[Cerebral metastases of malignant germinal tumors of the testis]

Cerebral metastases occur in 6% of cases of testicular cancer. In our study of 5 cases they occurred during the course of the disease (with a delay of 4-18 months, at the same time as pulmonary and abdominal metastases). The prognosis in these cases is poor (presence of choriocarcinomatous or vitelline elements, advanced stages). The diagnosis is easily established (clinical, encephalogram, scanner); the prognosis is hopeless (5 deaths in 3-90 days). When a metastasis is the first diagnostic clue (one case), the prognosis is slightly better (9 month survival). The incidence of cerebral metastasis is the same now as it was before the introduction of effective chemotherapy in patients who die from testicular cancer, but the death rate from this malignancy has decreased since the introduction of active chemotherapy with cisplatin. Hence, there is no indication for prophylactic treatment for cerebral metastases in patients in remission since metastases only appear in cases which are resistant to treatment.