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September 18, 1996

Undescended Testis

Author Affiliations

California; Section of Pediatric Urology Duke University Medical Center Durham, NC

JAMA. 1996;276(11):856. doi:10.1001/jama.1996.03540110010005

Q Left-sided inguinal exploratory surgery in a 5-year-old boy for a unilateral undescended testis demonstrated a normal vas deferens just beneath the external oblique fascia. The vas terminated in a 1.2-cm fibrous nodule located just outside the external ring. The nodule was excised, and histologic study showed portions of the vas deferens and hyalinized tissue with dystrophic calcification and without definable organoid structures. Now, 25 years later, the patient is healthy and has a normal testis palpable in the opposite side of the scrotum. Can it be assumed that the structure at the end of the vas was a maldeveloped testis? Is it possible that the actual testis remains undetected in the retroperitoneum, and therefore poses an increased risk for the development of a malignancy? If so, would imaging studies be helpful in searching for an undescended testis?

A It has become unusual in the United States for boys with