Tumor de Testículo / Testicular tumor

Introducción: los tumores testiculares representan el 4% de las neoplasias urogenitales, de las cuales el seminoma es el tumor maligno más frecuente del testículo en los varones jóvenes. El pronóstico es bueno con la orquiectomía total, llegando a una sobrevida del 95% en 10 años. Presentación de Caso: paciente de sexo masculino de 28 años con tumoración no dolorosa en región escrotal de 10 años de evolución, acude al servicio de urología por molestias y aumento importante de la tumoración en el último año. Conclusión: el tumor testicular tiene un muy buen pronóstico si es detectado a tiempo, teniendo en cuenta que con la exploración física ya se puede tener el diagnostico.

Introduction: testicular tumors represent 4% of urogenital neoplasms, of which seminoma is the most common malignant tumor of the testicle in young men. The prognosis is good with total orchiectomy, reaching a survival of 95% in 10 years. Case Presentation: a 28-year-old male patient with a non-painful tumor in the scrotal region of 10 years of evolution, went to the urology service due to discomfort and a significant increase in the tumor in the last year. Conclusion: the testicular tumor has a very good prognosis if it is detected in time, taking into account that with the physical examination the diagnosis can already be made.

Tumor de Testículo

Introducción: los tumores testiculares representan el 4% de las neoplasias urogenitales, de las cuales el seminoma es el tumor maligno más frecuente del testículo en los varones jóvenes. El pronóstico es bueno con la orquiectomía total, llegando a una sobrevida del 95% en 10 años. Presentación de Caso: paciente de sexo masculino de 28 años con tumoración no dolorosa en región escrotal de 10 años de evolución, acude al servicio de urología por molestias y aumento importante de la tumoración en el último año. Conclusión: el tumor testicular tiene un muy buen pronóstico si es detectado a tiempo, teniendo en cuenta que con la exploración física ya se puede tener el diagnostico.

Introduction: testicular tumors represent 4% of urogenital neoplasms, of which seminoma is the most common malignant tumor of the testicle in young men. The prognosis is good with total orchiectomy, reaching a survival of 95% in 10 years. Case Presentation: a 28-year-old male patient with a non-painful tumor in the scrotal region of 10 years of evolution, went to the urology service due to discomfort and a significant increase in the tumor in the last year. Conclusion: the testicular tumor has a very good prognosis if it is detected in time, taking into account that with the physical examination the diagnosis can already be made.

Sclerosing variant of well-differentiated testicular liposarcoma: a case report / Lipossarcoma testicular bem diferenciado com variante esclerosante: um relato de caso

ABSTRACT Testicular cancers are classified in germ cell and non-germ cell tumors, as well as, liposarcomas. We report the case of a patient with a large testicular liposarcoma, submitted to surgical treatment with excision of scrotal pouch and segment of the spermatic cord, and the left testicle, showing a good evolution. This report presents one of the first cases of a sclerosing variant of well-differentiated testicular liposarcoma, large in size and with no association with another cancer. Due to their location, the diagnosis is difficult and unusual. Complete tumor resection and regular medical follow-up show a good prognosis, less recurrence, and little cellular differentiation.

RESUMEN Los cánceres de testículo se clasifican en tumores de células germinales y células no germinales, así como en liposarcomas. Presentamos el caso de un paciente con un gran liposarcoma testicular, sometido a tratamiento quirúrgico con exéresis de la bolsa escrotal y segmento de cordón espermático y testículo izquierdo, con buena evolución. Este informe presenta uno de los primeros casos de una variante esclerosante de liposarcoma testicular bien diferenciado, de gran tamaño y sin asociación con otro cáncer. Debido a su ubicación, el diagnóstico es difícil e inusual. La resección completa del tumor y el seguimiento médico regular muestran un buen pronóstico, menor recidiva, y poca diferenciación celular.

