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Cryptorchid

Patient Information

Age
13 Years
Gender
Male, Intact

Keywords

Exam Findings

Images

A right cryptorchid testicle was present at the level of L4 to the cranial right position of the urinary bladder apex. This meas
The left inguinal ring demonstrated a second left cryptorchid testicle measuring 1.4cm adjacent to the prostate.

History

A 14 year old MI Poodle canine presented for history of possible retained testicle. Clinical exam revealed an empty scrotal sac and lack of typical incision scar from a hypothetical neuter surgery. Rectal palpation revealed a prominent prostate.

Clinical Differential Diagnosis

Bilateral cryptorchid, testicular agenesis/hypogenesis, neutered male with non visible scar and residual prostatic disease (carcinoma, abscess, prostatitis, hypertrophy owing to ectopic androgen treatment.)

Image Interpretation

The prostate demonstrated relatively uniform enlargement with some urethral impingement. Nebulous hyperechoic parenchyma intercalated with focal hypoechoic changes suggestive of either chronic inflammatory episodes, benign cystic pathology or both. Underlying neoplasia is possible but lower on the differential list. Fine needle aspirate or a biopsy (preferred) following coagulation assessment would need to be performed in order to define the pathology at the cellular or structural level respectively. No overt abscess or obvious neoplasia was present. This presentation is most consistent with benign prostatic hyperplasia with possible chronic active prostatitis. The prostate measured 2.3cm in diameter. A right cryptorchid testicle was present at the level of L4 to the cranial right position of the urinary bladder apex. This measured 1.7cm with a mild amount of structural loss. This could represent an emerging Sertoli cell tumor. The left inguinal ring demonstrated a second left cryptorchid testicle measuring 1.4cm adjacent to the prostate.

Sonographic Differential Diagnosis

Prominent prostate, consistent with persistent androgen production from cryptorchid testicles Bilateral cryptorchid, left testicle inguinal position. Right testicle cranial right at the urinary bladder. BPH prostate.

Sampling

Bilateral orchiectomy was performed through an inguinal incision and through the linea alba for the intrabdominal testis cranial to the bladder.

DX

Bilateral cryptorchid, BPH.

Outcome

Patient recovered normally. Histopathology not performed.

Videos

Left inguinal hypoechoic testicle in the near field and uniform, slightly swollen and heterogenous prostate.
Crypt intra-abdominal right testicle in the near field cranial to the urinary bladder.