with some cases showing only Sertoli cells.
Area of Science:
- Pediatric Surgery
- Urologic Pathology
- Developmental Biology
Background:
- Cryptorchidism affects 5% of patients with non-palpable gonads.
- Vanishing testis syndrome is diagnosed via physical examination or scrotal exploration.
- Testicular remnants may present as tissue nubbins or small nodules.
Purpose of the Study:
- To histologically characterize testicular remnants in patients diagnosed with vanishing testis syndrome.
- To compare these remnants with fetal, nonneoplastic, and cryptorchid testes.
- To inform surgical management and understanding of potential risks.
Main Methods:
- Analysis of 30 surgical pathology specimens from 29 patients with vanishing testis syndrome.
- Histologic and immunohistochemical comparison with control testicular tissues.
- Routine histological examination for specific tissue components.
Main Results:
- No seminiferous tubules were found in 60% of specimens.
- Fibrosis was present in all specimens (100%).
- Calcifications (53%) and hemosiderin deposits (30%) were common findings.
- Sertoli cells only were observed in 40% of cases with seminiferous tubules.
Conclusions:
- Histological examination of testicular remnants shows a spectrum including fibrosis, calcifications, and Sertoli cells only.
- Awareness of this spectrum aids in the definitive management of vanishing testis syndrome.
- While tumor risk is considered low, surgical removal is based on the presence of tissue.
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