Testis-Sparing Surgery for Metachronous Testicular Tumor Following Orchiectomy

For metachronous bilateral testicular tumors occurring in young adulthood, the post-treatment quality of life must be considered when making treatment decisions.

A 46-year-old man presented to our hospital with a chief complaint of two bean-sized hard masses palpable in the right testis. At the age of 35, he had undergone inguinal orchiectomy for a tumor in the left testis, and the histopathological diagnosis was seminoma, with the stage pT1, N0, M0, S0. Adjuvant chemotherapy with carboplatin was not administered postoperatively. To preserve fertility, testis-sparing surgery was performed. The warm ischemic time during surgery was 32 min. Histopathological examination indicated seminoma, and biopsy did not reveal germ cell neoplasia in situ. His sexual function was preserved at 22 months after surgery; however, semen analysis revealed azoospermia.

Testis-sparing surgery should be considered for metachronous bilateral testicular tumors, particularly for patients with tumor onset in young adulthood as it was thought to have the potential to maintain a favorable prognosis and fertility.