Carcinoma In Situ

There is a recognized preinvasive condition of the testes called carcinoma in situ. At present, however, this condition must be diagnosed by testicular biopsy, a procedure that does not lend itself to screening. Carcinoma in situ is found in less than 1% of subfertile men, about 5% of patients with corrected testicular maldescent, and in the contralateral testes of about 5% of men who have had an orchiectomy for a germ cell tumor. If the contralateral testis is atrophic, the risk of its containing carcinoma in situ is as high as 20 to 25%. An observational study has determined that the conversion of carcinoma in situ to invasive testic-ular cancer appears to occur at a rate of about 50% within 5 years. Although the condition is diagnosed definitively by biopsy, suspicion is increased by the ultrasonographic finding of macrocalcification.

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