title: [Clinical presentation of testicular germinal cancer].
abstract: OBJECTIVE
  To review the clinical features in our series of patients of germ-cell testicular cancer.
  
  
  METHODS
  The charts of 73 patients with diagnosis of germ-cell testicular tumours were reviewed. Age, history of cryptorchism, time to diagnosis, main symptoms, and serum markers values (alpha- fetoprotein and beta-HCG) were analysed. All cases underwent orchiectomy and extension study with abdominal CT-scan and either chest X-ray or Thoracic CT-scan. We follow the AJCC-UICC 1997 stage classification. Histological cell line, size, and clinical stage at presentation (local, regional and distance) have been analysed also.
  
  
  RESULTS
  Among 73 germ-cell testicular tumours 34 were seminomas (46.6%) and 39 were non-seminomatous (54.4%). Clinically, 58.9% of the patients had localised stage I tumours. On presentation 85.7% seminomas were stage I compared to 35.9% non-seminomatous tumours. The remaining tumours were diagnosed in advanced phases (stages II and III). Inguinal orchiectomy was performed in all patients except 5 in whom tumours were incidentally diagnosed (atrophic testis orchiectomy, hydrocoelectomy, trauma) and needed a second operation including ipsilateral scrotal excision. When size, cell line and primary tumour T category were reviewed we found that 32.3% seminomas and 20.5% non seminomas were smaller than 4 cm. 50% seminomas and 49.7% non seminomas were pT1; 41.2% seminomas and 28.2 non seminomas were pT2; finally 8.8% seminomas were pT3 compared to 23.1% non seminomas. Vascular infiltration, also evaluated in this chapter, was present in 38.2% seminomas compared to 38.5% non seminomas. Elements of embryonal carcinoma were found in 37 non seminomatous tumours, either isolated (14) or associated with other components. Teratoma appeared in 18 non seminomatous tumours, 16 of them associated to embryonal carcinoma alone or together with other components. Elements of choriocarcinoma and endodermal sinus were evident in 5 and 4 cases respectively, always associated with other elements.
  
  
  CONCLUSIONS
  Seminomas clinical presentation substantially differs from that of non seminomatous testicular tumours in age, clinical features, stage and histological aggressiveness.
authors.affiliation: Servicio de Urología I, Hospital Covadonga, Hospital Central de Asturias, Facultad de Medicina, Universidad de Oviedo, Oviedo, España.
authors.forename: Jesús María
authors.initials: JM
authors.lastname: Fernández Gómez
authors.forename: José Luis
authors.initials: JL
authors.lastname: Guate Ortiz
authors.forename: Agustín
authors.initials: A
authors.lastname: Martín Huescar
authors.forename: Florentino
authors.initials: F
authors.lastname: Fresno Forcelledo
authors.forename: Safwan
authors.initials: S
authors.lastname: Escaf Barmadah
authors.forename: Javier
authors.initials: J
authors.lastname: García Rodríguez
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Pérez García
authors.forename: Oscar
authors.initials: O
authors.lastname: Rodríguez Faba
authors.forename: Antonio
authors.initials: A
authors.lastname: Jalón Monzón
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase; D014408:Biomarkers, Tumor / Q000097:blood; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D003456:Cryptorchidism / Q000453:epidemiology; D058851:GPI-Linked Proteins; D006801:Humans; D007527:Isoenzymes / Q000097:blood; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D009373:Neoplasms, Germ Cell and Embryonal / Q000097:blood / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D009919:Orchiectomy; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013736:Testicular Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D014408:Biomarkers, Tumor; D018997:Chorionic Gonadotropin, beta Subunit, Human; D058851:GPI-Linked Proteins; D007527:Isoenzymes; D000509:alpha-Fetoproteins; D007770:L-Lactate Dehydrogenase; D000469:Alkaline Phosphatase; C019839:alkaline phosphatase, placental