Malignancy in an Undescended Intra-abdominal Testis: a Single Institution Experience

Cryptorchidism is one of the most common congenital anomalies of the genitourinary tract, encountered in 1% of men. The cancer risk in an ectopic testis is 40 times higher than a scrotal testis. However, not much literature is available on the management of this rare presentation of testicular cancer. A retrospective analysis was conducted at our institute of patients who were diagnosed with carcinoma in an undescended intra-abdominal testis between 2014 and 2019. Patients with an intra-abdominal mass with an empty hemiscrotum/scrotum were included in the study. In all 10 patients were identified with a mean age of 32 years. Four patients were non-seminomatous germ cell tumors, and other 6 were seminomatous tumors. Five were in stage I, two in stage II, and three in stage III. Six patients received induction chemotherapy with bleomycin, etoposide, and cisplatin, and four had complete response. Five patients underwent laparoscopic excision, and five underwent open surgery. Two patients with bilateral (B/L) cryptorchidism underwent contralateral orchidopexy. Two patients with B/L intra-abdominal gonads and uterus underwent excision of the malignant testicular mass with removal of atrophic uterus and contralateral dysgenetic gonad. One patient developed peritoneal recurrence within 3 months of completion of surgery. Both recurrence-free and overall survival were 90% after a median follow-up of 35 months. Malignancy in an undescended intra-abdominal testis is a rare presentation of testicular cancer, diagnosis of which requires a sharp correlation between clinical and radiological findings. There management and prognosis remains similar to classical testicular cancer.