Eight patients with mediastinal or retroperitoneal germ cell tumors who had undergone testicular biopsy or orchiectomy were retrospectively analyzed for primary testicular abnormalities, subfertility, and abnormal sex hormone levels. Testicular tissue was abnormal in all patients, revealing peritubular fibrosis (six), decreased spermatogenesis (eight), interstitial edema (five), Sertoli cells only (one), and Leydig cell hyperplasia (two). Detailed hormone analysis in five patients revealed elevations of luteinizing hormone in four, decreased serum testosterone in two, elevations of estradiol in two, and elevation of human chorionic gonadotropin in one patient. A history of infertility was documented 2 months to 13 years before presentation in four patients and suspected in another. Extragonadal germ cell tumors, like their testicular counterparts are associated with primary germ cell defects, some of which seem to be independent of gonadotropin production by the tumor. In addition, the rather high incidence of antecedent infertility suggests that either a congenital or acquired primary germ cell defect contributes to defective spermatogenesis and the development of cancer in incompletely migrated germ cells.
Cancer 60:108-113, 1987.
T Is WELL KNOWN that a significant proportion of men I with germinal testicular cancers have poor semen quality, abnormal sex hormone levels, and abnormal testicular histology in the uninvolved testicle at the time of orchiectomy. I-" We retrospectively reviewed a series of patients with extragonadal germ cell tumors (EGGCT) who had undergone testicular biopsy or orchiectomy before systemic chemotherapy to see whether similar defects were identifiable in these rare types of germ cell tumors.
Materials and Methods
The records of all patients with EGGCT who had undergone either testicular biopsy or orchiectomy at Memorial Sloan-Kettering Cancer Center during the years 1959 to 1982 were reviewed. Patients were ex-