Delayed Presentation of Mixed Testicular Tumor 19 Years After Orchiopexy: A Case Report and Literature Review.

Background: Testicular cancer is a relatively rare malignancy, accounting for 1% of solid tumors in adult males and 5% of all urological tumors. Orchidopexy has been shown to lower the risk of testicular cancer, but it does not prevent it.

Case presentation: A 20-year-old adult male presented with a painful and palpable mass in his right testicle. The patient had orchidopexy at six months old but had been asymptomatic until his recent hospital visit. There was no previous history of cancer. Tumor markers including AFP and β-HCG were found to be elevated. Preoperative ultrasonograghy (USG) showed a solid and cystic mass of the right testis with increased vascularization. Following these findings, the patient underwent an orchidectomy. Histopathology examination revealed mixed type NSGCT of embryonal and choriocarcinoma. However, after completing four cycles of chemotherapy, a CT scan evaluation showed an enlarged mass in the abdomen, which was confirmed to be a mature teratoma.

Conclusion: In patients with a history of cryptorchidism, orchidopexy does not rule out the possibility of testicular cancer. Orchidopexy did reduce the risk of seminoma, but not nonseminomatous germ cell tumor, which in our case continued to develop a growing teratoma on the abdomen. It is essential to conduct long-term monitoring of patients who have undergone orchiopexy due to their risk of developing testicular cancer.