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摘要: 睾丸异位症指睾丸在下降过程中发生了异常的迁移，是隐睾的一种类型。睾丸异位症的发病机制暂未明确，目前认为与遗传因素、胰岛素样激素、雄激素、生殖股神经、降钙素基因相关肽及引带的发育有关。睾丸异位症一旦发现，为延缓患儿患侧睾丸的退化及患侧睾丸的癌变进程，应积极行手术治疗。本综述就睾丸异位症的定义、分类、发病机制、合并疾病及诊疗现状作一综述。Abstract: Testicular ectopia refers to an abnormal migration of the testis during descent, and is a type of cryptorchidism. The pathogenesis of testicular ectopia is not clear yet, and is currently thought to be related to genetic factors, insulin-like hormones, androgens, genitofemoral nerves, calcitonin gene-related peptides, and the development of the leading zones. Once testicular ectopia is detected, it should be treated surgically in order to slow down the degeneration of the affected testis and the cancerous process of the affected testis. In this review, the definition, classification, pathogenesis, co-morbidities and current status of testicular ectopia are reviewed.
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Key words:
- children /
- testicular ectopia /
- treatment
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[1] Nounla J, Tröbs RB, Rolle U. Perineal ectopic testis: a rare cause of empty scrotum[J]. Urol Int, 2001, 67(3): 246-248. doi: 10.1159/000050997
[2] 薛恩生, 林礼务, 林晓东, 等. 睾丸下降异常的超声解剖定位及其分类的研究[J]. 中华超声影像学杂志, 2005, 14(8): 601-603. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHCY200508014.htm
[3] Hutcheson JC, Snyder HM 3rd, Zuñiga ZV, et al. Ectopic and undescended testes: 2 variants of a single congenital anomaly?[J]. J Urol, 2000, 163(3): 961-963. doi: 10.1016/S0022-5347(05)67864-0
[4] Sijstermans K, Hack WWM, Meijer RW, et al. The frequency of undescended testis from birth to adulthood: a review[J]. Int J Androl, 2008, 31(1): 1-11. doi: 10.1111/j.1365-2605.2007.00770.x
[5] 黄文琳, 徐勇, 刘劲戈. 1例隐睾症家系的外显子测序分析[J]. 临床泌尿外科杂志, 2023, 38(5): 382-386. doi: 10.13201/j.issn.1001-1420.2023.05.015
[6] Nistal M, Paniagua R, González-Peramato P, et al. Perspectives in pediatric pathology, chapter 9. alterations in the number and location of the testis[J]. Pediatr Dev Pathol, 2015, 18(6): 433-445. doi: 10.2350/14-04-1468-PB.1
[7] Punwani VV, Wong JSY, Lai CYH, et al. Testicular ectopia: Why does it happen and what do we do?[J]. J Pediatr Surg, 2017, 52(11): 1842-1847. doi: 10.1016/j.jpedsurg.2016.12.009
[8] Alamsahebpour A, Blachman-Braun R, Gupta A, et al. Laparoscopy and transseptal orchiopexy in the management of transverse testicular ectopia[J]. Curr Urol Rep, 2015, 16(7): 48. doi: 10.1007/s11934-015-0515-9
[9] Yang M, Lin XB, Liu ZJ, et al. Transverse testicular ectopia with persistent Mullerian duct syndrome: Report and review of two cases[J]. Andrologia, 2022, 54(11): e14637.
[10] Zhou GL, Yin JC, Jiang M, et al. Clinical characteristics, ultrasonographic findings, and treatment of pediatric transverse testicular ectopia: a 10-year retrospective review[J]. Urology, 2021, 154: 249-254. doi: 10.1016/j.urology.2021.01.006
[11] Vikraman J, Hutson JM, Li RL, et al. The undescended testis: Clinical management and scientific advances[J]. Semin Pediatr Surg, 2016, 25(4): 241-248. doi: 10.1053/j.sempedsurg.2016.05.007
[12] Hutson JM, Southwell BR, Li RL, et al. The regulation of testicular descent and the effects of cryptorchidism[J]. Endocr Rev, 2013, 34(5): 725-752. doi: 10.1210/er.2012-1089
[13] Alaqeel SM, Hakeem AH, Almaary JO. Testicular ectopia in a child's anterior abdominal wall: a case report and literature review[J]. Am J Case Rep, 2020, 21: e927495.
