Family History Of Testicular Cancer Research Articles

Saudi Nursing Students' Knowledge and Perception of Testicular Cancer Assessment and Management: A Cross-Sectional Study.

Testicular cancer (TC) incidence is increasing worldwide. This study aimed to investigate Saudi nursing students' knowledge and perception about TC. This cross-sectional study was done using convenience sampling method. In this study, 280 nursing students from different nursing schools in six cities of Saudi Arabia were recruited. A structured self-report questionnaire was used to collect data. About 49.2% of the participants received education about TC in their nursing schools. The findings showed lack of enough knowledge about TC among Saudi nursing students. Mostly, the participants reported that heredity factor and having family history of TC (48.9%) and age between 56 and 70 years (41.8%) were the most common risk factors of TC. According to the participants, physical examination was the most common diagnostic test usually used for early detection of TC (40.4%) and biopsy test was the most accurate test to confirm TC diagnosis (45.4%). Only one third of the participants (34.6%) knew that between 75% and 100% of TC cases can be cured in case of early detection. About half of the participants (51.8%) reported that surgical procedure was the most common treatment for TC. The nursing students who had high GPA (r=0.86, p<0.001), were unwilling to get more information on TC (r=0.24, p=0.04), had family history of TC (r= 0.53, p=0.02), medical problems with testicles (r= 0.69, p=0.01), received education about TC in their school of nursing (r=0.65, p=0.02), and were more self-confident in assessing and managing TC (r=0.38, p=0.03) had higher level knowledge about TC. Conclusion: Despite the importance of nurses' roles in assessing and managing TC, nursing students in Saudi Arabia still did not have enough knowledge about TC. Improving nursing programs' curricula and conducting health education programs are recommended.

Prevalence of pathogenic germline cancer risk variants in testicular cancer patients: Identifying high risk groups.

Germline studies in testicular cancer have focused on unselected populations but so far have not led to recommendations for testicular cancer screening. Herein, we hypothesized that men with testicular cancer and an additional risk factor for hereditary cancer predisposition carry a higher rate of pathogenic variants than men with testicular cancer without another risk factor. 187 patients with a personal history of testicular cancer underwent germline testing via Invitae. Patients were divided into low-risk and high-risk patients. Low-risk patients (n=83) had testicular cancer as their only primary malignancy without a family history of testicular cancer. High-risk patients (n=104) had additional primary malignancies and/or a family history of testicular cancer. 23.1% of patients harbored pathogenic germline variants with 19.6% carrying actionable variants. Among low-risk patients, 13.5% carried pathogenic variants versus 29.9% in the high-risk cohort. Of patients with a family history of non-testicular cancers and a personal history of additional primary malignancies, 32% harbored pathogenic variants. High-risk patients are twice as likely to harbor pathogenic variants compared to low-risk patients. Importantly, patients with a family history of cancer and other primary malignancies represent a subset of patients that may benefit from genetic evaluation.

Testicular Cancer, Version 2.2020, NCCN Clinical Practice Guidelines in Oncology.

Testicular cancer is relatively uncommon and accounts for <1% of all male tumors. However, it is the most common solid tumor in men between the ages of 20 and 34 years, and the global incidence has been steadily rising over the past several decades. Several risk factors for testicular cancer have been identified, including personal or family history of testicular cancer and cryptorchidism. Testicular germ cell tumors (GCTs) comprise 95% of malignant tumors arising in the testes and are categorized into 2 main histologic subtypes: seminoma and nonseminoma. Although nonseminoma is the more clinically aggressive tumor subtype, 5-year survival rates exceed 70% with current treatment options, even in patients with advanced or metastatic disease. Radical inguinal orchiectomy is the primary treatment for most patients with testicular GCTs. Postorchiectomy management is dictated by stage, histology, and risk classification; treatment options for nonseminoma include surveillance, systemic therapy, and nerve-sparing retroperitoneal lymph node dissection. Although rarely occurring, prognosis for patients with brain metastases remains poor, with >50% of patients dying within 1 year of diagnosis. This selection from the NCCN Guidelines for Testicular Cancer focuses on recommendations for the management of adult patients with nonseminomatous GCTs.

