Objective: To review the diagnostic and therapeutic aspects of carcinoma in situ of the testis, the preinvasive stage of testicular germ cell tumors.
Methods: The indications for performing testicular biopsy in patients with a higher incidence of testicular carcinoma in situ (patients with infertility, cryptorchidism and/or testicular atrophy, gonadal dysgenesis and a previous diagnosis of testicular or extragonadal germ cell tumor) are discussed, with special reference to the controversy of whether biopsy of the contralateral testis is necessary in patients with primary testicular tumor. The advantages and disadvantages of the noninvasive diagnostic techniques as an alternative to biopsy are also discussed.
Results/conclusions: Testicular biopsy is the main diagnostic procedure. Testicular ultrasonography is the most useful noninvasive diagnostic technique and can be considered in areas with a low incidence of tumor of the contralateral testis. Orchidectomy and radiotherapy are the two main therapeutic options for testicular carcinoma in situ. The choice between one or the other approach depends basically on whether the testicular involvement is unilateral or bilateral.