Testis

Abstract

Despite their rarity, tumours of the testis remain an important cause of mortality among young men. They rank behind only cerebral tumours and trauma as causes of death at this age. The incidence appears to be increasing world-wide. In England and Wales the Standardised Registration Ratio has risen from 2.1 to 2.8 per 100 000 males in the period from 1962 to 1972. This increase has been mainly in young men and is now the commonest neoplasm in men aged 25–34 (Table 13.1). This has also been reflected in the increased referral of patients to the Christie Hospital and Holt Radium Institute (Fig.13.1). There is no agreed explanation for these changes, the only constantly noted aetiological factor being maldescent of the testis. It has been calculated that a person with an undescended testis has a roughly 50 times greater chance of developing a testicular tumour (of either side) than a person with normally descended testes. Recent studies suggest that raised prenatal maternal oestrogen levels may be an important aetiological factor.