Spectrum of Extratesticular and Testicular Pathologic Conditions at Scrotal MR Imaging.

Diagnostic workup of scrotal lesions should begin with a complete clinical history and physical examination, including analysis of risk factors such as family history of testicular cancer, personal history of tumor in the contralateral testis, and cryptorchidism, followed by imaging. Scrotal ultrasonography (US) with a combination of gray-scale and color Doppler techniques has been the first-line imaging modality for evaluation of testicular and extratesticular lesions because of its low cost, wide availability, and high diagnostic accuracy. However, US has limitations related to operator dependence, the relatively small field of view, and lack of tissue characterization. Magnetic resonance (MR) imaging, because of its superior soft-tissue contrast and multiplanar capabilities, is increasingly being used as a supplemental diagnostic problem-solving tool in cases where scrotal US findings are inconclusive or nondiagnostic. In addition to morphology, lesion location, and tissue characterization (eg, fat, blood products, granulation tissue, and fibrosis), scrotal MR imaging provides important information that can affect surgical planning and improve patient care. MR imaging also is helpful for differentiating testicular and extratesticular lesions, distinguishing between benign and malignant lesions, and evaluating the local extent of disease. This review discusses the anatomy and MR imaging features of testicular and extratesticular neoplastic and nonneoplastic conditions and describes relevant MR imaging techniques. ©RSNA, 2018 Contact information that appeared in the print version of this article was updated in the online version on May 14, 2018.

Hereditary association between testicular cancer and familial ovarian cancer: A Familial Ovarian Cancer Registry study

BackgroundAlthough family history of testicular cancer is well-established as a risk factor for testicular cancer, it is unknown whether family history of ovarian cancer is associated with risk of testicular cancer. Materials and methodsUsing data from the Familial Ovarian Cancer Registry on 2636 families with multiple cases of ovarian cancer, we systematically compared relative frequencies of ovarian cancer among relatives of men with testicular and non-testicular cancers. ResultsThirty-one families with cases of both ovarian and testicular cancer were identified. We observed that, among men with cancer, those with testicular cancer were more likely to have a mother with ovarian cancer than those with non-testicular cancers (OR = 3.32, p = 0.004). Zero paternal grandmothers of men with testicular cancer had ovarian cancer. ConclusionThese observations provide compelling preliminary evidence for a familial association between ovarian and testicular cancers Future studies should be designed to further investigate this association and evaluate X-linkage.

The Validity and Reliability of Health Belief Scale for Testicular Cancer Self-Examination.

This study aimed to create a measurement tool for the determination of university students' health beliefs about testicular cancer (TC) and self-examination. This is a methodological and cross-sectional study. The study sample included 425 university students. Consents and approvals were obtained from the relevant institutions and the ethics committee prior to the research. The data were collected using an interview form that included questions about descriptive characteristics, family history of TC, and knowledge, beliefs, and practice of self-examination. The health belief model including 41 questions about self-examination and the interview form were administered to the students in their classrooms at a suitable time. Principal components analysis and varimax rotation were used for the examination of the structures of the factors. Accordingly, factor patterns, self-values, and the variance percentages they explained were evaluated. The average age of the participants is 22.2 ± 2.3 (min = 17; max = 40). Of them, 98.8% of the participants are single ( n = 420). Of them, 56.2% have heard about TC before, and 18.4% said they were informed about TC. Factor loading of the items in the first factor was 0.64 to 0.89, while it was 0.48 to 0.75 for the items in the second factor, 0.50 to 0.87 for the items in the third factor, 0.37 to 0.68 for the items in the fourth factor, 0.51 to 0.68 for the items in the fifth factor, and 0.65 to 0.79 for the items in the sixth factor. The health belief model scale may be used in TC screenings for males to measure susceptibility, seriousness, health motivation, barriers, benefits, and self-efficacy.

