In March 2020, Xiao Chen (pseudonym), who was 22 years old at the time, always felt that his stomach was bloated and did not get better for 1 month.
It was so uncomfortable that he went to the hospital for a check-up and found that there was a place next to the duodenum (colloquially speaking, "extra things").
The doctor recommended him to go to the Cancer Prevention and Treatment Center of Sun Yat-sen University. A check found that the problem of bloating was actually caused by the vicious change of "egg eggs"...
The patient was Professor Liu Zhuowei of the Department of Urology, who arranged for Xiao Chen to do a series of necessary examinations, and finally found that Xiao Chen's right side of the descending cryptorchidism had changed malignantly, and there were also multiple nodules in both lungs, which may have metastasized cancer cells.
(Source: Courtesy of the hospital)
Why is that?
It all started 14 years ago...
At birth, Xiao Chen only had one "egg" on the left side, and the scrotum on the other side was empty.
This disease is called cryptorchidism.
Popular science time
In the scrotum of a normal man, there are 2 testicles.
In general, before a baby boy is born, the testicles descend to the scrotum. After birth, the testicles are already inside the scrotum.
But sometimes, due to various factors, the baby's testicles may not fall to the scrotum, but stay on the way down, resulting in cryptorchidism (also called incomplete testicular decline).
(Tencent Medical Code)
Some of the "eggs" that do not reach their destination are still alive, while others may shrink or be inactivated. Cryptorchidism is also often associated with reproductive defects [1].
When he was 8 years old, his family took Xiao Chen to do a right testicular descent fixation to help the egg return to position. And the cancerous testicle this time is the one who underwent surgery at that time.
The reason is that the surgery was done a little late.
After the baby is born, it is possible for the late testicles to descend on their own, usually within 6 months of birth. In general, the farther the testicles are from the scrotum, the less likely they are to reach their normal position on their own.
After 6 months, the egg is less and less likely to return to its own position, and it is unlikely to decline on its own after the age of 1 year [2].
Eggs that cannot be returned to their place may become cancerous!
If the testicles stay in the abdominal cavity, they are prone to malignant tumors, which will also affect the spermatogenic ability of the testicles and affect future fertility.
Studies have shown that about 10% of all testicular tumors come from cryptorchidism.
Men with cryptorchidism have a two- to eight-fold risk of developing testicular tumors than healthy men [3-5].
Definitive treatment of cryptorchidism must be completed within 6 to 12 months of birth [6]. Treatment is predominantly surgery, which is testicular descent fixation.
If cryptorchidism is performed within 6 months of birth, the chance of testicular malignancy can be minimized.
If surgery is performed within the age of 2 years, the risk of testicular malignancy can also be reduced to some extent.
If you are over 2 years of age and have not had surgery, the risk of testicular malignancy increases with age [3].
Xiao Chen did not have surgery until he was 8 years old, which was really a bit late.
can be saved!
It's no problem to get married and have a baby!
The doctor's careful examination found that Xiao Chen's testicular cancer had reached clinical stage III. Fortunately, testicular cancer is a tumor that is sensitive to chemotherapy, and he still has hope of a cure .[7]
On July 27, 2020, Xiao Chen underwent minimally invasive surgery. The incision was small and the recovery after the operation was smooth.
Subsequently, he received 4 courses of chemotherapy, the effect was very good, and the metastases in the lungs basically disappeared.
(Photo of Xiao Chen undergoing minimally invasive surgery.) Source: Courtesy of the hospital)
In September 2021, Xiao Chen reviewed the tumor markers and CT without abnormalities, and the tumor control was very good.
What's even happier is that although he has been treated with chemotherapy and only one egg left, Xiao Chen's androgen levels are also normal.
At present, Xiao Chen's sex life is normal and he has plans to get married.
Cryptorchidism, one of the common congenital genitourinary malformations, has an increasing incidence and has become one of the important causes of male infertility.
What is even more frightening is that cryptorchidism has become one of the most important causes of testicular malignancy, and the incidence trend has increased in recent years.
Cryptorchidism, not far from us.
In full-term male infants, the incidence of cryptorchidism is 1% to 4.6% at the age of 1 year.
The incidence of cryptorchidism in preterm infants is significantly increased. Very low birth weight infants weighing less than 1,500 g at birth have a prevalence of cryptorchidism as high as 60% to 70% [8].
Remind all new parents, if you find that one side of the male baby's scrotum is empty, remember to consult a doctor to find and deal with the problem in time!
Seriously, boys' eggs are really fragile. There is also a kind of trauma that can also hurt men.
Poke the video to find out
Forward this article to your little friend with a baby
Maybe you can save an innocent egg
Correspondents: Zhao Xianting, Chen Zheng, Wen Chaoyang
The Party-run Propaganda Department of the Cancer Prevention and Control Center of Sun Yat-sen University
Reviewers:
Liu Zhuowei
Chief Physician of The Department of Urology, Cancer Prevention and Control Center of Sun Yat-sen University
Lee to the east
Deputy Chief Physician of The Department of Urology, Cancer Prevention and Control Center of Sun Yat-sen University
bibliography
[1] B S R Allin, et al. Systematic review and meta-analysis comparing outcomes following orchidopexy for cryptorchidism before or after 1 year of age. BJS Open. 2018 Feb 5;2(1):1-12.
Huang Jian, et al. Guidelines for the diagnosis and treatment of benign diseases of the scrotum and penis. Guidelines for the Diagnosis and Treatment of Urology and Male Diseases in China. Science Press, 2019:726.
[3] Wood HM, et al. Cryptorchidism and testicular cancer: separating fact from fiction. J Urol, 2009, 181(2): 452-462.
[4] Cook MB, et al. A systematic review and meta-analysis of perinatal variables in relation to the risk of testicular cancer-experiences of the son. Int J Epdemiol, 2010, 39(6):1605-1618.
[5] Trabert B, et al. Congenital malformations and testicular germ cell tumors. Int J Caner, 2013, 133(8):1900-1904.
[6] Kolon TF, et al. Evaluation and treatment of cryptorchidism: AUA guideline. J Urol, 2014, 192(2):377-345.
[7] Zachary L S, et al. Testicular Cancer: Epidemiology, Diagnosis, and Management. Med Clin North Am. 2018 Mar;102(2):251-264.
[8] Sijestermans K, et al. The frequency of undescended testis from birth to adulthood: a review. Int J Androl, 2008, 31(1)：1-11.
Editors: Zhang Jie, Zhang Li, Zhang Liang
Proofreading: Wu Yihe | Typesetting: Li Yongmin
Operation: Han Ningning | Coordinator: Wu Wei