Journal of Peking University(Health Sciences) ›› 2019, Vol. 51 ›› Issue (2): 365-368. doi: 10.19723/j.issn.1671-167X.2019.02.032

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Organ-sparing partial orchietectomy for testicular adenomatoid tumor

Jian-fei YE,Bing WANG,Lu-lin MA(),Lei ZHAO,Guo-liang WANG,Kai HONG   

  1. Department of Urology, Peking University Third Hospital, Beijing 100191, China
  • Received:2017-03-16 Online:2019-04-18 Published:2019-04-26
  • Contact: Lu-lin MA E-mail:malulin@medmail.com.cn

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Abstract:

Objective: The incidence of testicular tumors is relatively low which are mainly malignant, so the main way to treat testicular tumors is radical testicular resection. Testicular adenomatoid tumor is a rare testicular benign tumor, but is easily misdiagnosed as malignant tumors with removal of organs. This article aims to explore the clinical features of testicular adenomatoid tumor and its treatment.Methods: There were 133 cases of testicular tumor in the Peking University Third Hospital from May 1994 to November 2016. We conducted a retrospective analysis of three patients who underwent the treatment of partial orchiectomy with preservation of the organ and were pathologically diagnosed with testicular adenomatoid tumor after surgery. The follow-up was done by outpatient clinics and telephone inquiry after surgery. The related literature was also reviewed for further discussion.Results: Of all the 133 patients, 116 had radical resection of the testis and 17 had partial testicular resection due to specific reasons (5 cases of epidermoid cyst, 4 cases of teratoma, 3 cases of seminoma, 3 cases of adenomatoid tumor, and 2 cases of Sertoli cell tumor). The mean age of the 3 patients was (42.67±10.97) years (30-49 years), the mean hospital stay was (9.00±5.20) d (6-15 d), the mean body mass index was (26.20±1.42) kg/m 2 (25.00-27.76 kg/m 2), the mean serum human choionic gonadotophin (HCG) was (1.15±0.11) IU/L (1.07-1.23 IU/L) (all normal) and the mean serum alpha-fetoprotein (AFP) was (2.12±0.66) μg/L (1.65-2.58 μg/L) (both were normal). Ultrasound features revealed a clear or unclear border, solid, moderate echo nodule tumor in the testis. The mean maximal diameter of the tumor was (1.00±0.44) cm (0.50-1.30 cm), and the mean duration of intraoperative warm ischemia time was (19.67±17.10) min (0-31 min) (only the last two cases). No recurrence or malignant transformation was observed during the follow-up. Conclusion: Testicular adenomatoid tumor is mainly based on the characteristics of ultrasound to determine preoperatively, but easy to be misdiagnosed with testicular radical resection. The recommended surgery for adenomatoid tumor is partial resection of the testis via the inguinal approach according to the frozen section pathology to determine whether to retain the organ.

Key words: Testicular neoplasms, Adenomatoid tumor, Organ-sparing, Partial orchiectomy

CLC Number: 

  • R737.21

Table 1

Basic data of the 3 patients of testicular adenomatoid tumor"

No. Age/years Side Chief complain
1 49 Left Palpable mass in the left scrotum for 10 days
2 30 Right Palpable mass in the right scrotum for 6 months
3 49 Right Painful mass in the right testis for 2 months

Table 2

Perioperative data of the 3 patients of testicular adenomatoid tumor"

No. HCG/(IU/L) AFP/(μg/L) The largest diameter/cm Approach Surgery Ischemia time/min
1 - - 0.5 Scrotum Partialorchiectomy 0
2 1.23 1.65 1.3 Inguinal Partialorchiectomy 28
3 1.07 2.58 1.2 Inguinal Partialorchiectomy 31

Figure 1

Ultrasonography of adenomatoid tumor of testis"

Figure 2

Pathology of adenomatoid tumor of testis (HE ×200)"

[1] Albers P, Albrecht W, Algaba F , et al. Guidelines on testicular cancer: 2015 Update[J]. Eur Urol, 2015,68(6):1054-1068.
doi: 10.1016/j.eururo.2015.07.044
[2] 那彦群, 叶章群, 孙颖浩 , 等. 中国泌尿外科疾病诊断治疗指南(2014版)[M]. 北京: 人民卫生出版社, 2014: 90-114.
[3] Motzer RJ, Jonasch E, Agarwal N , et al. Testicular cancer, version 2.2015[J]. J Natl Compr Canc Netw, 2015,13(6):772-799.
doi: 10.6004/jnccn.2015.0092
[4] Makkar M, Dayal P, Gupta C , et al. Adenomatoid tumor of testis: A rare cytological diagnosis[J]. J Cytol, 2013,30(1):65-67.
doi: 10.4103/0970-9371.107519
[5] Liu W, Wu RD, Yu QH . Adenomatoid tumor of the testis in a child[J]. J Pediatr Surg, 2011,46(10):E15-E17.
[6] Alexiev BA, Xu LF, Heath JE , et al. Adenomatoid tumor of the testis with intratesticular growth: a case report and review of the literature[J]. Int J Surg Pathol, 2011,19(6):838-842.
doi: 10.1177/1066896911398656
[7] 沈华, 李权, 缪俊俊 , 等. 睾丸腺瘤样瘤2例并文献复习[J]. 中国男科学杂志, 2016,30(2):37-41.
[8] 盛斌武, 马茂, 南勋义 . 睾丸腺瘤样瘤1例报道[J]. 中国医科大学学报, 2010,39(11):970-971.
[9] Kassis A . Testicular adenomatoid tumours: clinical and ultrasonographic characteristics[J]. BJU Int, 2000,85(3):302-304.
doi: 10.1046/j.1464-410x.2000.00445.x
[10] Williams SB, Han M, Jones R , et al. Adenomatoid tumor of the testes[J]. Urology, 2004,63(4):779-781.
[11] Amin W, Parwani AV . Adenomatoid tumor of testis[J]. Clin Med Pathol, 2009(2):17-22.
[12] 李志强, 崔立刚, 陈文 , 等. 阴囊内腺瘤样瘤的声像图表现[J]. 中国超声医学杂志, 2013,29(11):1047-1049.
[13] Elert A, Olbert P, Hegele A , et al. Accuracy of frozen section examination of testicular tumors of uncertain origin[J]. Eur Urol, 2002,41(3):290-293.
doi: 10.1016/S0302-2838(02)00004-0
[14] 苏煌, 刘边疆, 宋宁宏 , 等. 保留睾丸手术治疗良性睾丸肿瘤的临床应用[J]. 中华男科学杂志, 2014,20(11):1020-1024.
[15] Evans K . Rapidly growing adenomatoid tumor extending into testicular parenchyma mimics testicular carcinoma[J]. Urology, 2004,64(3):589.
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