Daugaard G, von der Maase H, Olsen J, Rørth M, Skakkebaek N E
Lancet. 1987 Sep 5;2(8558):528-30. doi: 10.1016/s0140-6736(87)92922-9.
Testicular biopsies were done in 15 consecutive patients who were believed to have extragonadal germ-cell tumours. 8 patients (53%) had carcinoma-in-situ (CIS) in the gonads, although none had clinical signs of tumour. In addition, 3 of these patients had small areas of invasive tumour growth. Germ-cell tumours can only be diagnosed as being extragonadal in origin if testicular biopsy appearances are normal.