Extragonadal germ cell tumor: the preoperative urological evaluation.

Primary extragonadal germ cell tumors were diagnosed in 4 patients in whom surgical or postmortem examination of the testis failed to reveal germ cell tumor. A fifth patient underwent serial examination with testicular ultrasound without evidence of any abnormalities and he remains free of disease following chemotherapy. Based on our experience and a literature review, it is our opinion that orchiectomy is not indicated unless there is a palpable testicular abnormality, recent change in testicular size or consistency, abnormal testicular ultrasound or history of cryptorchidism, or if the primary tumor is choriocarcinoma.