Bilateral testicular tumors

Bilateral testicular tumors have been reported with an incidence of 0.5% to 0.7% [44]. In that series, 21 patients of 2088 studied presented with bilateral testicular tumors, 16 patients had meta-chronous lesions, and 5 had synchronous tumors. Approximately 50% of the metachronous lesions occurred within 5 years. Another large study that included almost 4000 patients found the incidence of bilateral testicular tumors to be slightly higher (1.5%) but had similar findings with regard to metachronous tumors (83%) being the most common bilateral presentation [45]. Of these tumors, the median interval between lesions was 50.5 months; however, 23% of the patients presented more than 10 years after the first tumor. The ten patients in this study who presented with synchronous lesions were all tumor free at a mean follow-up of 29.5 months. Most importantly, patients with bilateral testicular tumors (synchronous or metachronous) had similar outcomes as those with unilateral tumors. A third study that confirms these findings was recently published from Munich. Four percent of their patients developed bilateral tumors, with the majority being metachronous, and without any patient deaths from the second tumor [46]. These findings support the practice of not routinely performing contralateral testicular biopsies in patients with ITGCN, as well as emphasizing the need for long-term follow-up.

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