RESUMO Os tumores testiculares são classificados em células germinativas e não germinativas, assim como os lipossarcomas. Relatamos o caso de um paciente com lipossarcoma testicular de grande dimensão submetido a tratamentos cirúrgicos com ressecção de bolsa escrotal e segmento do cordão espermático e do testículo esquerdo, apresentando boa evolução do quadro. O relato traz um dos primeiros casos de lipossarcoma testicular bem diferenciado com variante esclerosante, de grande dimensão e sem associação a outra neoplasia. Devido à localização, apresenta diagnóstico difícil e pouco habitual. Com a ressecção total do tumor e o acompanhamento médico regular, o paciente apresenta bom prognóstico, menor recidiva e pouca diferenciação celular.

Metástasis retroperitonal gigante de un tumor del saco de Yolk / Giant retroperitonal metastasis from a Yolk sac tumor

RESUMEN Paciente con antecedentes de cirugía de tumor testicular, con biopsia de tumor de saco de Yolk y con diagnóstico de un tumor metastásico retroperitoneal irresecable. Un año más tarde de este último diagnóstico es remitido a nosotros, con un aumento considerable de dicha lesión y se logra su exéresis satisfactoriamente. Se realizó una revisión de la literatura, las indicaciones y técnicas en el tratamiento de la metástasis retroperitoneal de un tumor del saco de Yolk y se presentan los resultados de un paciente diagnosticado e intervenido en el Hospital Clínico Quirúrgico "Hermanos Ameijeiras", en el año 2016. La diseminación metastásica retroperitoneal del tumor del saco de Yolk es poco frecuente, muy poco reportado a nivel mundial y con pocas experiencias en su tratamiento. Se realizó una técnica de resección de una lesión gigante con quimioterapia adyuvante posoperatoria. No hubo complicaciones relacionadas con el proceder(AU)

ABSTRACT Patient with a history of testicular tumor surgery, with a Yolk sac tumor biopsy and with a diagnosis of an unresectable retroperitoneal metastatic tumor. One year after this last diagnosis, he was referred to us, with a considerable increase in this lesion and his excision was successfully achieved. A review of the literature, indications and techniques for the treatment of retroperitoneal metastasis from a Yolk sac tumor was performed, and the results of a patient diagnosed and operated on at the "Hermanos Ameijeiras" Clinical Surgical Hospital, in the year 2016. Retroperitoneal metastatic spread of Yolk sac tumor is infrequent, very little reported worldwide and with few experiences in its treatment. A giant lesion resection technique was performed with postoperative adjuvant chemotherapy. There were no complications related to the procedure(AU)

Linfoma no Hodgkin primario testicular / Non hodgkin primary testicular limphoma

Los linfomas constituyen un grupo diverso de neoplasias malignas, que se originan del sistema linfático(1). Aproximadamente el 85% se agrupan dentro de los denominados Linfomas No Hodgkin (LNH). Los LNH constituyen un numeroso grupo de linfomas derivados de la transformación neoplásica de los linfocitos B, T y Células NK, provenientes de diversas zonas que comprometen los folículos linfáticos en los nódulos linfáticos o en el sistema linfoide extranodal(2). Las localizaciones extra ganglionares primarias representan más de 10% de los casos y los sitios más frecuentes comprenden estómago, intestino delgado, orofaringe, piel, hígado y cerebro; además de otras bastante raras como ano, corazón, músculos y encías. Los linfomas testiculares primarios son muy raros, representan aproximadamente el 5% de todas las neoplasias testiculares malignas, menos del 1% de los LNH y el 4% de los LNH extra nodales(3). Esta neoplasia constituye el tumor maligno testicular más frecuente en sujetos ancianos. La presentación clínica típica es una masa testicular unilateral acompañada en ocasiones de hidrocele y dolor agudo escrotal. A continuación presentamos un caso que requirió de la participación de múltiples especialidades de nuestra institución para un manejo conjunto y finalmente el paciente falleció(AU)

