Germinal cell tumors of the testis in cryptorchids

The medical records of 876 patients with germinal cell tumor of the testis seen at our hospital between 1984 and 1996 were analyzed; 25 (2.85%) were r eported to have tumors in undescended testis. Twenty-one patients had unila teral involvement and four had bilateral. Cryptorchidism was corrected ipsi laterally in 7 patients with intrascrotal testicular cancer between 6 and 1 3 years of age. The primary tumor was in the abdominal testis in Ii patient s and in the inguinal canal in 7 (28%) patients. Three patients had persist ent Mullerian duct syndrome. One of the three patients with persistent Mull erian duct syndrome also had transverse testicular ectopia. Clinical stagin g showed 10 stage I, 8 stage LTC, 3 stage III and 4 stage IV. Tumor histolo gic types on orchidectomy showed seminoma in 20, non-seminoma in 3 and mixe d tumors in 2 patients. According to stage and histologic findings all pati ents were treated with radiotherapy or chemotherapy. Overall, 3 and 5 years survival in seminoma patients was 100% while in non-seminoma and mixed tum or patients was 80% and 60%, respectively. Since orchidopexy offers only li mited protection against future malignancy if performed after 2 years of ag e, the treatment of choice should be orchidectomy. Cryptorchid testes that descended spontaneously or by hormonal therapy should be followed lifelong by testicular ultrasound at least once a year for early detection of cancer . For bilaterally orchidectomised cases administration of androgens is mand atory to prevent sexual dysfunction and hot flushes.