Intratubular Germ Cell Neoplasia of the Testis, Bilateral Testicular Cancer, and Aberrant Histologies

Urol Clin North Am. 2015 Aug;42(3):277-85. doi: 10.1016/j.ucl.2015.04.002. Epub 2015 Jun 6.

Abstract

Intratubular germ cell neoplasia (ITGCN) is a precursor lesion for testicular germ cell tumors, most of which are early stage. ITGCN is also associated with testicular cancer or ITGCN in the contralateral testis, leading to a risk of bilateral testicular malignancy. Testicular biopsy detects most cases, and orchiectomy is the treatment of choice in patients with unilateral ITGCN. Low-dose radiation therapy is recommended in patients with bilateral ITGCN or ITGCN in the solitary testis, but the long-term risks of infertility and hypogonadism need to be discussed with the patient. Rare histologies of primary testicular cancer are also discussed.

Keywords: Bilateral testicular cancer; Cryptorchidism; Infertility; Intratubular germ cell neoplasia; Microlithiasis; Rare histologies; Testicular biopsy; Testicular germ cell tumor.

Publication types

  • Review

MeSH terms

  • Biopsy
  • Cryptorchidism / epidemiology
  • Disease Management
  • Germinoma / pathology
  • Humans
  • Infertility, Male / epidemiology
  • Male
  • Neoplasms, Germ Cell and Embryonal* / epidemiology
  • Neoplasms, Germ Cell and Embryonal* / pathology
  • Neoplasms, Germ Cell and Embryonal* / therapy
  • Neoplastic Processes
  • Orchiectomy / methods*
  • Precancerous Conditions / pathology*
  • Prognosis
  • Radiotherapy, Adjuvant / methods*
  • Risk Factors
  • Testicular Neoplasms* / epidemiology
  • Testicular Neoplasms* / pathology
  • Testicular Neoplasms* / therapy
  • Testis / pathology*

Supplementary concepts

  • Testicular Germ Cell Tumor