Authors from London looked at patients diagnosed with germ cell tumours of the testis who presented between 1983 and 2002. They found that there was an overall increase in the percentage of patients presenting with stage I seminoma, with a significant reduction in the size of the primary tumour. The authors do not feel that they can clarify the reason for these changes. There is a 20‐year follow‐up of patients who had tumours of the ureter and renal pelvis treated with resection and renal autotransplantation. In this fascinating series from Gothenberg, it was found that in patients with a normal contralateral kidney, resection and autotransplantation was not indicated. It was possibly beneficial in patients with solitary kidneys, but only after other treatments have been considered. OBJECTIVE To prospectively investigate the presentation of germ cell tumours (GCTs) of the testis in terms of stage or histology, as the incidence of this disease in increasing. PATIENTS AND METHODS Patients diagnosed with GCT of the testis between 1983 and 2002 were categorised into three periods depending on the date of diagnosis of the GCT, and the presentational characteristics assessed. RESULTS There was a significant increase in the proportion of patients presenting with stage I disease (59% to 78%) and seminoma (43% to 58%) over this period. There was also a significant reduction in the size of the primary tumour (5 to 4 cm). CONCLUSION A greater proportion of patients with GCT are presenting with stage I seminoma, the reasons for which are unclear, although earlier diagnosis through improved awareness of GCT may be important.

Testicular seminoma occurs significantly more frequently in HIV-positive men than in the matched control population. Patients with HIV-related GCTs present and should be treated in a similar manner to those in the HIV-negative population. After a median follow-up of 4.6 years, 9% of the patients died from GCT. Most of the mortality relates to HIV infection.