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A case presentation with tranverse testicular ectopia.

ABSTRACT: Transverse testicular ectopia (TTE) is a rare congenital anomaly, in which both gonads migrate toward the same hemiscrotum with increased risk of testicular malignancy and associated with various abnormalities. Proper knowledge and imaging techniques are essential in diagnosis. Ultrasonography(USG) offer an easy, safe, and convenient alternative in assessment of TTE. We report a case of 41-year-male with infertility, who presented with left reducible inguinal hernia and right undescended testis. Final diagnosis was confirmed by USG and magnetic resonance imaging(MRI). The embryology, imaging features and USG evaluation of infertility are discussed with review of pertinent literature.

SUBMITTER: Wan J

PROVIDER: S-EPMC8085697 | biostudies-literature | 2021 Sep

REPOSITORIES: biostudies-literature

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A case presentation with tranverse testicular ectopia.

Wan Jinzhou J Wang Yu Y Song Huizhen H Tang Ying Y

Urology case reports 20210405

Transverse testicular ectopia (TTE) is a rare congenital anomaly, in which both gonads migrate toward the same hemiscrotum with increased risk of testicular malignancy and associated with various abnormalities. Proper knowledge and imaging techniques are essential in diagnosis. Ultrasonography(USG) offer an easy, safe, and convenient alternative in assessment of TTE. We report a case of 41-year-male with infertility, who presented with left reducible inguinal hernia and right undescended testis. ...[more]

PMID: 33981585

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Project description:BackgroundTransverse testicular ectopia (TTE) is a rare anomaly in which both testes descend through a single inguinal canal into the same hemiscrotum. Although almost 20-50% of patients with TTE exhibit persistent Müllerian duct syndrome (PMDS) and many genetic analyses have been performed, no reports have described the genes contributing to TTE without PMDS. Here, we report two cases of TTE without PMDS using immunohistochemical staining and genetic analysis.Case presentationTwo Asian patients with TTE without PMDS were subjected to orchiopexy. We performed testicular biopsies during operation and obtained blood samples before the operation. Testicular tissues were stained for c-kit, placental alkaline phosphatase (PLAP), and undifferentiated embryonic cell transcription factor 1 (UTF1) to evaluate the presence of intratubular malignant germ cells. Additionally, we performed polymerase chain reaction-based direct sequencing to identify single nucleotide polymorphisms in genes associated with regression of the Müllerian duct and testicular descent (that is, anti-Müllerian hormone [AMH], AMH receptor 2 [AMHR2], insulin-like 3 [INSL3], and relaxin family peptide receptor 2 [RXFP2]). The three-dimensional structures of proteins were predicted using SWISS-MODEL. In immunohistochemical analysis, c-kit and UTF1 were positive, whereas PLAP was negative in three testicular tissue samples from the two patients. These features were also detected on the unaffected side. In variant analysis, common missense variants in the AMH gene (g.365G>T; c.165G>T; p.Ser49Ile [rs10407022]) were observed. All variants in INSL3 and RXFP2 genes were intronic or silent.ConclusionsBecause UTF1, a specific marker of spermatogonial stem cell activity, was expressed in both the affected and unaffected sides in the testicular tissues of two patients, the risk of malignancy may be high in these patients. Although the etiology of TTE without PMDS remains unclear, our variant analysis results were consistent with previous reports, and variants in the AMH gene (rs10407022) may contribute to the specific phenotype of TTE without PMDS.

Dataset Information

A case presentation with tranverse testicular ectopia.

Publications

A case presentation with tranverse testicular ectopia.

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