Since the initial discovery by Skakkebsk of ITGCN over 30 years ago, much progress has been made on the role it plays in TGCTs. In the future, new molecular tests might offer a less invasive method to detect ITGCN. At present the role of routine contralateral testicular biopsy in the diagnosis of ITGCN is controversial. While at an increased risk, most men will not develop a second testicular tumor and therefore routine biopsy is not recommended. We recommend a stratified biopsy strategy to for those at high risk, while following the majority of men for many years after their initial tumor. Orchiectomy is considered definitive treatment if ITGCN of the contralateral testicle occurs, while the less invasive option of radiation would also provide acceptable tumor control. Bilateral testicular tumors are a rare occurrence with the majority being metachronous and responding well to traditional treatment.

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