Testicular tumors of germ cell origin. 1. Epidemiology, pathogenesis, clinical presentation, and diagnosis

Germinal testicular tumors occur in all age-groups but are most prevalent in men 20 to 34 years old. Tumor development has been associated with incompletely descended testis, "dysgenetic" testis, tumor in the contralateral testis, and trauma. Testicular tumor most often presents as a painless enlargement and induration. Examination should be meticulous and thorough. Any testicular or scrotal mass should be considered neoplastic until proven otherwise. When a testicular or intrascrotal mass presents a diagnostic dilemma, the lesion should be explored through an inguinal exposure. This surgical maneuver spares the patient an unnecessarily long and uncertain follow-up.