Management of the contralateral testicle in patients with unilateral testicular cancer.
Patients with a prior history of a germ cell tumor of the testicle are known to have an increased risk of development of a second germ cell tumor in the contralateral testicle. It is believed that all patients who develop a germ cell tumor of the testicle have a precursor lesion know as carcinoma in situ (CIS) or intratubular germ cell neoplasia. Approximately 50% of these patients will subsequently go on to develop a germ cell tumor in the testicle. A biopsy of the contralateral testicle in a patient with a previous history of a germ cell tumor of the testicle has been advocated by some, while others recommend a biopsy only in patients with other risk factors as well. The arguments for biopsy are that intervention may be used to prevent the development of a second germ cell tumor when CIS is detected. In this review we present the arguments for and against a biopsy of the contralateral testicle, review the techniques of biopsy as well as its complications, and discuss the interventions employed to prevent CIS from progressing.
Lee
Eugene K
EK
University of Kansas Medical Center, Kansas City, KS 66160, USA. elee@kumc.edu
Holzbeierlein
Jeffrey M
JM
D001706:Biopsy; D002278:Carcinoma in Situ / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D008297:Male; D009362:Neoplasm Metastasis / Q000517:prevention & control; D009373:Neoplasms, Germ Cell and Embryonal / Q000175:diagnosis / Q000473:pathology*; D013736:Testicular Neoplasms / Q000175:diagnosis / Q000473:pathology*; D013737:Testis / Q000473:pathology*