Bilateral successive testicular tumors: A report of two cases and a review of the literature

Case 1: A 32-year-old man visited our department complaining of a left scrotal swelling. He underwent left radical orchiectomy. Histopathological diagnosis was pure seminoma. Since bipedal lymphangiography proved there to be paraaortic lymph node metastasis, he received 119Gy of irradiation. Fifteen years after the treatment, the patient found a contralateral scrotal mass. We performed right radical orchiectomy. The pathology revealed pure seminoma. The clinical stage was I and 72Gy of irradiation was given. Case 2: A 35-year-old man visited our department with the complaint of right scrotal swelling. He underwent right radical orchiectomy. Histopathological diagnosis was pure seminoma. Postoperative chemotherapy was performed with CDDP, Vinblastin and Bleomycin. About 4 years after the treatment, the patient detected a left testicular swelling, and the serum AFP and HCG-β levels were found to have increased. We performed left radical orchiectomy. The pathology revealed teratocarcinoma. Clinical stage was II(A) and four courses of chemotherapy with CDDP, VP 16 and Bleomycin resulted in a complete remission. Previous reports of bilateral successive germ cell tumor in the Japanese literature are reviewed and the incidence, age, interval between the first and second tumors, histology, clinical stage and treatment are discussed.