Abdominal pain associated with an intra-abdominal gonad in an adult

Abstract

Controversy still surrounds management of cryptorchidism in adults. Options include orchiectomy, orchiopexy, and close observation. What about fertility if orchiectomy is chosen? How is the risk of cancer affected when observation is the choice? Follow the reasoning for the management strategy for this adult presenting with abdominal pain.

Figure 1

An abdominal CT scan demonstrating a right-sided, intra-abdominal testicle.

Figure 2

Laparoscopic view of the intra-abdominal testicle showing its position at the internal inguinal ring.

Figure 3

Microscopic view of the pathologic specimen demonstrating Leydig cell predominance and an almost complete lack of germ cells within the seminiferous tubules.