BILATERAL TESTICULAR-TUMORS - MANAGEMENT AND OUTCOME IN 21 PATIENTS

BACKGROUND, The authors examined the clinical course of patients with bilateral testicular tumors to determine whether the outcome after tre atment was different from patients, with unilateral tumors. METHODS. U sing a computerized data base of 2088 patients with testicular carcino ma at Indiana University, 21 patients (1%) were identified with bilate ral testicular carcinoma. A retrospective review of hospital and clini c charts was performed. Sixteen patients with metachronous and 5 patie nts with synchronous testicular tumors were identified. RESULTS. Treat ment was based on clinical stage and was similar to therapy given for unilateral disease. The mean age at presentation of the first testicul ar tumor was 28.4 years (range, 16-47 years). Approximately 50% of the second primary tumors presented > 5 yea.rs after the contralateral tu mor. At a mean follow-up of 49.9 months (range, 1-276 months), 18 pati ents were without evidence of disease, 2 were alive with disease; and 1 patient had died of disease. CONCLUSIONS. The treatment of patients with bilateral germ cell tumors is based on the pathology and clinical stage and should not be different from the traditional management of unilateral testicular carcinoma. Patients with unilateral testicular c arcinoma should be informed of the necessity of long term follow-up be cause contralateral testicular carcinoma may occur as long as 25 years later. Cancel 1998; 83:547-52, (C) 1998 American Cancer Society.