Bir Üniversite Hastanesine Başvuran Erkek İnfertilite Tanılı ve Asemptomatik Hastalarda Testis Tümörü Sıklığı
Öz
Amaç: Testis tümörü genç erişkin erkeklerde en sık görülen kanserdir. İnmemiş testis, testis tümörü riskini artıran en önemli sebep olmakla birlikte birinci derece akrabalarda testis kanseri öyküsü, karşı testiste insitu germ hücre neoplazisi ve testiküler disgenezis sendromu etyolojide yer almaktadır. Bu çalışmadaki amaç erkek infertilitesi tanısı ile incelenen hastalarda testis tümörü sıklığını araştırmaktır.
Hastalar ve Yöntem: Ağustos 2015 - Ağustos 2018 tarihleri arasında üroloji polikliniğine infertilite şikayeti ile başvuran veya kadın hastalıkları ve doğum kliniklerinden konsülte edilen erkek faktörü tanılı 954 erkek hastanın retrospektif değerlendirilmesi yapıldı. Hastaların anamnez, fizik muayene ve spermiogram bulguları kayıt edildi. Yapılan rutin fizik muayenelerinde testiküler kitle saptanan ve bu nedenle radikal orşiektomi yapılan hastaların verileri analiz edildi.
Bulgular: İncelenen 954 erkek hastanın dördünde sağ, birinde ise sol testiküler kitle saptandı. Hastaların yaş ortalaması 31,6 (30-35) idi. Bu hastaların hiçbirinde inmemiş testis öyküsü mevcut değildi. Tüm hastaların tümör belirteçleri normal, yapılan bilgisayarlı tomografilerinde lenf nodu veya organ metastazı izlenmedi. Beş hastanın üçünde oligospermi , ikisinde azospermi mevcuttu. Yapılan inguinal orşiektomi operasyon patolojileri ise tüm hastalarda saf seminom olarak raporlandı.
Sonuç: Özelllikle infertil erkek hastalarda testis muayenesi yapılırken artmış risk nedeniyle dikkatli olunmasının ve bu popülasyondaki bireylere kendi kendine yapılacakları testis muayenesinin erken tanıda önemli olduğu düşünülmektedir.
Anahtar Kelimeler
Destekleyen Kurum
yok
Proje Numarası
yok
Kaynakça
- La Vecchia C, Bosetti C, Lucchini F, Bertuccio P, Negri E, Boyle P et al. Cancer mortality in Europe, 2000-2004, and an overview of trends since 1975. Ann Oncol 2010;21:1323-60.
- Rosen A, Jayram G, Drazer M, Eggener SE. Global trends in testicular cancer incidence and mortality. Eur Urol 2011;60:374-9.
- Manecksha RP, Fitzpatrick JM. Epidemiology of testicular cancer. BJU Int 2009;104:1329-33.
- Walsh TJ, Croughan MS, Schembri M, Chan JM, Turek PJ. Increased risk of testicular germ cell cancer among infertile men. Arch Intern Med 2009;169:351-6.
- Eisenberg ML, Betts P, Herder D, Lamb DJ, Lipshultz LI. Increased risk of cancer among azoospermic men. Fertil Steril 2013;100:681-5.
- Dada R, Kumar M, Jesudasan R, Fernandez JL, Gosalvez J, Agarwal A. Epigenetics and its role in male infertility. J Assist Reprod Genet 2012;29:213-23.
- Hotaling JM, Walsh TJ. Male infertility: a risk factor for testicular cancer. Nat Rev Urol 2009;6:550-6.
- Gonsalves J, Sun F, Schlegel PN, Turek PJ, Hopps CV, Greene C et al. Defective recombination in infertile men. Hum Mol Genet 2004;13:2875-83.
- Maduro MR, Lamb DJ. Understanding new genetics of male infertility. J Urol 2002;168:2197-205.
- Ji G, Long Y, Zhou Y, Huang C, Gu A, Wang X. Common variants in mismatch repair genes associated with increased risk of sperm DNA damage and male infertility. BMC Med 2012;10:49.
- Germa-Lluch JR, Garcia del Muro X, Maroto P, Paz-Ares L, Arranz JA, Guma J et al. Clinical pattern and therapeutic results achieved in 1490 patients with germ-cell tumours of the testis: the experience of the Spanish Germ-Cell Cancer Group (GG). Eur Urol 2002;42:553-62.
- Moul JW. Timely diagnosis of testicular cancer. Urol Clin North Am 2007;34:109-17.
- Zapzalka DM, Redmon JB, Pryor JL. A survey of oncologists regarding sperm cryopreservation and assisted reproductive techniques for male cancer patients. Cancer 1999;86:1812-7.
