Predisposing factor of Testicular germ cell tumor ?
High-Yield Explanation
Ans is 'a' i.e. Cryptorchidism; 'b' i.e. Testicular Feminization syndrome; 'c' i.e. Klinefelter's syndrome Predisposing factors for testicular GCTs are a) Cryptorchidism b) Testicular feminization syndrome c) GCT of one testis is a risk factor for the other testis d) Testicular Ca in a sibling e) Klienfelter syndrome - is associated with mediastinal GCT f) Administration of estrogens (eg DES) to the mother during pregnancy is associated with increased incidence of testicular Ca in male offspring. Some points are woh mentioning about cryptorchidism Of the predisposing factors, cryptorchidism has the strongest association with testicular Ca. Increased risk is seen for both the testis i.e. the cryptorchid testes as well as the normally descended testes Abdominal cryptorchid testes are at a higher risk than inguinal cryptorchid testes. Seminoma is the most common type of testicular cancer seen in a cryptorchid testes Remember this : Placement of the cryptorchid testis into the scrotum (orchipexy) does not alter its malignant potential, however it facilitates examination and tumor detection [Ref: Campbell's Urology 8/e, p 2882; Smith's Urology I7/e, p3751 (Note that Harrison (17/e, p601) contradicts the above statement but we should follow what Campbell & Smith say)