[Diagnostic and therapeutic approach to bilateral germinal tumor. Presentation of a case and review of the literature].
The germinal bilateral tumor represents from 1 to 4% of the testicle tumors, and it usually turns to be one of the most difficult ones when talking about diagnosis and treatment. We are attaching a 30 years old patient case, with a diagnosis consisting in a seminoma with yolk sac tumor area from the left testicle, that was treated with orquiectomy. Eleven months later, the patient presented a second neoplasm in the contralateral testicle, whose histology was a classical seminoma with carcinoma "in situ" peritumoral, being also treated with orquiectomy. Medical literature is revised with emphasis in the involved risk factors and the techniques used to treat these testis tumor groups: carcinoma "in situ" detection appears to be the strongest predicting factor. Testicular contralateral biopsy is proposed in some select cases. Even though radical orquiectomy is still the treatment to choose, local radiotherapy and conservative surgery are also an option in patients with bilateral tumor.
Servicio y Cátedra de Urología Hospital del Mar, Univesitat Autónoma de Barcelona, Barcelona.
D
D
Cañís Sánchez
G
G
Conde Santos
N
N
Alonso Gracia
E
E
De León Morales
O
O
Arango Toro
A
A
Gelabert Mas
D000328:Adult; D001706:Biopsy; D002278:Carcinoma in Situ / Q000453:epidemiology; D018240:Endodermal Sinus Tumor / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D006801:Humans; D015994:Incidence; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D016609:Neoplasms, Second Primary / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D009919:Orchiectomy; D018239:Seminoma / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D013736:Testicular Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery