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.
University of Kansas Medical Center, Kansas City, KS 66160, USA. elee@kumc.edu
Eugene K
EK
Lee
Jeffrey M
JM
Holzbeierlein
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*