Testicular intraepithelial neoplasia
The testicular intraepithelial neoplasia (TIN) is a cell change in the testicles a testicular tumor precedes ( precancer ). Since it develops from germ cells ( spermatogonia ), it is considered a preliminary stage of germ cell tumors, which make up 95% of all testicular tumors. It is believed that testicular intraepithelial neoplasia is an obligate precancerous condition, which means that a testicular tumor develops from every testicular intraepithelial neoplasm . The risk of malignant degeneration of testicular intraepithelial neoplasia is 70%.
pathology
The cells that are found in a testicular intraepithelial neoplasm have significantly larger cell nuclei than the healthy cells. In addition, in contrast to these PAS, they are positive and express placental alkaline phosphatase ( PLAP ), which can be detected immunohistochemically .
Occurrence
Testicular intraepithelial neoplasia, like the testicular tumor resulting from it, is most common in the age group from 20 to 35. If a testicular tumor is present, 5% of the TIN is found in the contralateral testicle.
Diagnosis
method
- biopsy
- immunohistological examination
Indications for diagnosis
- contralateral testes in post-testicular tumor condition
- with organ-preserving tumor excision
- in certain forms of microlithiasis testis
- Maldescensus testis
therapy
The standard therapy for testicular intraepithelial neoplasia currently consists of local radiation therapy of 20 Gy , which is administered in several sessions (2 Gy each over 2 weeks). While the hormone-producing Leydig cells remain largely functional, the germ cells can be damaged by the toxicity . If you wish to have children, sperm should be preserved before therapy .
An orchiectomy can also be performed if the second testicle is healthy and should not be endangered by radiation .
Chemotherapy alone has a cure rate of almost 70%. Existing TIN cells should receive secondary irradiation.
The prognosis for testicular intraepithelial neoplasia is good.
