Carcinoma in Situ of Contralateral Testis in Patients with Testicular Germ Cell Cancer: Study of 27 Cases in 500 Patients

Abstract

Carcinoma in situ in the contralateral testis was diagnosed in 27 of 500 patients (5.4%) with unilateral testicular germ cell cancer. Eight of the 27 patients received intensive chemotherapy for spread of their initial testicular cancer. Follow up biopsy studies did not detect changes of carcinoma in situ in any of these patients, and none developed a contralateral testicular tumour (observation time 12-88 months). Of the remaining 19 patients with carcinoma in situ, seven developed contralateral testicular cancer. The estimated risk of developing invasive growth was 40% within three years and 50% within five years. None of the 473 patients without carcinoma in situ detected by screening biopsy developed contralateral testicular cancer (observation time 12-96 months). No serious complications arose from the biopsy procedures.All patients with unilateral testicular germ cell cancer should be offered biopsy of the contralateral testis.

Orchidectomy after chemotherapy for patients with metastatic testicular germ cell cancer

“…Furthermore, the cumulative incidence of ITGCN in patients treated with systemic chemotherapy for known testicular ITGCN in association with metastatic testicular GCT has been shown to increase significantly with time, with an estimated incidence of 21% and 42% at 5 and 10 years, respectively [6]. Left untreated (by excision or radiotherapy) ITGCN is associated with a 50% risk of progression to invasive GCT over 5 years [7]. Orchidectomy after chemotherapy provides definitive treatment for persistent ITGCN remaining within the primary lesion after chemotherapy.…”

“…[4][5][6][7][8][9][10][11][12][13][14] years. Only 23 of the patients (38%) had testicular symptoms or signs at presentation, although 55 (92%) had an abnormal baseline testicular US.…”

Origins and molecular biology of testicular germ cell tumors

“…49 A total of 27 patients (5.4%) were found to have 'carcinoma in situ'. Eight patients received systemic chemotherapy for advanced disease.…”

Cancer testis antigen expression in testicular germ cell tumorigenesis

“…5,6 It is important because patients with intratubular germ cell neoplasia unclassified have a 50% risk of developing an invasive germ cell tumor within 5 years without treatment. 2,7 Furthermore, intratubular germ cell neoplasia unclassified is frequently encountered in patients with an increased risk to develop a testicular germ cell tumor, eg gonadal dysgenesis, 8 a previous testicular germ cell tumor 9 or cryptorchidism. 10,11 POU5F1, 12 PLAP 13 and KIT 14 are immunohistochemical markers for the identification of intratubular germ cell neoplasia unclassified.…”