Autopsy findings are reviewed in 154 patients treated for germ cell tumors of the testis. OF the patients with apparently pure seminoma, 44% had autopsy evidence of nonseminomatous metastases. For all tumor types, the most common sites of distant metastasis were lung (89%), liver (73%), brain (31%), and bone (30%). There was a high incidence of brain metastases in choriocarcinoma and of bone metastases in seminoma. Brain, liver, and bone metastases were late Occurrences in the course of the disease and were almost always associated with involvement of other sites. Recurrences in the retroperitoneal area after lymph node dissection occurred mainly in those who had had retroperitoneal lymph node metastases. No difference in site or frequency of metastases was apparent in autopsied patients treated before or after introduction of platinum containing regimens. Respiratory failure, secondary to lung metastases, was the most common cause of death. Of the autopsied patients, 6% died of iatrogenic causes.
Cancer 50:548-551, 1982.
LTHOUGH TREATMENT ADVANCES have resulted in A improved survival rates for patients with germ cell tumors of the testis,'-6 there is need for better understanding of clinicopathologic features associated with treatment failure. Retroperitoneal recurrence after lymph node dissection, the possibile affinity of some histologic subgroups for spread to certain sites, histologic alterations associated with tumor spread and treatment, and the relation of site of metastasis to treatment failure need better documentation. With such in mind, a review of the postmortem findings in patients who died with germ cell tumor of the testis was undertaken.