Germ cell cancer risk in DSD patients.

The risk of germ cell cancer is elevated in many DSD patients, although not to the same extent. A number of risk factors have been identified recently, but their interplay and relative impact is currently not fully clear. Until the advent of reliable screening tools for the detection of pre-invasive cancer lesions, managing germ cell tumour risk focuses on the question if and when to perform biopsy or gonadectomy in most patients and how to interpret the histological findings.