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C C Anunobi1, A A Phillips, N Z Ikeri
1College of Medicine, Univeristy of Lagos, Idi-Araba, Lagos, Nigeria.
Introduction:
Removal of testicular tissue is often performed for the evaluation or treatment of testicular lesions. Orchiectomy is a proven treatment modality for prostatic cancer. Testicular biopsy is also of vital importance in the management of infertility especially relating to artificial reproductive technology. Histopathologic assessment of such specimens is therefore useful in the review of current urological practice.
Aim And Objectives:
This study aims to characterize the histologic spectrum of testicular lesions relating them to the various surgical procedures by which they were taken with a view to reviewing the current clinical practice in our environment.
Methodology:
Records of all testicular specimen received in the Department of Anatomic and Molecular Pathology from 2005 to 2014 were retrieved. Data such as age, indication for biopsy, nature of surgical specimen and histologic diagnosis for all such cases were retrieved from these records. They were classified, analyzed and represented in tables and charts using Microsoft Excel 2007.
Results:
A total of 173 testicular and paratesticular specimens were submitted during the study period constituting 0.7% of surgical specimens received during the study period. One hundred and sixty two (93.6%) were testicular while remaining 11 samples (6.4%) were paratesticular.The most common indication for the submission of testicular specimen was for the treatment of prostate cancer (42.2%) followed by presence of a mass (20.2%) and pain (19.7%). Orchiectomy specimens were the commonest samples received (79.8%). A significant proportion of orchiectomy cases (57.1%) wereperformed for benign lesions. Hypospermatogenesis with maturation arrest (57.8%), hypospermatogenesis (15.8%) and tubular hyalinization (15.8%) were the commonest histologic diagnoses of male infertility. Germ cell tumours were the commonest testicular neoplasms (62.5%). Seminoma was the commonest testicular malignancy (50%) while embryonal rhabdomyosarcoma was the only paratesticular malignancy seen.
Conclusion:
Treatment of prostate cancer was the commonest indication for testicular biopsies in our environment. Testicular tumours are not common. Twelve (57.1%) out of a total of 21 cases of testicular masses that had orchiectomy were benign lesions. With core needle biopsies and frozen section analysis, unnecessary orchiectomies can be avoided.
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