The lymphomas constitute a diverse group of malignant neoplasms, which originate from the lymphatic system(1). Approximately 85% are grouped into the so-called Non-Hodgkin's Lymphomas (NHL). NHL are a large group of lymphomas derived from the neoplastic transformation of B, T and NK cells of different areas with involvement of lymphatic follicles in the lymph nodes or the extranodal lymphoid system(2). The primary extraganglionic sites represent more than 10% of the cases and the most frequent sites include stomach, small intestine, oropharynx, skin, liver and brain; others, quite rare, are anus, heart, muscles and gums.Primary testicular lymphomas are extremely rare, accounting for approximately 5% of all malignant testicular neoplasms, less than 1% of NHL and 4% of extranodal NHL(3). This neoplasm constitutes the most frequent testicular malignant tumor in elderly subjects. The typical clinical presentation is a unilateral testicular mass, sometimes accompanied by hydrocele and acute scrotal pain. We present a case which required the participation of multiple specialties of our institution for management but the patient finally died(AU)

Fibroma testicular / Testicular fibroma

El fibroma paratesticular es un proceso proliferativo benigno de origen incierto, probablemente inflamatorio reactivo no tumoral. El objetivo del trabajo es presentar un caso de fibroma paratesticular, así como la secuencia diagnóstica y terapéutica adoptada. Se presenta un paciente de 55 años de edad con antecedentes de hipertensión arterial. Acude a la consulta externa de Urología por presentar aumento de volumen del testículo derecho, de un año de evolución, que en los últimos tres meses le había ocasionado molestias leves. Al interrogatorio no se recogieron antecedentes de traumatismos o inflamaciones en ese testículo. En el examen físico presentó, hacia el polo inferior del testículo y cola del epidídimo derechos, una masa de consistencia pétrea, irregular, de 3 a 4 cm de diámetro, fija e indolora. El ultrasonido testicular reportó la presencia de una imagen compleja, hacia polo inferior, heterogénea hipo e hiperecoica calcificada en su interior, que medía 33 x 18 x 34 mm para 11cm³ de volumen, y con ligero hidrocele asociado. El paciente fue sometido a orquiectomia radical derecha, proceder que transcurrió sin complicaciones. El resultado histopatológico fue proliferación fibrosa nodular e hialinizante que afecta la túnica albugínea, fibroma calcificado del testículo derecho. La evolución posoperatoria fue satisfactoria. Aunque el diagnóstico definitivo de fibroma paratesticular es histopatológico, sus características clínicas y ecográficas lo hacen ser uno de los diagnósticos diferenciales a tener en cuenta, con los tumores malignos del testículo(AU)

Paratesticular fibroma is a benign proliferative process of uncertain origin, probably non-tumor reactive inflammatory. The aim of the study is to present a case of paratesticular fibroma, as well as the diagnostic and therapeutic sequence implemented. We present a 55 year old patient with a history of hypertension. This patient visits the Urology outpatient clinic because of an increase in volume of the right testicle, a year of evolution, which in the last three months had caused slight discomfort. No history of trauma or inflammation was recorded in the testicle. On the physical examination he presented, to the lower pole of the testis and tail of the right epididymis, a mass of irregular stony consistency, 3 to 4 cm in diameter, fixed and painless. The testicular ultrasound reported the presence of a complex image, towards the lower pole, heterogeneous hypo and hyperechoic calcified inside, which measured 33 x 18 x 34 mm for 11 cm3 volume, and with associated light hydrocele. The patient underwent right radical orchiectomy with no complications. The histopathological result was nodular and hyalinizing fibrous proliferation affecting the tunica albuginea, calcified fibroma of the right testicle. Postoperative evolution was satisfactory. Although the definitive diagnosis of paratesticular fibroma is histopathological, its clinical and ultrasound characteristics make it one of the differential diagnoses to be considered with malignant tumors of the testis(AU)

