Special ArticleReporting and Staging of Testicular Germ Cell Tumors The International Society of Urological Pathology (ISUP) Testicular Cancer Consultation Conference RecommendationsVerrill, Clare FRCPath*; Yilmaz, Asli MD†; Srigley, John R. FRCPath‡; Amin, Mahul B. MD§; Compérat, Eva MD∥; Egevad, Lars MD¶; Ulbright, Thomas M. MD#; Tickoo, Satish K. MD**; Berney, Daniel M. FRCPath††; Epstein, Jonathan I. MD‡‡; the Members of the International Society of Urological Pathology Testicular Tumor Panel§§Author Information *Nuffield Department of Surgical Sciences, University of Oxford, Oxford ††Department of Molecular Oncology, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom †Department of Pathology and Laboratory Medicine, Calgary Laboratory Services and University of Calgary, Calgary, AB ‡Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada §Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Centre, Los Angeles, CA #Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN **Department of Pathology, Memorial Sloan Kettering Cancer Centre, New York, NY ‡‡Department of Pathology, John Hopkins Hospital, Baltimore, MD ∥Department of Pathology, Hopital Tenon, Assistance Publique – Hopitaux de Paris, Université Pierre et Marie Curie, Paris VI, Paris, France ¶Department of Pathology and Cytology, Karolinska Hospital, Stockholm, Sweden §§Members of the ISUP Testicular Tumor Panel: Brett Delahunt, Cristina Magi-Galluzzi, Ferran Algaba, Esther Oliva, Rodolfo Montironi, Robert H Young, Muhammad T Idrees, Sean R Williamson, Ming Zhou, Peter A Humphrey, Antonio Lopez-Beltran, and Joanna Perry-Keene Conflicts of Interest and Source of Funding: The International Society of Urological Pathology (ISUP) 2015 consultation on testis and penile cancer was generously supported by Orchid. The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Correspondence: Clare Verrill, FRCPath, Nuffield Department of Surgical Sciences, University of Oxford Level 6, John Radcliffe Hospital, Headington, Oxford OX3 9DU, UK (e-mail: [email protected]). The American Journal of Surgical Pathology: June 2017 - Volume 41 - Issue 6 - p e22-e32 doi: 10.1097/PAS.0000000000000844 Buy Metrics Abstract The International Society of Urological Pathology held a conference devoted to issues in testicular and penile pathology in Boston in March 2015, which included a presentation and discussion led by the testis microscopic features working group. This conference focused on controversies related to staging and reporting of testicular tumors and was preceded by an online survey of the International Society of Urological Pathology members. The survey results were used to initiate discussions, but decisions were made by expert consensus rather than voting. A number of recommendations emerged from the conference, including that lymphovascular invasion (LVI) should always be reported and no distinction need be made between lymphatic or blood invasion. If LVI is equivocal, then it should be regarded as negative to avoid triggering unnecessary therapy. LVI in the spermatic cord is considered as category pT2, not pT3, unless future studies provide contrary evidence. At the time of gross dissection, a block should be taken just superior to the epididymis to define the base of the spermatic cord, and direct invasion of tumor in this block indicates a category of pT3. Pagetoid involvement of the rete testis epithelium must be distinguished from rete testis stromal invasion, with only the latter being prognostically useful. Percentages of different tumor elements in mixed germ cell tumors should be reported. Although consensus was reached on many issues, there are still areas of practice that need further evidence on which to base firm recommendations. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.