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 reported to have tumors in undescended testis. Twenty-one patients had unilateral involvement and four had bilateral. Cryptorchidism was corrected ipsilaterally in 7 patients with intrascrotal testicular cancer between 6 and 13 years of age. The primary tumor was in the abdominal testis in 11 patients and in the inguinal canal in 7 (28%) patients. Three patients had persistent Mullerian duct syndrome. One of the three patients with persistent Mullerian duct syndrome also had transverse testicular ectopia. Clinical staging showed 10 stage I, 8 stage IIC, 3 stage III and 4 stage IV. Tumor histologic types on orchidectomy showed seminoma in 20, non-seminoma in 3 and mixed tumors in 2 patients. According to stage and histologic findings all patients were treated with radiotherapy or chemotherapy. Overall, 3 and 5 years survival in seminoma patients was 100% while in non-seminoma and mixed tumor patients was 80% and 60%, respectively. Since orchidopexy offers only limited protection against future malignancy if performed after 2 years of age, 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 mandatory to prevent sexual dysfunction and hot flushes.