Kans op testiculair carcinoma in situ in cohort van 204 patiënten met niet-obstructieve azoöspermie

Summary: Risk of testicular carcinoma in situ in a cohort of 204 patients with non-obstructive azoospermia Introduction:: Infertile men have a higher chance of testicular germ cell tumors (TGCT). The non-invasive stage of TGCT, also known as carcinoma in situ (CIS), can only be diagnosed by a testicular biopsy. Testicular CIS is found in 2,2% of the general infertile male population. Five percent of men with a history of TGCT will develop a contralateral TGCT. At routine biopsy during orchiectomie for TGCT 5% of men will have CIS in the contralateral testis. We found no reports on the prevalence of CIS in men undergoing TEsticular Sperm Extraction (TESE) for non-obstructive azoospermia (NOA). Patients and methods:: From 2007 to 2014 testicular histology was performed in all men that had TESE for NOA. In addition, reproductive hormones, scrotal ultrasound, genetic analyses and risk factors for TGCT were determined Results:: In 204 patients with NOA, eight patients had CIS (4,0%). Four of these patients had a history of a TGCT. Of the remaining four patients with CIS (2,0%), one had bilateral CIS. Two of the four patients had a history of cryptorchidism. Conclusion:: Testicular CIS is more prevalent in men with NOA than in the general male population. If a patient has no history of unilateral TGCT the chance of having CIS is equal to that of the male infertile population. In men with NOA and a history of TGCT the chance of having CIS in the contralateral testis is high (57%). Keywords:: testicular carcinoma in situ, non-obstructive azoospermia, TESE

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