- Hartmann JT, Albrecht C, Schmoll HJ, Kuczyk MA, Kollmannsberger C, Bokemeyer C. Long-term effects on sexual function and fertility after treatment of testicular cancer. Br J Cancer 1999;80:801-7.
- Ho GT, Gardner H, DeWolf WC, Loughlin KR, Morgentaler A. Influence of testicular carcinoma on ipsilateral spermatogenesis. J Urol 1992;148:821-5.
- Agarwal A, Allamaneni SS. Disruption of spermatogenesis by the cancer disease process. J Natl Cancer Inst Monogr 2005;(34):9-12.
- Höbarth K, Klingler HC, Maier U, Kollaritsch H. Incidence of antisperm antibodies in patients with carcinoma of the testis and in subfertile men with normogonadotropic oligoasthenoteratozoospermia. Urol Int 1994;52:162-5.
- Petersen PM, Skakkebaek NE, Rorth M, Giwercman A. Semen quality and reproductive hormones before and after orchiectomy in men with testicular cancer. J Urol 1999;161:822-6.
- Petersen PM, Hansen SW, Giwercman A, Rorth M, Skakkebaek NE. Dose-dependent impairment of testicular function in patients treated with cisplatin-based chemotherapy for germ cell cancer. Ann Oncol 1994;5:355-8.
- Jacobsen R, Bostofte E, Engholm G, Hansen J, Olsen JH, Skakkebaek NE et al. Risk of testicular cancer in men with abnormal semen characteristics: cohort study. BMJ 2000;321:789–92.
- Hanson HA, Anderson RE, Aston KI, Carrell DT, Smith KR, Hotaling JM. Subfertility increases risk of testicular cancer: evidence from population-based semen samples. Fertil Steril 2016;105:322-8.e1.
- Raman JD, Nobert CF, Goldstein M. Increased incidence of testicular cancer in men presenting with infertility and abnormal semen analysis. J Urol 2005;174:1819-22.
- Znaor A, Lortet-Tieulent J, Jemal A, Bray F. International variations and trends in testicular cancer incidence and mortality. Eur Urol 2014;65:1095-106.
- Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 2010;127:2893-917.
- Albers P, Albrecht W, Algaba F, Bokemeyer C, Cohn-Cedermark G, Fizazi K et al. European Association of Urology. Guidelines on Testicular Cancer: 2015 Update. Eur Urol 2015;68:1054-68.
- Westlake SJ, Frank JW. Testicular self-examination: an argument against routine teaching. Fam Pract 1987;4:143-8.
Frequency of Testicular Tumor in Patients with a Diagnosis of Infertility and Asymptomatic Male Applied to a University Hospital
Öz
Purpose: Testicular tumor is the most common cancer among the young adult men. Although the undescended testicle is the most common cause which increases the risk of testicular tumor, the testicular cancer diagnosis of any of the first degree relatives, in situ germ cell neoplasia of the other testicle and the testicular dysgenesis syndrome are also included in the etiology. The aim of this study is to investigate the frequency of testicular tumor in patients with infertility.
Methods and Materials: 954 male patients, who presented to the urology polyclinic with a complaint of infertility or who were consulted from gynecology and obstetrics clinics with male infertility factor, between August 2015 and August 2018, were evaluated retrospectively. Medical records, physical examination and spermiogram findings were considered. The data of the patients who were diagnosed with testicular mass through physical examinations and underwent radical orchiectomy, were analyzed.
Results: Of 954 evaluated male patients with a mean age of 31,6 (30-35) years, four had right testicular mass and one had left testicular mass. None of these patients had a medical record of undescended testicle. Tumor markers of all patients were normal and neither lymph node nor organ metastasis were observed through computerized tomography analysis. 3 of 5 patients had oligospermia and 2 had azoospermia. Pathologic diagnosis of inguinal orchiectomy materials were reported as pure seminoma in all patients.
Conclusions: Especially in infertile male patients, when performing testicular examination it should be taken into consideration that there is an increased risk of testicular tumor. It is considered that informing individuals of this population about doing an examination of testicle is important in early diagnosis.
Anahtar Kelimeler
Proje Numarası
yok
Kaynakça
- La Vecchia C, Bosetti C, Lucchini F, Bertuccio P, Negri E, Boyle P et al. Cancer mortality in Europe, 2000-2004, and an overview of trends since 1975. Ann Oncol 2010;21:1323-60.
- Rosen A, Jayram G, Drazer M, Eggener SE. Global trends in testicular cancer incidence and mortality. Eur Urol 2011;60:374-9.
- Manecksha RP, Fitzpatrick JM. Epidemiology of testicular cancer. BJU Int 2009;104:1329-33.
