In testicular malignancies – colloquially called testicular tumors – (synonyms: Anaplastic seminoma; Malignant leydig cell tumor in man; Malignant androblastoma in man; Malignant arrhenoblastoma in man; Chorionic carcinoma in man; Yolk sac tumor in man; Dysgerminoma in man; Embryoma of a descended testis; Embryoma of undescended testis; Embryonal cell carcinoma; Epithelioma seminifere; Epithelioma spermatogonique Masson; Testicular chorionic epithelioma; Testicular embryoma; Testicular seminoma; Testicular carcinoma; Testicular carcinoma in cryptorchidism; Testicular mesothelioma; testicular seminoma; testicular teratocarcinoma; testicular teratoma; germ cell tumor; malignant testicular tumor; metastatic testicular tumor; orchioblastoma; polyvesicular yolk sac tumor in man; polyvesicular vitellus tumor in man; Seminoma; sertoli cell carcinoma; sertoli cell carcinoma in man; spermatocytic seminoma; spermatocytoma; teratocarcinoma; teratoma; teratoma of maldescended testis; teratoma of scrotal testis; testicular carcinoma; ICD-10-GM C62. -: Malignant neoplasm of the testis) is a malignant neoplasm (malignant neoplasm) in the testicular region. In 95% of men, the tumors occur in the testis and only in 5% extragonadally (outside the testis). Both testicles are affected in about 1-2% of men with the disease. Different groups of testicular malignancies can be distinguished:
- Germ cell tumors (CRT) – account for approximately 85-90% of testicular tumors; in men between 20 and 44 years of age, CRT is the most common malignancy, accounting for approximately 25%; CRT can be divided into:
- Seminomas (more common than non-seminomas)
- Uniform nonseminomatous germ cell tumors.
- Combined non-seminomatous germ cell tumors
- Combined tumors
- Tumors of the gonadal stroma such as the Leydig or Sertoli cell tumors.
- Germ cell-stroma mixed tumors
- Malignant lymphomas
Testicular malignancies account for circa 1-2% of male malignancies. Peak incidence: the maximum incidence of testicular malignancies is generally between the ages of 20 and 45. The median age of onset is 38 years. Considering the tumor type, the following frequency peaks can be mentioned:
- Seminomas have their disease peak between the 35th and 45th year of life.
- Non-seminomas have their disease peak between the 20th and 30th year of life
The incidence (frequency of new cases) is about 11.9 cases per 100,000 inhabitants per year in Germany. The national differences are large: in Norway it affects 13.5 men per 100,000 inhabitants, in Sweden 9.3, in Denmark 7.8, in Finland 3.1, in Austria 7.5, in Switzerland 10, in Italy 3.9, in France 5.0, in Spain 2.2, in Holland 5.8, in Belgium 3.0, in England 5.4, in Ireland 4.4 and in Poland 2.7. In recent years, an increase in the disease could be recorded, especially in the group of 35 to 49 years. Course and prognosis: Testicular malignancies usually have a very high chance of cure, with early detection having a major impact on prognosis. Up to 80% of seminomas are in clinical stage I and only about 3% in stage III.For prognosis, see classification under “Prognosis-dependent classification of metastatic germ cell tumor according to IGCCCG”. Cure rates in the lower stages reach up to 100%. Late recurrences, i.e. recurrences more than two years after the onset of the disease, can be fatal. The prognosis of patients depends mainly on histology (fine tissue findings), tumor stage, age and quality of care. The lethality (mortality related to the total number of patients suffering from the disease) is about 4%. Clinical stage I (CS1) testicular tumors have a long-term remission rate that is close to 100%. This is true regardless of the primary therapeutic strategy chosen.The stage-independent 5-year survival probability for patients with germ cell tumor (SCT) in Germany is 97.9% for seminoma and 94.9% for non-seminomatous SCT.For patients with stage I SCT, the cancer-specific 10-year survival probability is 99.7% and the 10-year overall survival probability is 95-99%. For metastatic CCT, the 5-year survival probabilities range from 86% to 95% for patients in the good prognosis group, from 72% to 8 5% for patients in the intermediate prognosis group, and from 48% to 64% for patients in the poor prognosis group.[S3 guideline].