Varón joven con disnea y hemoptisis

La hemoptisis puede ser la primera manifestación de un gran número de enfermedades, cuyo diagnóstico y tratamiento pueden ser muy diversos. En la práctica clínica es muy importante identificar su causa, localizar su origen, estimar su gravedad e instaurar lo más precoz el tratamiento específico. Reportamos un caso de hemoptisis y disnea, acompañado de síndrome constitucional de un mes de evolución, en paciente varón de 20 años, con una masa de 2 cm en testículo derecho, infiltrado nodular difuso en ambos pulmones y nódulos hepáticos. Esputo sanguinolento negativo para BAAR. Presentó desenlace fatal.

Hemoptysis may be the first manifestation of a large number of diseases with very diverse diagnosis and treatment. In the clinical practice, it is very important to identify the cause, locate its origin, estimate the seriousness and install the specific treatment as early as possible. We report here a case of hemoptysis and dyspnea, accompanied by a constitutional syndrome of a 1-month evolution in a 20-year-old male patient with a 2-cm mass in his right testicle, diffuse nodular infiltrate in both lungs and hepatic nodules. Bloody sputum was negative for AARB. It has a fatal outcome.

Leiomioma Paratesticular / Paratesticular leiomyoma

Los tumores genitourinarios tienen presentaciòn testicular (98%) o paratesticular (2%). La incidencia de los tumores paratesticulares es mínima, ya que son más comunes los tumores del tejido testicular como tal y no tanto así los originados en tejidos mesenquimales como el leiomioma, el cual es considerado una neoplasia rara en su presentación para esta localización. Al ser una entidad de presentación poco común, su diagnóstico es un reto ya que la mayoría de estos son referidos como tumores testiculares, se debe tener en cuenta que hoy en día hay nuevas alternativas para su adecuado diagnóstico pre-operatorio como por ejemplo uso de Resonancia magnética ya que es de elección en tumores de partes blandas. Es por esta razón que se presenta este caso, para poder dar a conocer su incidencia en nuestro medio, su presentación clínica, las técnicas de abordaje diagnóstico además de los diagnósticos diferenciales y su terapéutica.

The tumors genitourinarios have presentaciòn testicular (98 %) or paratesticular (2 %).The incident of the tumors paratesticulares is minimal, since the tumors of the fabric are more common testicular as such and not so much this way the originated ones in fabrics mesenquimales as the leiomioma, which is considered to be a rare neoplasia in his presentation for this location.To the being an entity of slightly common presentation, his diagnosis is a challenge since the majority of these they are recounted as tumors testiculares, it is necessary to to bear in mind that nowadays there are new alternatives for his suitable pre-operative diagnosis as for example use of magnetic Resonance since it is of choice in tumors of soft parts. It is for this reason that appears this case, to be able to announce his incident in our way, his clinical presentation, the technologies of diagnostic boarding besides the differential diagnoses and his therapeutics.

Quiste epidermoide testicular: diagnóstico ecográfico preoperatorio y correlación radiopatológica / Testicular epidermoid cyst. preoperative ultrasound diagnosis and radiopathological correlation

The low incidence of testicular epidermoid cyst (1-2 percent of all testicular tumors), makes ultrasound findings the key to making, or at least suggesting, a precise preoperative diagnosis, thus making a conservative treatment possible. We present two cases with ultrasound diagnosis of epidermoid cyst, confirmed later after surgery. We review the literature, emphasizing the evaluation of the ultrasound images and their correlation with the anatomopathological findings.

La escasa incidencia del quiste epidermoide de testículo (1-2 por ciento de todos los tumores testiculares), hace de los hallazgos ecográficos la clave para realizar o al menos sugerir un diagnóstico prequirúrgico preciso, haciendo por tanto posible un tratamiento conservador. Presentamos dos casos con diagnóstico ecográfico de quiste epidermoide, confirmado posteriormente tras cirugía. Realizamos una revisión de la bibliografía, enfatizando en la valoración de las imágenes ecográficas y su correlación con los hallazgos anatomopatológicos.

