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Infertility and testis cancer risk: causal or association?

In his state-of-the-art lecture, Prof. Leendert Looijenga (Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands) discussed the connection between infertility and testicular cancer [1]. The molecular associations were reviewed as well as putative causality.

Testicular germ cell tumours (TGCTs) display a tremendous variety of morphologic elements, often in mixed pathologies. Generally, TGCTs are classified as either germ cell neoplasia in situ (GCNIS), or non-GCNIS-associated TGCTs. Most malignant TGCTs originate from GCNIS. Molecular and genetic studies have highlighted 7 types of TGCTs, which can also be understood within terms of developmental processes.

Diagnosis, treating, and follow-up of TGCTs relies on understanding of the biological drivers of the disease, yet little is really known. In patients with TGCTs, fertility preservation is an important component following cancer treatment, and the question posed here is whether in...

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