Testicular germ cell tumours and parental occupational exposure to pesticides: a register-based case–control study in the Nordic countries (NORD-TEST study)

ObjectivesA potential impact of exposure to endocrine disruptors, including pesticides, during intrauterine life, has been hypothesised in testicular germ cell tumour (TGCT) aetiology, but exposure assessment is challenging. This large-scale...

Genetics of testicular germ cell tumors

Testicular cancer is by far the most common neoplasm among young males between the ages of 20 and 40years and with an increasing incidence rate worldwide. Congenital malformations of the male genitals, such as cryptorchidism or inguinal hernia are established risk factors. Men with a family history of testicular cancer are also associated with an increased risk of the disease. In the testes more than 90 % of tumors develop from germ cells (progenitor cells) and represent a histologically heterogeneous group. Germ cell tumors in extragonadal localizations are rare. Isochromosome i(12p), the typical marker chromosome in testicular germ cell tumors, occurs as an early event in tumorigenesis. Spermatocytic seminoma is a rare variant of germ cell tumors and according to the current classification is a distinct entity with different morphological, clinical and also cytogenetical features compared with other germ cell tumors.

Primary classical seminoma of testis with foci of signet-ring-cell morphology: A case report and review of the literature including ESMO guidelines on management of seminoma of testis

Background: Signet-ring-cell carcinoma is a rare variant of mucinous adenocarcinoma. Only about 3 cases of primary testicular cancer with signet-ring-cell morphology have been reported so far in the literature. There is lack of knowledge regarding the biological behaviour of this type of tumour affecting the testis. Seminoma of the testis is quite common and its biological behaviour is well known. When a classical seminoma of the testis is found to be contemporaneously associated with signet-ring-cell morphology, in view of the absence of any detailed literature on this rare clinical entity, the biological behaviour of such a tumour cannot be predicted. Objectives: To report a case of Classical Seminoma of the testis interspersed with seminoma cells with signet-ring morphology. To review the literature on signet-ring-cell carcinomas including carcinomas of testis with signet- ring- cell morphology. To review the ESMO guidelines on management of seminoma of testis Results: A 32-year-old man came for urology consultation 11 months after he had noticed a lump in his left testis. He had a family history of testicular cancer. A hard lump clinically suspicious of a tumour was palpable in the lower pole of his left testis. The right testis felt normal on palpation. His serum Beta HCG level was raised. He had ultra-sound scan of testis which showed bilateral microlithiasis with a tumour in the left testis but no tumour in the right testis. He underwent left radical orchidectomy and histology of the testicular tumour revealed a classical testicular seminoma with foci of signet-ring -cell morphology based upon haematoxylin and eosin staining as well as positive immunostaining for CD117 and OCT 3 / 4. Literature review revealed paucity of literature on testicular tumours with signet-ring-cell morphology. Conclusions: There is paucity of literature on primary testicular tumours with signet-ring-cell morphology. In order to establish the biological behaviour of such tumours we would encourage pathologists and urologists to report cases of testicular tumours associated with signet-ring-cell morphology together with the long term biological behaviour of such tumours. They should also report on the percentage of testicular tumours that have signet–ring-cell morphology and their distribution whether patchy or diffuse. Ultrasound-scan of testis was required to establish the diagnosis of testicular cancer in the patient. Ultrasound-scan of testis is useful in the investigation of a testicular lump. Ultrasound and CT scans are also useful for the follow-up of patients with testicular cancer and microlithiasis.

