Do not skip the pre-treatment tumor markers and staging record
Freiburg lists AFP, HCG and LDH together with ultrasound and CT/MRI as core diagnostic information. For an international second opinion, send the marker values with dates, the original imaging and the operative/pathology report rather than only a short diagnosis such as 'seminoma' or 'testicular cancer'.
Orchiectomy provides both treatment and definitive pathology
Düsseldorf and Freiburg describe inguinal surgical removal of the affected testis as a central initial step when a malignant testicular tumor is suspected or confirmed. The post-operative pathology then helps distinguish seminoma from non-seminomatous germ-cell tumor and contributes to stage- and risk-adapted planning.
The next step can range from surveillance to systemic treatment
Further management depends on tumor type, stage, marker dynamics and risk group. German specialist centers document surveillance for selected early-stage disease, chemotherapy for metastatic or higher-risk disease, radiotherapy in selected seminoma pathways and retroperitoneal lymph-node surgery for selected situations. These options are not interchangeable and should be discussed in a germ-cell-tumor specialist setting.
Fertility preservation belongs before treatment when possible
Freiburg explicitly advises that sperm can be cryopreserved before treatment when future fertility is a concern, and Düsseldorf's fertility-preservation program offers sperm and testicular-tissue cryopreservation before fertility-threatening cancer therapy. International referrals should raise this before chemotherapy or radiotherapy rather than after treatment has started.
Advanced or residual disease may require specialist retroperitoneal surgery
Freiburg lists retroperitoneal lymph-node dissection (RPLND) for selected affected lymph nodes, while Düsseldorf runs dedicated testicular-tumor clinics and studies in retroperitoneal surgery. This is a specialist indication and should not be treated as a routine operation for every patient.
Records to send for specialist review
A concise germ-cell-tumor referral should reconstruct the whole sequence.
- Testicular ultrasound report and images when available
- AFP, HCG and LDH values with dates
- Orchiectomy operative report
- Complete pathology with seminoma/non-seminoma components
- CT/MRI staging images in DICOM format
- Post-orchiectomy tumor-marker trend
- Previous chemotherapy, radiotherapy or surgery
- Current fertility goals and whether sperm cryopreservation has been discussed
- A clear question about surveillance, chemotherapy, RPLND, recurrence or second opinion
Follow-up planning matters even when treatment is successful
Testicular cancer surveillance can require repeated tumor markers, imaging and specialist visits. Before travelling, ask the German center to define the follow-up schedule and which tests can be performed safely and reliably in the home country.
Official sources
Sources last checked 2026-08-30. Confirm current eligibility, procedure details and hospital requirements directly with the treating urology team.
- Testicular tumors – diagnostics and treatment — University Medical Center Freiburg ↗
- Testicular cancer – treatment and fertility considerations — University Medical Center Freiburg ↗
- Testicular tumors – diagnostics and therapy — University Hospital Düsseldorf ↗
- Urology treatment focus – European reference center for testicular cancer — University Hospital Düsseldorf ↗
- Malignant testicular diseases — Heidelberg University Hospital ↗