THE EFFECT OF TESTICULAR NONGERM CELL TUMORS ON LOCAL SPERMATOGENESIS

Objective: To assess ipsilateral spermatogenesis in men with malignant and benign nongerm cell tumors of the testis. Design, Patients: Histo logic review of radical orchiectomy specimens performed for 20 men wit h malignant nongerm cell tumors and 15 with benign testicular lesions, including five Leydig cell tumors with benign clinical features. Main Outcome Measures: Degree of spermatogenesis was determined on a 1 to 10 scale, with 10 representing mature sperm within a seminiferous tubu le. For each patient ''near'' and ''far'' scores were determined by ob taining the mean score of 50 tubules adjacent (<3 mm) to the tumor and 50 tubules distant (>3 mm) from the tumor, respectively. Results: Tot al, near, and far scores were all lower for malignant tumors than for benign lesions. Scores for Leydig cell tumors were similar to benign l esions. Malignant tumors demonstrated a gradient effect, with greatest impairment of spermatogenesis occurring adjacent to tumor. In contras t, a distinction between near and far scores was not observed for beni gn lesions or Leydig cell tumors. Conclusions: Malignant nongerm cell tumors of the testis were associated with significant impairment of ip silateral spermatogenesis, particularly in areas adjacent to tumor. Th ese findings are similar to those observed for testicular germ cell tu mors, suggesting a generalized negative influence on ipsilateral sperm atogenesis by malignant tumors.