Cryptorchism is important because of the threat to fertility, should the testis remain undescended and because of increased incidence of neoplasm, especially should the gland lie within the abdominal cavity. Preoperative radiologic localization of the testes aids in surgical management.
Detection of an undescended testis by CT is based on the recognition on a mass which is of soft tissue density and is oval in shape, along the expected course of testicular descent.
CT was accurate in localizing the 13 undescended testes in 8 cryptorchid patients. There were nine in the inguinal canal and four in the abdomen, one of which was false positive on CT, proved to he a lymph node by operation. In one patient, detection of unusually large intrapelvic testes, bilateral, alerted the surgeon to their possible malignant transformation.
The advantages and potential pitfalls of CT in preoperative localization are discussed.
|