In March 2020, Xiao Chen (pseudonym), who was 22 years old at the time, always felt bloated and did not get better for a month.
It was really uncomfortable. He went to the hospital for an examination and found that there was a space occupant next to the duodenum.
The doctor recommended him to visit Sun Yat-sen University Cancer Center. After an investigation, it was found that the problem of abdominal distension was actually caused by the malignant transformation of “Egg”…
Professor Liu Zhuowei from the Department of Urology, who arranged for Xiao Chen to do a series of necessary examinations, finally found that the cryptorchidism that had descended on Xiao Chen’s right side had undergone malignant transformation, and there were multiple lungs in both lungs. Nodules may be cancer cells that have metastasized.
(Source: Photo courtesy of the hospital)
Why is this happening?
It started 14 years ago…
At the time of birth, Xiao Chen only had an “Egg” on the left side, and the scrotum on the other side was empty.
This disease is called cryptorchidism.
Popular Science Time
A normal male has 2 testicles in the scrotum.
Generally, the testicles descend into the scrotum before a baby boy is born. After birth, the testicles are already in the scrotum.
But sometimes, due to various factors, the baby’s testicles may not descend to the scrotum, but stay on the way of descending, which leads to cryptorchidism (also called incomplete testicular descent).
(Made by Tencent Medical Code)
Eggs that do not reach their destination, some are still alive, and some may shrink or become inactive. Cryptorchidism is also often associated with reproductive defects [1].
When she was 8 years old, her family took Xiao Chen to perform right orchidopexy to help Eggy return to her place. And this cancerous testicle is the one that underwent surgery at that time.
The reason is that the surgery was done a little late.
After the baby is born, it is possible for the late testicles to descend on their own, usually within 6 months after birth. In general, the farther the testicle is from the scrotum, the less likely it is to reach its normal position on its own.
After 6 months, Dandan is less and less likely to return on its own, and less likely to drop on its own after 1 year of age [2].
An egg that can’t be returned may become cancerous!
If the testis stays in the abdominal cavity, it is prone to malignant tumors, and it will also affect the spermatogenesis ability of the testis and affect future fertility.
Studies show that about 10% of all testicular tumors arise from cryptorchidism.
Men with cryptorchidism are two to eight times more likely to develop testicular tumors than healthy men [3-5].
Definitive treatment of cryptorchidism should be completed within 6-12 months after birth[6]. The main treatment method is surgery, that is, orchiopexy.
If a cryptorchidism is performed within 6 months of birth, the chance of testicular malignancy can be minimized.
Operation within 2 years of age can also reduce the risk of testicular malignancy to a certain extent.
If no surgery is performed over the age of 2, the risk of testicular malignancy increases with age [3].
Xiao Chen didn’t have surgery until he was 8 years old, which is really a bit late.
Help!
It’s okay to get married and have kids!
The doctor carefully checked and found that Xiao Chen’s testicular cancer had reached clinical stage III. But fortunately, testicular cancer is a tumor that is more sensitive to chemotherapy, and he still has hope of cure [7].
On July 27, 2020, Xiao Chen underwent minimally invasive surgery. The incision is small and recovery is smooth after surgery.
Subsequently, he received 4 courses of chemotherapy. The effect was very good, and the metastases in the lungs basically disappeared.
(Photo of Xiao Chen undergoing minimally invasive surgery. Source: Photo courtesy of the hospital)
In September 2021, Xiao Chen’s re-examination of tumor markers and CT showed no abnormalities, and the tumor was well controlled.
What’s even happier is that despite having undergone chemotherapy and only one egg is left, Xiao Chen’s androgen levels are also normal.
Currently, Xiao Chen’s sex life is normal and he has plans to get married.
Popular Science Time
Cryptorchidism is one of the common congenital urogenital malformations, and its incidence is on the rise. It has become one of the important causes of male infertility.
What is even more frightening is that cryptorchidism has become one of the most important causes of testicular malignancies, and the incidence has increased in recent years.
cryptorchidism, not far from us.
The incidence of cryptorchidism in term boys at 1 year of age is 1% to 4.6%.
The incidence of cryptorchidism is significantly increased in premature infants. In very low birth weight infants with a birth weight of less than 1500 g, the incidence of cryptorchidism is as high as 60% to 70% [8].
Remind novice parents that if you find that one side of the scrotum of your baby boy is empty, you must consult a doctor to find and deal with the problem in time!
Seriously, boys’ balls are really fragile. There is another kind of trauma that can also hurt a man.
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Forward this article to friends with kids
Maybe an innocent egg can be saved
Correspondents: Zhao Xianting, Chen], Wen Chaoyang
Sun Yat-sen University Cancer Center Party Office Publicity Section
Reviewers:
Liu Cheuk-wai
Chief Physician of Urology, Sun Yat-sen University Cancer Center
Li Xiangdong
Deputy Chief Physician, Department of Urology, Sun Yat-sen University Cancer Center
References
[1]BSR Allin, et al. Systematic review and meta-analysis comparing outcomes following orchidopexy for cryptorchidism before or after 1 year of age. BJS Open. 2018 Feb 5;2(1) :1-12.
[2] Huang Jian, et al. Guidelines for the diagnosis and treatment of benign diseases of the scrotum and penis. Guidelines for the diagnosis and treatment of urology and male diseases in China. Science Press, 2019:726.
[3] Wood HM, et al. Cryptorchidism and testicular cancer: separating fact from fiction. J Urol, 2009, 181(2): 452-462.
[4]Cook MB, et al. A systematic review and meta-analysis of perinatal variables in relation to the risk of testicular cancer-experiences of the son. Int J Epdemiol, 2010, 39 (6):1605-1618.
[5]Trabert B, et al. Congenital malformations and testicular germ cell tumors. Int J Caner, 2013, 133(8):1900-1904.
[6]Kolon TF, et al. Evaluation and treatment of cryptorchidism: AUA guideline. J Urol, 2014, 192(2):377-345.
[7]Zachary L S, et al. Testicular Cancer: Epidemiology, Diagnosis, and Management. Med Clin North Am. 2018 Mar;102(2):251-264.
[8]Sijestermans K, et al. The frequency of undescended testis from birth to adulthood: a review. Int J Androl, 2008, 31(1):1-11.
Editors: Zhang Jie, Zhang Li, Zhang Liang
Proofreading: Wu Yihe | Typesetting: Li Yongmin
Operation: Han Ningning | Coordinator: Wu Wei