Spectrum of Morphologic Findings in Orchiectomy Specimens from Individuals Undergoing Gender-Affirming Surgery

Summary: The incidence of gender dysphoria and those seeking surgical procedures to address gender dysphoria is increasing. We provide a histologic review of morphologic features observed in orchiectomy specimens from individuals who have undergone hormonal therapy prior to gender-affirming surgery. Pathologists must be aware of the histologic changes related to treatment in patients undergoing gender-affirming surgery including reduction of germ cells with frequently encountered atypical germ cell forms. In rare cases, especially in the absence of maturation, GCNIS may be overlooked on routine H&E stain alone. Proper utilization of immunohistochemistry may aid to distinguish GCNIS from potential mimics.