Hiperplasia nodular de células de Leydig / Nodular Leydig cell hyperplasia

A hiperplasia de células de Leydig (HCL) é uma condiçãobenigna que pode trazer dificuldade no diagnósticodiferencial com neoplasias testiculares, levando aorquiectomia desnecessária. Não existem diretrizes notratamento, riscos e acompanhamento destes pacientes.Discute-se a possibilidade de diagnóstico desta condiçãobenigna pré-tratamento. Relatamos o caso de umnódulo sólido testicular em um paciente de 33 anos percebidopela palpação e confirmado pela ecografia commarcadores tumorais negativos. Submetido à orquiectomiaradical direita, o exame histológico revelou hiperplasianodular de células de Leydig e ectopia adrenalem cordão espermático. A conduta seguinte constituiuacompanhamento clínico trimestral. Conclusão: pareceser consenso que um nódulo sólido testicular palpávelou demonstrado por USG em homem jovem, independentementedos marcadores tumorais, deverá ser levadoa orquiectomia radical. Mas o achado de múltiplos nódulosmenores que 6mm bilaterais sugerem, inicialmente,HCL e podem ser seguidos, desde que apresentem marcadoresnegativos. De modo semelhante, quando houveressecção prévia de uma HCL, a exerese parcial pode seruma alternativa.

The Leydig cell hyperplasia (LCH) is a benign conditionthat can cause difficulty in differential diagnosiswith testicular neoplasms, leading to unnecessary orchiectomy.There are no guidelines for the treatment,risks and monitoring these patients. It discusses the possibilityof pretreatment diagnosing this benign conditio.The case of a solid testicular nodule in a patient of 33years detected by palpation and confirmed by sonographywith negative tumor markers. Underwent right radicalorchiectomy, the histologic examination revealednodular hyperplasia of Leydig cells and adrenal ectopicin the spermatic cord. The following constitutes conductclinical monitoring quarterly. It seems to be consensusthat a solid nodule or a palpable testicular demonstratedby ultrasonography in a young man, regardless of tumormarkers should be taken to radical orchiectomy. Butthe finding of multiple bilateral nodules smaller than6mm suggests, initially, LCH and may be followed, providedthat they have negative markers. Similarly, whenthere was a previous resection of the LCH partial resectionmay be an alternative.

Tumores testiculares bilaterais por hiperplasia congênita de restos adrenais / Bilateral testicular tumors caused by congenital adrenal rest hyperplasia

OBJETIVOS: Tumores testiculares são uma rara condição associada à hiperplasia adrenal congênita (HAC) que decorrem da hiperplasia de restos adrenais intratesticulares (HRA), raramente ocorrendo associados a neoplasias malignas. Sua diferenciação histológica com tumores de células de Leydig é muito difícil, podendo levar a orquiectomias desnecessárias. O objetivo deste relato foi apresentar esse dilema diagnóstico em um paciente com HAC e tumores testiculares bilaterais. MÉTODOS: Relatou-se o caso de um paciente masculino, 16 anos, com diagnóstico de HAC desde os 3 anos de idade, que apresentava tumorações testiculares endurecidas, indolores e de crescimento lento, sendo encaminhado para orquiectomia bilateral. RESULTADOS: Foi decidido por tratamento conservador com prednisona, havendo significativa diminuição do volume testicular e normalização dos níveis de andrógenos. CONCLUSÃO: Este caso demonstra a importância de sempre se considerar a hipótese de HRA intratesticulares no diagnóstico diferencial dos tumores testiculares. A investigação e a conduta devem ser conduzidas de maneira cautelosa para se evitar orquiectomias desnecessárias.

