Morphologie, Biologie und Therapeutische Konsequenzen der atypischen Keimzellen des Hodens

Bannwart, Fridolin; Sigg, C; Hedinger, Chr.

doi:10.1007/978-3-642-75893-5_13

Cited by 4 publications

(3 citation statements)

References 29 publications

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“…Provided the patient complies with repeated clinical and sonographic examinations the surveillance option is safe, since only 50% of all TINbearing testes progress t o frank germ-cell cancer within 5 years (Skakkebaek & Berthelsen, 1978). In fact, in some cases TIN m a y not progress t o invasive cancer after 10 o r even 16 years (Bannwart et al, 1988). T h e option of surveillance for patients w i t h TIN in the contralateral testis is substantiated with regard t o fertility by the report of a patient who developed bilateral sequential testicular germcell tumours with an interval of 20 years and who fathered t w o healthy children during that interval (Dieckmann et al, 1988).…”

Section: Discussionmentioning

confidence: 99%

Paternity in a patient with testicular seminoma and contralateral testicular intraepithelial neoplasia

Dieckmann¹,

Loy²

1993

Int J of Andrology

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A 32-year-old patient with unilateral beta hCG-positive seminoma and contralateral testicular intraepithelial neoplasia (TIN; so-called carcinoma-in-situ) with no metastases (clinical stage I) received one course of adjuvant carboplatin therapy. He refused further treatment of TIN in his remaining testis. His wife became pregnant by him 4 months later and delivered a healthy child at term. This case shows that patients with TIN in their remaining solitary testis are not necessarily infertile, and testes afflicted with TIN must also contain tubules that retain normal spermatogenic potential. Surveillance may be an treatment option for patients with TIN in their remaining testis in cases where there is a strong desire for paternity.

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Section: Discussionmentioning

confidence: 99%

Paternity in a patient with testicular seminoma and contralateral testicular intraepithelial neoplasia

Dieckmann¹,

Loy²

1993

Int J of Andrology

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“…There are only weak clinical markers such as age below 30 years, history of bilateral cryptorchidism [3], and increased serum follicle-stimulating hormone (FSH) [4] that may identify patients at a particular high risk for a sec ond testicular cancer. After Skakkebaek's first description of carcinoma in situ of the testis (CIS) in 1972 [5], the concept of CIS being the uniform precursor of testicular GCT [6] has gained increas ing acceptance [1,[7][8][9][10][11][12], CIS has been shown to be present in a testis many years before the clinical manifestation of a tumour. It has been demonstrated that once a testicle is afflicted with CIS the majority of the seminiferous tubules are likely to contain these cells [12], Thus, a random surgi Terminology Skakkebaek, in 1972, used the term 'carcinoma in situ' when he first described atypical large spermatogonia [5] that were later shown to be precursor cells of testicular patients with condition based on total number of patients examined.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Contralateral Testicular Intraepithelial Neoplasia (Carcinoma in situ) in Patients with Testicular Germ Cell Tumour

Loy

Dieckmann²

1993

Eur Urol

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“…Cases of GCNis without progression to germ cell neoplasia after more than 10 years have been reported. 3 In addition, the number of actual CTGCT events in our study is also much larger than the number of contralateral GCNis (39) in the study of Ruf et al, 4 allowing (more) stable estimation of at least CTGCT risk in our cohort.…”

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confidence: 64%

Reply to K. P. Dieckmann

Schaapveld

Blok

2021

JCO

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We thank Dr Dieckmann for his letter 1 in response to our recently published article. 2 Our study showed a higher absolute excess risk for developing a contralateral testicular germ cell tumor (CTGCT) in primary seminoma compared with primary nonseminoma. 2 This is in line with the main result of our study, namely, that receipt of platinum-based chemotherapy is associated with a dose-dependent decrease in the risk of developing a CTGCT, and the fact that platinum-based chemotherapy is offered in a higher proportion to patients with nonseminoma, to which Dr Dieckmann also alludes. 1 Our multivariable (cause-specific) analysis, however, also suggested that seminoma histology was associated independently with the development of CTGCT, mainly because of a somewhat higher risk of CTGCT in patients with chemotherapy-naive seminoma. This was also to some extent reflected by the 10-year cumulative incidence of CTGCT in patients without chemotherapy-naive seminoma, which was 2.5% compared with 3.6% in patients with chemotherapy-naive seminoma. We agree that this finding should be treated with some caution, as a biological explanation is not clear. Contralateral testicular biopsies are infrequently performed in the Netherlands, so we have no information on the presence of contralateral germ cell neoplasia in situ (GCNis) before treatment. Nonetheless, the 20-year cumulative incidence of CTGCT in chemotherapy-naive patients (3.9% in patients with nonseminoma v 4.6% in patients with seminoma) agrees well with a 5%-6% prevalence of GCNis in contralateral testicular biopsies of patients with unilateral testicular germ cell tumor. The distribution of the tumor histology of the CTGCT did not differ in patients with chemotherapy-naive nonseminoma (77.3% seminoma) compared with patients with chemotherapy-naive seminoma (76.9% seminoma, P 5 .97). In contrast, the CTGCT among chemotherapytreated patients with nonseminoma was predominantly of nonseminoma histology (63.2%) and CTGCT histology differed significantly between patients with chemotherapynaive and chemotherapy-treated nonseminoma. The overrepresentation of seminoma CTGCT among patients with a nonseminoma germ cell tumor primary is interesting. As stated by Dieckmann, 1 it is known that patients with nonseminoma are usually several years younger than their seminoma counterparts. Could our data show that when our patients with nonseminoma age, they do tend to develop more often CTGCT with a seminoma origin as do their peers in the general population, while GCNis with nonseminoma delineation does develop into CTGCT less

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Morphologie, Biologie und Therapeutische Konsequenzen der atypischen Keimzellen des Hodens

Cited by 4 publications

References 29 publications

Paternity in a patient with testicular seminoma and contralateral testicular intraepithelial neoplasia

Paternity in a patient with testicular seminoma and contralateral testicular intraepithelial neoplasia

Prevalence of Contralateral Testicular Intraepithelial Neoplasia (Carcinoma in situ) in Patients with Testicular Germ Cell Tumour

Reply to K. P. Dieckmann

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