Father-son testicular tumors: evidence for genetic anticipation? A case report and review of the literature.
BACKGROUND
The etiology of testicular carcinomas is unknown. Father-son testicular tumors represent an important subset of patients because the sons have a 6- to 10-fold increase in the risk of developing a testicular tumor compared with the general population, suggesting a possible genetic component in the etiology of the disease. Genetic anticipation has been established for several diseases and manifests itself clinically with earlier age of onset (AO) of disease or with increased severity of disease in children compared with their parents.


METHODS
We report only the 13th case of pure seminoma occurring in both a father and a son. The most striking feature of our case study was a 27-year difference in the AO between father and son. A review of the literature from 1972 through 1999 provided 47 cases of father-son testicular tumors in which sufficient information was available to compare the AO and the severity of the disease in the fathers (G1) and the sons (G2).


RESULTS
The mean AO for G1 was 43.3 (+/- 1.6) years compared with a mean AO for G2 of 27.0 (+/- 1.0) years for all 47 cases (P < 0.01). For fathers presenting with a pure seminoma, the mean AO was 45.9 (+/- 1.8) years for G1 compared with 27.0 (+/- 1.1) years for G2 (P < 0.01). For fathers presenting with a nonseminomatous tumor, the mean AO in G1 was 37.9 (+/- 2.6) years and 26.9 (+/- 1.8) years for G2 (P < 0.01). For the entire group of 47 cases, disease was more severe in G2 compared with G1 in 43% of cases, of equal severity in 47% of cases, and less severe in G2 compared with G1 in 10% of cases.


CONCLUSIONS
Genetic anticipation may be responsible for many father-son testicular tumors.
Han
S
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Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut 06520, USA.
Peschel
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D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D020132:Anticipation, Genetic; D006801:Humans; D008297:Male; D008875:Middle Aged; D018239:Seminoma / Q000235:genetics*; D013736:Testicular Neoplasms / Q000235:genetics*