OBJECTIVES: Testicular tumors are a rare condition associated with congenital adrenal hyperplasia (CAH), originated from intratesticular adrenal rest tumors, and they are rarely associated with malignant tumors. Their histological differentiation from Leydig-cell tumors is quite difficult, which would lead to inappropriate orchiectomies. Thus the objective of this report was to present this diagnostic dilemma. METHODS: Reported the case of 16-yr-old boy with previous diagnosis of CAH with bilateral testicular enlargement who was recommended to be submitted to a bilateral orchiectomy. RESULTS: Considering this findings, it was decided to treat conventionally with prednisone with significant reduction of testicular volume, and normalization of androgens levels. CONCLUSION: This case shows the importance of intratesticular adrenal rest tumors in the differential diagnosis of testicular tumors. Cautious approach during investigation and treatment are recommended to avoid inappropriate orchiectomies.

Linfadenectomía lumboaórtica laparoscópica para cáncer testicular no seminomatoso estadio clínico I / Laparoscopic lumbo-aortic lymph-node dissection in clinical stage i non-seminomatous testicular germ-cell tumors

Reportar la morbilidad y resultados oncológicos de la Linfadenectomía Lumboaórtica por vía laparoscópica (LLA lap) en pacientes portadores de tumor de células germinales no seminomatoso (TCGNS) estadio I, operados en el Hospital Ramón Barros Luco Trudeau. Pacientes y Métodos: Entre octubre de 2005 y agosto de 2008, 29 pacientes con TCGNS estadio I, fueron sometidos a LLA lap. No se realizó selección de pacientes en relación a los hallazgos anatomopatológicos o a la presencia de factores de riesgo. La Linfadenectomía retroperitoneal fue realizada por el mismo cirujano, respetando los límites descritos por Weissbach y Boedefeld. Resultados: De los 29 pacientes operados, el procedimiento fue completado en su totalidad por vía laparoscópica. La pérdida sanguínea promedio fue de 27,7 cc (5–250). No fue necesaria tranfusión sanguínea. El tiempo operatorio promedio fue de 170 min (150–240). El número de ganglios resecados promedio fue de 12,8 (4–25). El tiempo de hospitalización fue de 2 días. Se registró una complicación vascular intraoperatoria, que se manejo satisfactoriamente sin necesidad de conversión. Se preservó la eyaculación anterograda en la totalidad de los pacientes. Cuatro pacientes (13,8 por ciento) tuvieron estadio patológico IIa y recibieron quimioterapia adyuvante con Cisplatino, Etopósido y Bleomicina. Durante un periodo de seguimiento promedio de 19 meses (2-36) ninguno de los pacientes ha presentado recidiva. Conclusión: La Linfadenectomía Lumboaórtica por vía Laparoscópica ha demostrado ser una excelente herramienta de estadificación, la cual ofrece una alternativa mínimamente invasiva a la cirugía convencional abierta. Los resultados de la serie, durante el periodo de seguimiento, demuestran su equivalencia oncológica a la cirugía abierta, sumándose los beneficios de la técnica laparoscópica que incluyen, una menor morbilidad y una mejoría tanto en la visualización intraoperatoria, resultado estético como en la calidad de vida del paciente.

To report the morbidity and oncological results of laparoscopic lumbo-aortic lymph-node dissection (LLA lap) in clinical stage I non-seminomatous testicular germ cell tumors (TCGNS), operated at the Hospital Ramón Barros Luco Trudeau.Patients and Methods: Between October 2005 and August 2008, 29 patients with stage I TCGNS, underwent LLA lap. No patient selection was made in relation to the pathological findings or the presence of risk factors. Retroperitoneal lymphadenectomy was performed by the same surgeon within the limits described by Weissbach and Boedefeld. Results: The procedure was completed in its entirety with laparoscopic procedure. The average blood loss was 27.7 cc (5-250). There was no blood tranfusion. The average operative time was 170 min (150-240). The average number of lymph nodes resected was 12.8 (4-25). The hospitalization time was 2 days. There was an intraoperative vascular complication, which satisfactorily manage without conversion to open surgery. Antegrade ejaculation was preserved in all patients. 4 patients (13.8 percent) had pathological stage II received adjuvant chemotherapy with cisplatin, etoposide and bleomycin. During an average follow-up period of 19 months (2-36) none of the patients presented recurrence. Conclusion: The laparoscopic lumbo-aortic lymph-node dissection has proven to be an excellent staging tool, which offers a minimally invasive alternative to conventional open surgery. The results of the series during the follow-up period, demonstrate oncological equivalence to open surgery, adding the benefits of laparoscopic technique including a lower morbidity and an improvement in intraoperative visualization, aesthetic result and the quality of patient’s life.