[14] Raitio A, Syvänen J, Tauriainen A, et al. Congenital abdominal wall defects and cryptorchidism: a population-based study[J]. Pediatr Surg Int, 2021, 37(7): 837-841. doi: 10.1007/s00383-021-04863-9
[15] Naji H, Peristeris A, Stenman J, et al. Transverse testicular ectopia: three additional cases and a review of the literature[J]. Pediatr Surg Int, 2012, 28(7): 703-706. doi: 10.1007/s00383-012-3105-7
[16] Yong EX, Huynh J, Farmer P, et al. Calcitonin gene-related peptide stimulates mitosis in the tip of the rat gubernaculum in vitro and provides the chemotactic signals to control gubernacular migration during testicular descent[J]. J Pediatr Surg, 2008, 43(8): 1533-1539. doi: 10.1016/j.jpedsurg.2007.11.037
[17] Kaplan LM, Koyle MA, Kaplan GW, et al. Association between abdominal wall defects and cryptorchidism[J]. J Urol, 1986, 136(3): 645-647. doi: 10.1016/S0022-5347(17)45003-8
[18] Logsdon NT, Sampaio FJB, Favorito LA. The role of intra-abdominal pressure in human testicular migration[J]. Int Braz J Urol, 2021, 47(1): 36-44. doi: 10.1590/s1677-5538.ibju.2021.99.03
[19] Cromie WJ. Congenital anomalies of the testis, vas epididymis, and inguinal canal[J]. Urol Clin North Am, 1978, 5(1): 237-252. doi: 10.1016/S0094-0143(21)00031-8
[20] Mirilas P, Mentessidou A. The secondary external inguinal ring and associated fascial planes: surgical anatomy, embryology, applications[J]. Hernia, 2013, 17(3): 379-389. doi: 10.1007/s10029-013-1048-0
[21] Braga LH, Lorenzo AJ, Pippi Salle JL, et al. Patency of the "third inguinal ring" in children with unilateral cryptorchidism: fact or fiction?[J]. Z Fur Kinderchirurgie, 2008, 18(4): 237-240.
[22] Gauderer MW, Grisoni ER, Stellato TA, et al. Transverse testicular ectopia[J]. J Pediatr Surg, 1982, 17(1): 43-47. doi: 10.1016/S0022-3468(82)80323-0
[23] Karnak I, Tanyel FC, Akçören Z, et al. Transverse testicular ectopia with persistent müllerian duct syndrome[J]. J Pediatr Surg, 1997, 32(9): 1362-1364. doi: 10.1016/S0022-3468(97)90323-7
[24] Cansaran S, Moralioglu S, Celayir A, et al. Management of transverse testicular ectopia with persistent Mullerian duct syndrome[J]. North Clin Istanb, 2018, 5(4): 357-360.
[25] Tasian GE, Copp HL, Baskin LS. Diagnostic imaging in cryptorchidism: Utility, indications, and effectiveness[J]. J Pediatr Surg, 2011, 46(12): 2406-2413. doi: 10.1016/j.jpedsurg.2011.08.008
[26] 李洲, 李昭铸. 睾丸异位症的研究进展[J]. 中国男科学杂志, 2017, 31(6): 70-72. https://www.cnki.com.cn/Article/CJFDTOTAL-NXXX201706017.htm
[27] Smith-Bindman R, Lipson J, Marcus R, et al. Radiation dose associated with common computed tomography examinations and the associated lifetime attributable risk of cancer[J]. Arch Intern Med, 2009, 169(22): 2078-2086. doi: 10.1001/archinternmed.2009.427
[28] Matsumoto F, Matsui F, Yazawa K, et al. A case of chromosomal disorders of sex development with transverse testicular ectopia mimicking mixed gonadal dysgenesis[J]. Urology, 2017, 101: 116-118. doi: 10.1016/j.urology.2016.10.005
[29] Yeap E, Nataraja RM, Pacilli M. Undescended testes: What general practitioners need to know[J]. Aust J Gen Pract, 2019, 48(1-2): 33-36. doi: 10.31128/AJGP-07-18-4633
[30] Ku JH, Jeon YS, Lee NK, et al. Two cases of perineal ectopic testis[J]. Int J Urol, 2000, 7(8): 307-309. doi: 10.1046/j.1442-2042.2000.00194.x
[31] Deshpande AV, La Hei ER. Impact of laparoscopy on the management of transverse testicular ectopia[J]. J Laparoendosc Adv Surg Tech A, 2009, 19(3): 443-446. doi: 10.1089/lap.2008.0106
[32] Dean GE, Shah SK. Laparoscopically assisted correction of transverse testicular ectopia[J]. J Urol, 2002, 167(4): 1817. doi: 10.1016/S0022-5347(05)65238-X
[33] Ren XY, Wu D, Gong CX. Persistent Müllerian duct syndrome: a case report and review[J]. Exp Ther Med, 2017, 14(6): 5779-5784.
