RT Book, Section A1 Moore, Joseph A. A1 Tu, Shi-Ming A2 Kantarjian, Hagop M. A2 Wolff, Robert A. A2 Rieber, Alyssa G. SR Print(0) ID 1190838034 T1 Germ Cell Tumors T2 The MD Anderson Manual of Medical Oncology, 4e YR 2022 FD 2022 PB McGraw Hill Education PP New York, NY SN 9781260467642 LK accessmedicine.mhmedical.com/content.aspx?aid=1190838034 RD 2024/03/28 AB KEY CONCEPTSGerm cell tumors (GCTs) are the most common new cancer diagnosis in young men and are divided into two types, seminoma and nonseminoma germ cell tumors (NSGCTs).In a young man without obvious testicular primary or unknown primary tumor, serum tumor markers, specifically human chorionic gonadotropinβ-, α-fetoprotein (AFP), and cytogenetic study, namely i(12p), have unique diagnostic and prognostic significance in GCTs.GCTs follow a distinct pattern of spread and metastasis—the right testicle drains to the interaortocaval lymph nodes, and the left testicle drains to the left paraaortic lymph nodes.Approximately half of testicular GCTs show histologic elements other than seminoma or produce serum elevation of AFP indicating nonseminoma. These cancers are collectively known as mixed NSGCTs, and they form a group of histologically and clinically diverse cancers.Optimal management of patients with high-risk or mixed NSGCTs requires a multidisciplinary approach, integrating chemotherapy and surgery, to achieve the highest cure rates.Patients who pose a unique diagnostic or therapeutic challenge should be considered for early referral to a large tertiary care center.