Prognóstico de tumores testiculares germinativos

OBJECTIVE: The aim of the study is to analyze the characteristics and the evolution of patients with testicular germ cell tumors. METHODS: We analyzed 29 patients: 14 seminomas and 15 non-seminomas. All of them underwent orquiectomy. Patients with seminomas stage II and III received adjuvant treatment with raditherapy, and those with non-seminomas stage II and III received neoadjuvant chemotherapy followed by lymphadenectomy. Mean followup for seminomas was 56 months and for non-seminomas it was 40 months. RESULTS: The most common complain was an increase in testis volume (57%) and pain (30%). The mean age in seminomas was 41.2 years and in non-seminomas it was 29.2 years. Previous criptorquidy was refered by 28.5% of patients with seminomas and 15.5% with non-seminomas. The respective proportions of stages I, II and III were 79%, 14% and 7% in seminomas, and 40%, 27% and 33% in non-seminomas. Patients with seminomas did not show serum rise of alfa-fetoprotein or b-HCG while those with non-seminomas such tumor markes were elevated respectively in 46.6% and 33.3% of the sample. Disease specific death occurred in 1 patient with seminoma and in 3 with non-seminoma tumor, but survival curves were similar for both groups. CONCLUSION: In spite of the earlier treatment of criptorquidy such an antecedent stand as an important risk factor for the development of testicular germ cell tumor. Even though non-seminomas presents with higher stages the survival curves are similar for both groups of tumors. Analyze 29 patients that were submitted to orquiectomy (14 seminomas e 15 non seminomas), concerning their age, signs and symptoms, risk factors, clinical staging, tumor markers follow up and survival rates. RESULTS: There was no statistically difference in survival rates of patients with seminomas and non-seminomas tumors.

OBJETIVO: Investigar as características e a evolução de homens adultos portadores de tumores germinativos do testículo. MÉTODOS: Estudamos as características e a evolução 29 pacientes tratados (14 seminomas e 15 não seminomas). O tempo médio de seguimento foi de 56 meses para os seminomas e de 40 meses para os não seminomatosos. Todos foram submetidos a orquiectomia. Nos estádios II e III associou-se radioterapia para os seminomas, e quimioterapia e linfadenectomia para os não seminomatosos. RESULTADOS: As queixas mais freqüentes foram aumento de volume testicular (57%) e dor (30%). Nos seminomas a idade média foi de 41,2 anos e nos não seminomas foi de 29,2 anos. Antecedente de criptorquidia foi assinalada em 28,5% dos seminomas e em 15,5% dos não seminomatosos. As proporções respectivas de estádios I, II e III foram de 79%, 14% e 7% em seminomas, e 40%, 27% e 33% em não seminomas. Os seminomas não provocaram elevação dos marcadores AFP ou b-HCG enquanto os não seminomatosos elevaram esses marcadores respectivamente em 46,6% e 33,3% dos casos. Morte pela doença ocorreu em 1 caso de seminoma e 3 de não seminomas, mas não houve diferença na sobrevida entre os grupos. CONCLUSÃO: A criptorquidia continua sendo um fator predisponente importante na etiologia dos tumores germinativos. Apesar dos tumores não seminomatosos se apresentarem em estádios mais avançados a sobrevida dos pacientes não difere da apresentada pelos portadores de seminomas.