Histopathological spectrum of testicular lesions- A retrospective study

Introduction & Objectives: Testis is affected by both neoplastic and non- neoplastic conditions. Although testicular neoplasms are rare, most of the previous studies of testis are on them only. Our study was undertaken to study histopathological spectrum, age-wise distribution, laterality and clinical presentation of all testicular lesions (both neoplastic and non- neoplastic). Materials and Method: This was a three year retrospective study including all the testicular specimens referred to Department of Pathology, GMC Jammu from 1st Jan 2014 to 31st Dec 2016. Results: The study comprised a total of 57 cases. Non- neoplastic testicular lesions were more common than the neoplastic ones (93 vs. 7%). Non- neoplastic lesions were most common in 2nd decade of life with a wide age range of 5 months- 80 years. Among non-neoplastic lesions (n=53), undescended testis (39.62%) was the most common non-neoplastic lesion followed by inflammatory lesions (24.53%), infarcted testis (torsion, 18.86%) and atrophic testis (16.98%). Inflammatory lesions included nonspecific epididymo-orchitis (15.1%), testicular abscess (5.66%) and tubercular epididymo-orchitis (3.77%). Only 4 cases (7%) of testicular neoplasm were diagnosed in the study period amounting to only 1.33 case/ year. All 4 cases were germ cell neoplasms with age range of 14 months- 35 years and mean age 20.54 years. One case each of seminoma, yolk sac tumour, immature teratoma and mixed germ cell tumour (mixed teratoma and seminoma) was diagnosed. All the lesions were unilateral and 58% of non-neoplastic lesions were right sided. Among both neoplastic and non-neoplastic lesions, the most common symptom was testicular (scrotal/inguinoscrotal) swelling (87%). The second most common presenting complaint was empty scrotum (36.84%) and pain (36%). Inflammatory lesions in addition had history of fever(22.80%). No tumour was found in undescended testes unlike western countries. Conclusion: Majority of testicular lesions are non- neoplastic and neoplastic lesions are rare, most being germ cell neoplasms. Non- neoplastic lesions are seen in all age groups but neoplasms are usually seen in younger age. Non- neoplastic lesions mimic neoplastic ones clinically, testicular swelling being the most common complaint. So histopathological examination is necessary to serve an accurate diagnosis of testicular swellings. Our findings are comparable with most studies.