Testicular cancer primarily affects men of reproductive age. Therefore, fertility preservation is important in managing testicular cancer. In patients with a solitary testis, oncological testicular sperm extraction (onco-TESE) is used to retrieve sperm from tumor-bearing testis.
A 39-year-old man with congenital absence of the left testis presented with a 4-month history of progressive right testicular swelling. Laboratory tests showed elevated β-human chorionic gonadotropin and follicle-stimulating hormone concentrations, and ultrasonography showed a heterogeneous hypoechoic mass with microcalcifications. A seminal analysis showed azoospermia with AZFc partial deletion. Following orchiectomy, microsurgical onco-TESE was performed. Motile sperm were successfully retrieved from preserved seminiferous tubules. A pathological examination demonstrated a pure seminoma. In preserved seminiferous tubules, the Johnsen score was 9-10, and partial tubular hyalinization and microcalcifications were observed.
Microsurgical onco-TESE is for retrieving sperm in patients with testicular cancer with a solitary testis, even in the presence of impaired spermatogenesis.
IJU case reports. 2026 May 10*** epublish ***
Yuki Matsumoto, Toshiyasu Amano, Mamoru Hachiya, Tomohisa Fujita, Tetsuya Imao
Department of Urology Nagano Red Cross Hospital Nagano Japan., Center for Reproductive Medicine Nagano Red Cross Hospital Nagano Japan.