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Abstract

Volume 17, Issue 1 (January 2015) 17, 154–158; 10.4103/1008-682X.128514

Testicular parenchymal abnormalities in Klinefelter syndrome: a question of cancer? Examination of 40 consecutive patients

Giacomo Accardo1, Gianfranco Vallone2, Daniela Esposito1, Filomena Barbato1, Andrea Renzullo1, Giovanni Conzo3, Giovanni Docimo3, Katherine Esposito3, Daniela Pasquali1

1 Department of Cardiothoracic and Respiratory Sciences, Endocrine Unit, Second University of Naples, Italy
2 Department of Biomorphological and Functional Sciences, Second University of Naples, Naples, Italy
3 Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy

Correspondence: Dr. D Pasquali (daniela.pasquali@unina2.it)

Received: 13 September 2013; Revised: 23 November 2013; Accepted: 12 January 2014

Abstract

Klinefelter syndrome (KS) is a hypergonadotropic hypogonadism characterized by a 47, XXY karyotype. The risk of testicular cancer in KS is of interest in relation to theories about testicular cancer etiology generally; nevertheless it seems to be low. We evaluated the need for imaging and serum tumor markers for testicular cancer screening in KS. Participants were 40 consecutive KS patients, enrolled from December 2009 to January 2013. Lactate dehydrogenase (LDH), alpha-fetoprotein (AFP), and beta-human chorionic gonadotrophin subunit (β-HCG) serum levels assays and testicular ultrasound (US) with color Doppler, were carried out at study entry, after 6 months and every year for 3 years. Abdominal magnetic resonance (MR) was performed in KS when testicular US showed micro-calcifications, testicular nodules and cysts. Nearly 62% of the KS had regular testicular echotexture, 37.5% showed an irregular echotexture and 17.5% had micro-calcifications and cysts. Eighty seven percent of KS had a regular vascular pattern, 12.5% varicocele, 12.5% nodules <1 cm, but none had nodules >1 cm. MR ruled out the diagnosis of cancer in all KS with testicular micro calcifications, nodules and cysts. No significant variations in LDH, AFP, and β-HCG levels and in US pattern have been detected during follow-up. We compared serum tumor markers and US pattern between KS with and without cryptorchidism and no statistical differences were found. We did not find testicular cancer in KS, and testicular US, tumor markers and MR were, in selected cases, useful tools for correctly discriminating benign from malignant lesions.

Keywords: abdomen magnetic resonance; alpha-fetoprotein; beta-human chorionic gonadotrohin subunit; klinefelter syndrome; lactate dehydrogenase; testicular ultrasound

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Asian Journal of Andrology CN 31-1795/R ISSN 1008-682X  Copyright © 2023  Shanghai Materia Medica, Chinese Academy of Sciences.  All rights reserved.