If a rising level is noted on a follow-up AFP or ß-HCG, a physician will treat the patient for recurrence. This is sometimes called a "marker only relapse."
The spermatic cord is usually excised with the testicle, although the cord may not be mentioned in the pathology report. Unless the operative report states that the cord was not removed, the surgery code for excision of a testicle would be 30, excision of the testicle with cord.
Testicular cancers are usually not graded; the 6th digit differentiation code would be 9.
Simultaneous bilateral occurrence is defined as diagnosis within two months.
The majority of mixed cell type testicular cancers are single primaries. The pathologist should indicate the percentage of each cell type in the tumor. Follow the ICD-O-3 rules for coding common combinations of cell types and for coding to the higher code number for combinations that do not have unique codes.
Trans-scrotal orchiectomy (surgical approach by incising the scrotal sac) may result in tumor seeding in the skin and inguinal nodes. Transinguinal orchiectomy (surgical approach via the inguinal canal) is the surgical approach of choice.
Germ cell neoplasms, particularly seminomas, may also occur in such non-gonadal sites as the mediastinum, presacral area, or pineal gland. These cases are coded to the primary site of origin, not to the testis.