Posted by CLDing on August 07, 1999 at 10:03:59:
In Reply to: Re: Undescended Testes posted by Chit Sin on August 06, 1999 at 23:39:40:
I advised exploration of both inguinal regions with view to bilateral orchiectomy. Androgen replacement was discussed and agreed upon. Foremost at the back of my mind was Ca testis, which prompted me to advise this drastic move. Such testes have a 40 - 50 fold increased chance of malignancy and being useless for reproduction and with the ease of hormonal replacement, I advised him to opt for bilateral orchiectomy - after all if this was unilateral the advice would be very readily given.
At exploration, both testes were trapped among scar tissue at the root of scrotum-superficial inguinal ring region. Each measured 2.5cm and were soft. I removed both of them.
Histopathology shows intraductal seminoma in both testicles with local infiltration and on the right side with infiltration of capsule. His tumour markers were negative and CT abdomen did not reveal any retroperitoneal lymphadenopathy and his CXR is clear.
What will you advise next?