Development of a testicular tumour during cisclomiphene therapy.

Enlargement of an atrophic testis occurred in an oligospermic patient during long-term therapy with a low dosage of cisclomiphene. Orchidectomy revealed an adult teratoma combined with an atypical seminoma. The development of a germinal-cell neoplasm during pituitary-gonadal stimulation therapy raises the question of a possible cause-effect relationship. Available evidence does not support this possibility. However, it is less clear whether hormonal influences may promote the growth of a germ-cell tumour focus. Therefore, prolonged treatment with such agents demands close supervision, particularly in patients with a predisposition to gonadal carcinogenesis.