Abstract 4468: Pre-diagnostic steroid hormone levels and risk of testicular germ cell tumors

Abstract Background: Testicular germ cell tumors (TGCT), the most commonly occurring cancer among young men in the U.S., are thought to be endocrine-related tumors. The relationship between steroid hormone levels and development of TGCT, however, has been difficult to study given the rarity of the tumor in the general population and the paucity of pre-diagnostic serum from young men. The U.S. Servicemen's Testicular Tumor Environmental and Endocrine Determinants (STEED) study, however, was able to overcome these obstacles by enrolling military servicemen who had previously donated serum specimens to the Department of Defense Serum Repository. Methods: STEED participants were enrolled between 2002 and 2005. The associations between TGCT risk and log-transformed serum concentrations of testosterone, free testosterone, estradiol, free estradiol, 3α-androstanediol glucuronide (3α-diol-G), an indicator of peripheral androgen action, and sex hormone-binding globulin (SHBG) were examined in 517 case and 790 control participants. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression models, adjusting for date of serum donation, age, race/ethnicity, family history of testicular cancer, history of cryptorchidism, height, and body mass index. Results: The analysis found that while testosterone was not significantly associated with TGCT risk, there was an inverse association between 3α-diol-G and risk (OR=0.80, 95%CI=0.63-0.99). In addition, there was a significant inverse association with TGCT and the ratio of 3α-diol-G to testosterone (OR=0.76, 95%CI=0.61-0.93). There was also a significant direct association between estradiol and TGCT risk (OR=1.41, 95%CI=1.06-1.87). The relationships between the free forms of testosterone and estradiol and risk were the same as the relationships between the total forms of each hormone and risk. There was no association between TGCT and SHBG. Conclusion: These results suggest that the hormone metabolism of men who subsequently develop TGCT may vary from that of other men. In men who develop TGCT, more testosterone may be converted to estradiol and less to dihydrotestosterone, the most potent form of androgen, than in men who do not develop TGCT. Further examination of metabolites, both upstream and downstream in the steroid hormone pathway, may help elucidate the mechanism by which these exposures are related to development of TGCT. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 4468. doi:1538-7445.AM2012-4468

Abstract 4470: Pre-diagnostic gonadotropin levels and development of testicular germ cell tumors

Abstract INTRODUCTION: Testicular germ cell tumors (TGCT) are the most common cancer among young men (20-45 years of age). The pathogenesis of TGCT remains largely unknown; however, there is evidence that TGCT is related to other male reproductive disorders namely infertility and genitourinary malformations (cryptorchidism and hypospadias). It is generally assumed that the development of TGCT is under endocrine control and it has been hypothesized that gonadotropin dysregulation may be one potential cause of TGCT, as the testes are primary target organs for the gonadotropins, follicle-stimulating hormone (FSH) and luteinzing hormone (LH). FSH stimulates spermatogenesis via binding to receptors in Sertoli cells, while LH stimulates the Leydig cells to produce testosterone. Data support the role of primary LH deficiency in cryptorchidism, and also support the role of gonadotropin deficiency in infertility. It is currently not known whether FSH and LH levels are associated with TGCT risk. Thus, we assessed associations of pre-diagnostic serum FSH and LH concentrations and risk of TGCT among participants in the U.S. Servicemen's Testicular Tumor Environmental and Endocrine Determinants (STEED) Study. METHODS: TGCT cases diagnosed between 2002 and 2005 (n=517) were matched on age, race and serum draw date to at least one control (n=790). Associations between pre-diagnostic serum FSH and LH levels and TGCT were estimated using conditional logistic regression with further adjustment for prior cryptorchidism, family history of testicular cancer, height, body mass index and serum testosterone. Associations stratified on histology (seminoma, nonseminoma) were also examined. RESULTS: Overall, TGCT was associated with increased levels of FSH and decreased levels of LH. Men had an increased risk of TGCT if they were in the highest quartile of FSH [Q4 vs. Q1: OR 2.17, 95% CI 1.35-3.48] and in the lowest quartile of LH [Q1 vs. Q4: OR 1.99, 95% CI 1.25-3.16]. These associations were independent of one another and independent of serum testosterone concentration. In analyses stratified by histologic subtype the increased risk of TGCT with high FSH [Q4 vs. Q1: OR 2.86, 95% CI 1.33-6.18] and low LH [Q1 vs. Q4: OR 2.55, 95% CI 1.18, 5.49] was consistent for seminomas. Among nonseminomas, the ORs were indicative of elevated TGCT risk with high FSH [Q4 vs. Q1: OR 1.81, 95% CI 0.96-3.43] and low LH [Q1 vs. Q4: OR 1.80, 95% CI 0.97-3.36], albeit the results did not attain statisitical significance. DISCUSSION: Our findings of associations of TGCT with FSH and LH suggest that gonadotropin disruption may be a critical event in development of TGCT. LH deficiency has previously been associated with risk factors for TGCT, cryptorchidism and infertility, while high levels of FSH may indicate a defect in Sertoli cell production of inhibin B, a negative feedback regulator of FSH. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 4470. doi:1538-7445.AM2012-4470

