Carcinoma in situ of germ cells and subsequent development of an invasive seminoma in a hyperprolactinaemic man

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Abstract
A 25-yr-old man was first seen complaining of impotence and found to have a pituitary tumor and hyperprolactinemia. Both testes were small and atrophic, but a testicular tumor was not apparent. Biopsy of the right testis was performed, and the pathology report described thickening of the seminiferous tubule walls and impaired spermatogenesis. The patient refused to undergo an operation for his pituitary tumor and was lost to follow-up. Five years later, the same patient presented with enlargement of his right testis, and this and the pituitary tumor were excised. The testicular tumor was classified as seminoma, and the pituitary tumor as an adenoma with low malignancy. Reexamination of the previous specimen of his right testis revealed foci of carcinoma in-situ. This is an additional example of the growth of an envasive germ cell tumor from non-invasive carcinoma in-situ of the testis.