Lumbar pain in stage 1 testicular germ cell tumours: a symptom preceding radiological abnormality.

In a series of 114 stage 1 testicular tumour patients managed by a surveillance policy there have been 26 relapses. Three of these patients presented with lumbar pain as the first sign of relapse. All 3 were tumour marker non-producers and the onset of pain pre-dated radiological abnormality by up to 4 months. Stage 1 surveillance patients who develop lumbar pain must be considered to be at high risk of relapse to avoid delay in diagnosis which may prejudice survival.