[34] Patil V, Muktinaini S, Patil R, et al. Persistent müllerian duct syndrome: a case report[J]. Indian J Surg, 2013, 75(Suppl 1): 460-462.
[35] 张正涛, 高晓峰, 刘国昌, 等. 异位肾上腺34例病例分析及文献回顾[J]. 广州医科大学学报, 2022, 50(4): 61-64, 94. https://www.cnki.com.cn/Article/CJFDTOTAL-GZXI202204011.htm
[36] Manjunath BG, Shenoy VG, Raj P. Persistent müllerian duct syndrome: How to deal with the müllerian duct remnants-a review[J]. Indian J Surg, 2010, 72(1): 16-19. doi: 10.1007/s12262-010-0003-x
[37] Josso N, Belville C, di Clemente N, et al. AMH and AMH receptor defects in persistent Müllerian duct syndrome[J]. Hum Reprod Update, 2005, 11(4): 351-356. doi: 10.1093/humupd/dmi014
[38] Hsieh MH, Breyer BN, Eisenberg ML, et al. Associations among hypospadias, cryptorchidism, anogenital distance, and endocrine disruption[J]. Curr Urol Rep, 2008, 9(2): 137-142. doi: 10.1007/s11934-008-0025-0
[39] Skakkebaek NE, Rajpert-De Meyts E, Main KM. Testicular dysgenesis syndrome: an increasingly common developmental disorder with environmental aspects[J]. Hum Reprod, 2001, 16(5): 972-978. doi: 10.1093/humrep/16.5.972
[40] van der Horst HJR, de Wall LL. Hypospadias, all there is to know[J]. Eur J Pediatr, 2017, 176(4): 435-441. doi: 10.1007/s00431-017-2864-5
[41] Swerdlow AJ, Higgins CD, Pike MC. Risk of testicular cancer in cohort of boys with cryptorchidism[J]. BMJ, 1997, 314(7093): 1507-1511. doi: 10.1136/bmj.314.7093.1507
[42] Berkmen F, Alagöl H. Germinal cell tumors of the testis in cryptorchids[J]. J Exp Clin Cancer Res, 1998, 17(4): 409-412.
[43] Pugach JL, Steinhardt GF. Evaluation and management of ectopic penile testis[J]. Urology, 2002, 59(1): 137.
[44] 张大, 范应中, 张谦, 等. 异位睾丸3例临床分析[J]. 郑州大学学报(医学版), 2012, 47(2): 276-277. https://www.cnki.com.cn/Article/CJFDTOTAL-HNYK201202047.htm
[45] Akre O, Pettersson A, Richiardi L. Risk of contralateral testicular cancer among men with unilaterally undescended testis: a meta analysis[J]. Int J Cancer, 2009, 124(3): 687-689. doi: 10.1002/ijc.23936
[46] Wood HM, Elder JS. Cryptorchidism and testicular cancer: separating fact from fiction[J]. J Urol, 2009, 181(2): 452-461. doi: 10.1016/j.juro.2008.10.074
[47] Miura T, Takahashi G. Crossed ectopic testis with common vas deferens[J]. J Urol, 1985, 134(6): 1206-1208. doi: 10.1016/S0022-5347(17)47688-9
[48] 王宁, 萨音白刚, 刘宏, 等. 异位睾丸19例诊治分析[J]. 临床小儿外科杂志, 2017, 16(2): 178-181. https://www.cnki.com.cn/Article/CJFDTOTAL-LCXR201702020.htm
[49] Kotb M, Hassan A, Abouheba M. Transverse testicular ectopia with Müllerian duct remnant in an incarcerated congenital inguinal hernia-a case report[J]. BMC Urol, 2020, 20(1): 112. doi: 10.1186/s12894-020-00680-9
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