Attempted preservation of one gonad in patients with bilateral germ cell tumours

Almost all patients with early stage testicular or ovarian germ cell tumours can now expect to be cured of their disease. The preservation of fertility and sex hormone production after treatment are of importance in these predominantly young adults, especially in the uncommon cases of bilateral tumours. We present the case reports of a woman with bilateral dysgerminoma and a man with bilateral testicular seminoma, who were managed by organ-sparing surgery of the least affected gonad followed by chemotherapy. Both patients regained fertility, but a further germ tumour has developed in the man's remaining testicle. The merits and potential pitfalls of this approach are discussed.