Editorial comment on “Testicular microlithiasis: Case report and literature review”

This is certainly an interesting case report. Fig. 1 shows a cystic intratesticular mass in the right testis in addition to bilateral testicular microlithiasis. The authors were silent on the possible significance of the presence of an intratesticular cyst in this patient. It must be pointed out that most intratesticular cysts are malignant [1–3]. Classical ultrasound features of a benign intratesticular cyst include: imperceptible wall, an anechoic centre and through transmission [1–3]. The centre of the cyst in Fig. 1 does not appear anechoic and neither can the wall of the cyst be described as imperceptible. Consequently, if I were managing this patient, with a positive family history of testicular cancer, with the patient being in the right age group for development of testicular cancer and in the presence of

Testicular microlithiasis: Case report and literature review

We present an interesting case of bilateral microlithiasis. Microlithiasis is usually considered a benign condition with no need for follow-up. However, when a patient with testicular microlithiasis has a positive family history of testicular cancer, such patients should be followed up closely to detect the development of testicular cancer.

Gestational age at birth and risk of testicular cancer

Most testicular germ cell tumors originate from carcinoma in situ cells in fetal life, possibly related to sex hormone imbalances in early pregnancy. Previous studies of association between gestational age at birth and testicular cancer have yielded discrepant results and have not examined extreme preterm birth. Our objective was to determine whether low gestational age at birth is independently associated with testicular cancer in later life. We conducted a national cohort study of 354,860 men born in Sweden in 1973-1979, including 19,214 born preterm (gestational age < 37 weeks) of whom 1,279 were born extremely preterm (22-29 weeks), followed for testicular cancer incidence through 2008. A total of 767 testicular cancers (296 seminomas and 471 nonseminomatous germ cell tumors) were identified in 11.2 million person-years of follow-up. Extreme preterm birth was associated with an increased risk of testicular cancer (hazard ratio = 3.95; 95% confidence interval = 1.67-9.34) after adjusting for other perinatal factors, family history of testicular cancer and cryptorchidism. Only five cases (three seminomas and two nonseminomas) occurred among men born extremely preterm, limiting the precision of risk estimates. No association was found between later preterm birth, post-term birth or low or high fetal growth and testicular cancer. These findings suggest that extreme but not later preterm birth may be independently associated with testicular cancer in later life. They are based on a small number of cases and will need confirmation in other large cohorts. Elucidation of the key prenatal etiologic factors may potentially lead to preventive interventions in early life.

