American Urological Association - Cryptorchid Testes
- Derived from Greek word crypto – hidden and orchid – testicle.
- Most common birth defect of male genitalia; affects 2-4% of male infants.
- Failure of testis to descend into scrotum and accounts for ~25% of cases of empty scrotum.
- Testes are generally found in the inguinal canal or upper scrotum; occasionally intraabdominal.
- Causes: anatomical abnormalities of the gubernaculum; hormonal dysfunction; mechanical impairment (short spermatic cord, underdeveloped vaginal process); dysgenesis (primary testicular anomaly); heredity.
- Opposite testis involved in 20%.
- Gross: cryptorchid testis is often smaller than the contralateral testis.
- Decreased diameter of seminiferous tubules (image A) & (image B).
- Tubules may contain only Sertoli cells and no spermatogonia.
- Tubular sclerosis and thickened hyalinized basement membranes are present.
- Relative Leydig cell "hyperplasia" – look more numerous because the rest of testis is atrophic.
- Hypoplastic rete testis.
- May have "pick adenoma" or Sertoli cell nodule.
- Precursor intratubular germ cell neoplasia (ITGCN) may be present.
- Increase risk of testicular cancer (5-10X, especially germ cell neoplasms, most commonly seminoma) and infertility.