MULTIPLE, ATYPICAL NEVI - A CUTANEOUS MARKER OF GERM-CELL TUMORS

Purpose: This study assessed whether a specific association exists bet ween atypical nevi and germ cell tumors (GCT). Methods: A prospective comparison was performed on a cohort of 129 unselected patients with G CT and a series of 153 healthy men. Three or more of the following cri teria were required for diagnosis of multiple atypical nevi: greater t han 5 mm in diameter; variegated color, often speckled black/brown, wi th irregularly distributed pigmentation; irregular outline re or indis tinct border; and at least three such lesions. Results: Prevalences fo r multiple atypical nevi in patients with GCT and in healthy controls were 37% and 15%, respectively (P < .01). Two patients with these lesi ons also had documented malignant melanoma. In contrast, 16% of patien ts with GCT had a history of testicular maldescent (the most common kn own risk factor), compared with 5% of healthy controls (P < .01). Conc lusion: Multiple atypical nevi occur with a statistically significant increased prevalence in patients with GCT as compared with healthy con trols, and constitute one of the most common known clinical associatio ns with this malignancy. These data may be of relevance for our unders tanding of the biology of GCT and of malignant melanoma, in the design of screening programs for testis cancer, and in the follow-up evaluat ion of patients with each of these disorders. (C) 1994 by American Soc iety of Clinical Oncology.