Six of 276 prepubertal testicular specimens had atypical germ cells. Specimens from 3 intersex patients met the criteria for intratubular germ cell neoplasia, unclassified type (IGCNU). Of the remaining 3 specimens (2 patients), 1 from a Down syndrome patient had centrally positioned germ cells with mild nuclear enlargement and hyperchromasia and expressed fetal germ cell markers (Oct3/4, placental alkaline phosphatase, CD117); it was classified as "delayed germ cell maturation". The remaining 2 specimens (1 patient) were diagnosed as IGCNU but, in retrospect, the patient had an undiagnosed intersex disorder. We therefore did not find a bona fide case of IGCNU in prepubertal testes apart from an intersex disorder.
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Fan et al. (2011) studied this question.
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