Screening for testicular cancer

Testicular cancer commonly affects men aged between 20 and 35 years. Screening for testicular cancer may reduce both morbidity and mortality, yet the effectiveness of any method is unknown. Equally, screening may also promote treatment procedures that are unwarranted or may adversely affect the health outcomes of the patient with no net benefit. Additionally, many organisations recommend against screening for testicular cancer due to the low incidence of testicular cancer and favourable outcomes in the absence of screening. The primary objective of this review is to determine whether screening for testicular cancer (physician or patient self-examination) reduces testicular cancer-specific mortality. The secondary objective of this review is to determine impact of screening for testicular cancer on quality of life and adverse outcomes. Electronic searches were conducted across MEDLINE, CINAHL, the Cochrane Central Register of Controlled Trials (CENTRAL) and PsychINFO. All published randomised controlled trials (RCTs) of screening versus no screening for testicular cancer were eligible for inclusion in this review. The search identified 19 potentially relevant articles, which were selected for full text review. None of the articles that were reviewed were evaluated as eligible for inclusion in this review. There are no published RCTs evaluating the effectiveness of screening for testicular cancer. Patients with increased clinical risk factors for testicular cancer, including a family history of testicular cancer, undescended testis (cryptorchidism) or testicular atrophy should be informed by their physicians of their potential increased risk of testicular cancer, along with potential benefits and harms associated with screening.

Family history of cancer and malignant germ cell tumors in children: A report from the Children’s Oncology Group

Family history of testicular cancer is an established risk factor for adult testicular germ cell tumors (GCT). We evaluated the association between family history of cancer and pediatric GCT in a Children's Oncology Group case-control study that included 274 GCT cases (195 female and 79 male) diagnosed < age 15 years and 418 controls frequency matched to cases on sex and age. Family history data were collected through telephone interviews with biological mothers and fathers and unconditional logistic regression was used to evaluate associations with GCT adjusting for potential confounders. A family history of cancer with onset < age 40 years was associated with a reduced risk of GCT among female cases (Odds Ratio (OR) = 0.50, 95% Confidence Interval (CI) 0.28-0.89) and an increased risk among male cases (OR = 2.56, 95% CI 1.02-6.44). Male cases were more likely to report family history of melanoma compared with male controls (OR = 4.65, 95% CI 1.40-15.4). There was an inverse association between family history of ovarian or uterine cancers and GCT in girls (OR = 0.46, 95% CI 0.22-0.96). These sex and cancer site specific associations should be confirmed in additional studies as they may provide clues to the etiology of pediatric GCT.

Epidemiology of testicular cancer

Testicular cancer is of interest and importance because its incidence has been increasing in most countries over the past four decades. Although it remains an uncommon malignancy overall accounting for 1-2% of all tumours in men, testicular cancer is the most common malignancy in young men. There is marked geographical variation in the incidence of testicular cancer, with the highest incidence among men in Nordic countries and lowest incidence among men in the Middle East and Asia. The association between some risk factors, including cryptorchidism, a previous history of testicular cancer and a family history of testicular cancer, and the incidence of testicular cancer has been widely reported. We reviewed published reports and present the evidence to support or refute the association between the well-established and the less well-established risk factors and the incidence of testicular cancer.

Factors associated with testicular self-examination among unaffected men from multiple-case testicular cancer families

BackgroundThe lifetime testicular cancer (TC) risk in the general population is relatively low (~1 in 250), but men with a family history of TC are at 4 to 9 times greater risk than those without. Some health and professional organizations recommend consideration of testicular self-examination (TSE) for certain high-risk groups (e.g. men with a family history of TC). Yet little is known about factors associated with TSE behaviors in this at-risk group.MethodsWe collected information on this subject during an on-going NCI multidisciplinary, etiologically-focused, cross-sectional Familial Testicular Cancer (FTC) study. We present the first report specifically targeting TSE behaviors among first- and second-degree relatives (n = 99) of affected men from families with ≥ 2 TC cases. Demographic, medical, knowledge, health belief, and psychological factors consistent with the Health Belief Model (HBM) were evaluated as variables related to TSE behavior, using chi-square tests of association for categorical variables, and t-tests for continuous variables.ResultsFor men in our sample, 46% (n = 46) reported performing TSE regularly and 51% (n = 50) reported not regularly performing TSE. Factors associated (p < .05) with regularly performing TSE in multivariate analysis were physician recommendation and testicular cancer worry. This is the first study to examine TSE in unaffected men from FTC families.ConclusionThe findings suggest that, even in this high-risk setting, TSE practices are sub-optimal. Our data provide a basis for further exploring psychosocial issues that are specific to men with a family history of TC, and formulating intervention strategies aimed at improving adherence to TSE guidelines.