- Walsh TJ, Croughan MS, Schembri M, Chan JM, Turek PJ. Increased risk of testicular germ cell cancer among infertile men. Arch Intern Med 2009;169:351-6.
- Eisenberg ML, Betts P, Herder D, Lamb DJ, Lipshultz LI. Increased risk of cancer among azoospermic men. Fertil Steril 2013;100:681-5.
- Dada R, Kumar M, Jesudasan R, Fernandez JL, Gosalvez J, Agarwal A. Epigenetics and its role in male infertility. J Assist Reprod Genet 2012;29:213-23.
- Hotaling JM, Walsh TJ. Male infertility: a risk factor for testicular cancer. Nat Rev Urol 2009;6:550-6.
- Gonsalves J, Sun F, Schlegel PN, Turek PJ, Hopps CV, Greene C et al. Defective recombination in infertile men. Hum Mol Genet 2004;13:2875-83.
- Maduro MR, Lamb DJ. Understanding new genetics of male infertility. J Urol 2002;168:2197-205.
- Ji G, Long Y, Zhou Y, Huang C, Gu A, Wang X. Common variants in mismatch repair genes associated with increased risk of sperm DNA damage and male infertility. BMC Med 2012;10:49.
- Germa-Lluch JR, Garcia del Muro X, Maroto P, Paz-Ares L, Arranz JA, Guma J et al. Clinical pattern and therapeutic results achieved in 1490 patients with germ-cell tumours of the testis: the experience of the Spanish Germ-Cell Cancer Group (GG). Eur Urol 2002;42:553-62.
- Moul JW. Timely diagnosis of testicular cancer. Urol Clin North Am 2007;34:109-17.
- Zapzalka DM, Redmon JB, Pryor JL. A survey of oncologists regarding sperm cryopreservation and assisted reproductive techniques for male cancer patients. Cancer 1999;86:1812-7.
- Hartmann JT, Albrecht C, Schmoll HJ, Kuczyk MA, Kollmannsberger C, Bokemeyer C. Long-term effects on sexual function and fertility after treatment of testicular cancer. Br J Cancer 1999;80:801-7.
- Ho GT, Gardner H, DeWolf WC, Loughlin KR, Morgentaler A. Influence of testicular carcinoma on ipsilateral spermatogenesis. J Urol 1992;148:821-5.
- Agarwal A, Allamaneni SS. Disruption of spermatogenesis by the cancer disease process. J Natl Cancer Inst Monogr 2005;(34):9-12.
- Höbarth K, Klingler HC, Maier U, Kollaritsch H. Incidence of antisperm antibodies in patients with carcinoma of the testis and in subfertile men with normogonadotropic oligoasthenoteratozoospermia. Urol Int 1994;52:162-5.
- Petersen PM, Skakkebaek NE, Rorth M, Giwercman A. Semen quality and reproductive hormones before and after orchiectomy in men with testicular cancer. J Urol 1999;161:822-6.
- Petersen PM, Hansen SW, Giwercman A, Rorth M, Skakkebaek NE. Dose-dependent impairment of testicular function in patients treated with cisplatin-based chemotherapy for germ cell cancer. Ann Oncol 1994;5:355-8.
- Jacobsen R, Bostofte E, Engholm G, Hansen J, Olsen JH, Skakkebaek NE et al. Risk of testicular cancer in men with abnormal semen characteristics: cohort study. BMJ 2000;321:789–92.
- Hanson HA, Anderson RE, Aston KI, Carrell DT, Smith KR, Hotaling JM. Subfertility increases risk of testicular cancer: evidence from population-based semen samples. Fertil Steril 2016;105:322-8.e1.
- Raman JD, Nobert CF, Goldstein M. Increased incidence of testicular cancer in men presenting with infertility and abnormal semen analysis. J Urol 2005;174:1819-22.
- Znaor A, Lortet-Tieulent J, Jemal A, Bray F. International variations and trends in testicular cancer incidence and mortality. Eur Urol 2014;65:1095-106.
- Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 2010;127:2893-917.
- Albers P, Albrecht W, Algaba F, Bokemeyer C, Cohn-Cedermark G, Fizazi K et al. European Association of Urology. Guidelines on Testicular Cancer: 2015 Update. Eur Urol 2015;68:1054-68.
- Westlake SJ, Frank JW. Testicular self-examination: an argument against routine teaching. Fam Pract 1987;4:143-8.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Proje Numarası | yok |
| Yayımlanma Tarihi | 1 Temmuz 2021 |
| Gönderilme Tarihi | 18 Aralık 2020 |
| Yayımlandığı Sayı | Yıl 2021Cilt: 12 Sayı: 3 |
