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Onco-testicular sperm extraction (Onco-TESE) from a single testis with metachronous bilateral testicular cancer: a case report
Authors:Itsuto Hamano  Shingo Hatakeyama  Rika Nakamura  Rie Fukuhara  Daisuke Noro  Hiroko Seino  Takahiro Yoneyama  Yasuhiro Hashimoto  Takuya Koie  Yoshihito Yokoyama  Chikara Ohyama
Institution:1.Department of Urology,Hirosaki University Graduate School of Medicine,Hirosaki,Japan;2.Department of Obstetrics and Gynecology,Hirosaki University Graduate School of Medicine,Hirosaki,Japan;3.Department of Pathology and Bioscience,Hirosaki University Graduate School of Medicine,Hirosaki,Japan;4.Department of Advanced Transplant and Regenerative Medicine,Hirosaki University Graduate School of Medicine,Hirosaki,Japan
Abstract:

Background

Although oncologic testicular sperm extraction (onco-TESE) has been increasingly practiced, the evidence of onco-TESE performed in patients with testicular cancer is insufficient. Furthermore, in bilateral testicular cancer, accounting for 0.5%–1% of testicular cancers, onco-TESE is more challenging and has been insufficiently reported.

Case presentation

Here we report the case of a 25-year-old man who underwent onco-TESE from his residual single testis with a nonseminomatous germ cell tumor that occurred 5 years after orchiectomy of the contralateral testis. A second orchiectomy and simultaneous TESE from the noncancerous testicular tissue were performed. The pathological diagnosis was germ cell tumors, tumors of more than one histological type (embryonal carcinoma, immature teratoma, yolk sac tumor, seminoma, and choriocarcinoma; pT1N0M0). The patient subsequently married and hoped for fatherhood 3 years later. Whereas histological diagnosis of the normal testicular tissue was Johnsen score 6 (maturation arrest), morphologically normal and motile sperms were successfully retrieved from thawed TESE samples and used for multiple cycles of intracytoplasmic sperm injection. Although the conception has not been succeeded to date, ICSI attempts have been continuing.

Conclusion

This case demonstrates the effectiveness of onco-TESE for challenging cases such as bilateral and nonseminmatous testicular cancer.
Keywords:
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