Metachronous bilateral testicular seminoma developing after an interval of 31 years: case report and review of the literature.

Men diagnosed with testicular germ cell tumors are at higher risk for development of a second germ cell tumor in the contralateral testis. Metachronous bilateral testicular germ cell tumors usually occur within 5 years. Here, we report a case of a 63-year-old man previously diagnosed with testicular seminoma and treated with a left orchiectomy followed by radiation, developing contralateral testicular seminoma after an interval of 31 years. The patient was asymptomatic and found to have an enlarged, nontender right testis on routine urological examination. Further workup did not reveal evidence of metastatic disease or lymphadenopathy. The surgery specimen revealed a 4.2 × 3.1 × 1.8 cm distinct mass without tumor involvement of tunica albuginea or the tunica vaginalis. Microscopy showed classic seminoma with venous/lymphatic tumor invasion. The current case underscores the importance of recommending lifelong follow-up for patients with testicular germ cell tumors.