Precancerous condition of the testicle

There is one precancerous condition of the testicle – germ cell neoplasia in situ (GCNIS). With this condition, changes to testicular cells make them more likely to develop into testicular cancer if not treated. But the condition is not yet cancer.

Germ cell neoplasia in situ

GCNIS is a precancerous condition that can develop in the testicle. It is also called intratubular germ cell neoplasia, unclassified, or sometimes called testicular intraepithelial neoplasia.

GCNIS is when germ cells in the seminiferous tubules change so they are no longer normal. The germ cells look like cancer cells, but they aren’t behaving like cancer cells yet. This means that they are not growing into the surrounding tissues (they are non-invasive).

GCNIS can develop into any type of germ cell tumour. About 5% of men with a germ cell tumour in one testicle will have GCNIS in the other testicle.

Risk factors

The following risk factors increase your chance of developing GCNIS:

  • personal history of testicular cancer
  • undescended testicle (cryptorchidism)
  • a birth defect where the genitals do not look normal (called ambiguous genitalia)
  • abnormal shrinking of the testicles (called testicular atrophy)
  • infertility

Symptoms

GCNIS usually doesn’t cause any symptoms because a lump does not form. But it may cause fertility problems in some cases.

Diagnosis

GCNIS is usually found during surgery to remove one or both testicles (called an orchiectomy). It can also be found when the doctor is looking for the cause of other problems.

GCNIS is diagnosed by a biopsy. A biopsy can be done as part of an orchiectomy. A biopsy may also be done to find the reason for other problems, such as infertility.

Treatments

Experts are trying to find the best ways to treat GCNIS. Currently, there are no standard treatments. Treatment is based on risk factors and each man’s needs and preferences.

Treatment options for GCNIS may include:

  • watchful waiting
  • orchiectomy
  • radiation therapy

Expert review and references

  • American Cancer Society. What Is Testicular Cancer?. 2018. https://www.cancer.org/.
  • Basiri A, Movahhed S, Parvin M, et al. The histologic features of intratubular germ cell neoplasia and its correlation with tumor behavior. Investigative and Clinical Urology. 2016. http://www.icurology.org/.
  • National Cancer Institute. Testicular Cancer Treatment (PDQ®) – Health Professional Version. Bethesda, MD: National Cancer Institute; 2018. https://www.cancer.gov/.
  • Reuter, VE. Anatomy and Pathology of Testis Cancer. Scardino PT, Lineham WM, Zelefsky MJ & Vogelzang NJ (eds.). Comprehensive Textbook of Genitourinary Oncology. 4th ed. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins; 2011: 31:532-543.
  • Williams MB. Medscape Reference: Testicular Seminoma Pathophysiology. 2016. https://emedicine.medscape.com/article/437966-overview#a6.
  • Williamson SR, Delahunt B, Magi-Galluzzi C, et al. The World Health Organization 2016 classification of the testicular germ cell tumours: a review and update from the International Society of Urological Pathology Testis Consultation Panel. Histopathology. 2017.

Medical disclaimer

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