Maternal Smoking and Testicular Germ Cell Tumors

Testicular germ cell tumors (TGCT) are the most common cancer among men ages 15 to 35 years in the United States. The well-established TGCT risk factors cryptorchism, prior diagnosis of TGCT, and family history of testicular cancer indicate that exposures in early life and/or in the familial setting may be critical to determining risk. Previous reports of familial clustering of lung cancer in mothers and testicular cancers in sons suggest that passive smoking in childhood may be such an exposure. To clarify the relationship of passive smoking exposure to TGCT risk, data from 754 cases and 928 controls enrolled in the Servicemen's Testicular Tumor Environmental and Endocrine Determinants study were analyzed. Data from 1,086 mothers of the cases and controls were also examined. Overall, there was no relationship between maternal [odds ratio (OR), 1.1; 95% confidence interval (95% CI), 0.9-1.3] or paternal smoking (OR, 1.0; 95% CI, 0.8-1.3) and TGCT risk. Although living with a non-parent smoker was marginally related to risk (OR, 1.4; 95% CI, 1.0-2.1), there was no relationship with number of smokers, amount smoked, or duration of smoking. Responses from both case-control participants and mothers also revealed no relationship between either maternal smoking while pregnant or while breast-feeding. Results did not differ by TGCT histology (seminoma, non-seminoma). These results do not support the hypothesis that passive smoking, either in utero or in childhood, is related to risk of TGCT. Other early life exposures, however, may explain the familial clustering of lung cancer in mothers and TGCT in sons.

Testicular ultrasound (TU) screening in men from familial testicular cancer (FTC) kindreds

14547 Background: A family history of testicular cancer (TC) is associated with a 2- to 10-fold increase in TC risk. Specific abnormalities of the urogenital tract (e.g., cryptorchidism, inguinal hernia) also increase risk. The association between testicular microlithiasis (TM) and testicular intraepithelial neoplasia (TIN) has suggested that the former may be a TC risk factor. The finding of inhomogenous echotexture on ultrasound has also been associated with an increased risk of TIN. In this study, we evaluate ultrasongraphic abnormalities in men with a history of TC and their kindreds. Methods: We analyzed testicular ultrasounds (TU) from 45 FTC cases and 35 unaffected male relatives, drawn from 31 multiple-case FTC families. TU were performed between January 2003 and November 2005 as part of an NCI multidisciplinary etiologic study of FTC. All studies were reviewed by a single radiologist. Results: We found no incident TC. Five focal lesions were seen. Three were thought to be cysts and 2 required further follow-up. The frequency of varicocele and epididymal cyst was similar in both groups. Hydrocele was seen in 7 (16%) cases and 3 (9%) unaffecteds (OR = 2.0; 95% CI = 0.5–8.3). Inhomogenous testicular parenchyma was noted in 12 (27%) cases and 3 (9%) unaffected family members (OR = 3.9; 95% CI = 1.0–15.0). TM was seen in 20 subjects [15 (34%) cases and 5 (14%) unaffecteds, OR = 3.1; 95% CI = 1.0–9.6]. An additional 10 subjects (7 cases, 3 unaffecteds) had calcifications that did not meet diagnostic criteria for TM. The finding of TM was confined to 13 of the 31 families. In 6 of these 13 families, 2 or more subjects had TM. Conclusion: A number of genitourinary conditions were more common in FTC cases than in unaffected blood relatives, providing support for the testicular dysgenesis hypothesis related to TC etiology. TM was found in a high proportion of cases and in a smaller proportion of unaffecteds. In this small series, TM appeared to cluster in families. If validated, these findings could have important implications for both screening and follow-up of FTC families. No significant financial relationships to disclose.