Guidelines for the Implementation of a Testis-sparing Approach to Testicular Cancer.[16]
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A proportion of patients with testicular cancer will present with synchronous bilateral masses, which are often discovered incidentally. Treatment is no different for patients with bilateral germ cell tumors than for patients with unilateral germ cell tumors; however, special consideration is warranted for patient with bilateral masses because of the psychological and endocrine sequelae of surgical castration. Testis-sparing approaches can be employed, but these necessitate thorough patient counseling and careful follow-up. Considerable controversy remains in the literature regarding the optimum treatment of patients with stage I seminoma, and very few data specific to bilateral tumors are available, making it difficult to counsel these patients about surveillance and adjuvant therapy. As such, it is essential to discuss thoroughly all treatment options with patients to attempt to elucidate patient preferences and attitudes towards treatment.
Charles P Vega, University of California, Irvine, CA, is the author of and is solely responsible for the content of the learning objectives, questions and answers of the Medscape-accredited continuing medical education activity associated with this article.
Matthew J Resnick, Division of Urology, University of Pennsylvania School of Medicine, 9 Penn Tower, 34th and Civic Center Boulevard, Philadelphia, PA 19104, USA; Email:[email protected]