Germ cell tumours

BackgroundPoly(ADP-ribose)polymerase (PARP) inhibitors represent a new class of promising drugs in anticancer therapy.AimsTo evaluate PARP expression in testicular germ cell tumours (GCTs) and to correlate expression patterns with clinicopathological variables.MethodsIn this translational study, tumour specimens from 124 patients with GCTs (114 patients with testicular primary tumours and 10 with extragonadal GCTs) were identified. PARP expression was detected by immunohistochemistry using monoclonal antibodies, scored by the multiplicative quickscore (QS) method and compared to PARP expression in normal testicular tissue.ResultsWe observed higher expression of PARP in testicular tumours compared to normal testicular tissue (mean QS=10.04 vs 3.31, p<0.0000001). Mean QS±SD for each histological subtype was as follows: intratubular germ cell neoplasia unclassified (IGCNU)=18.00±0.00, embryonal carcinoma=9.62±5.64, seminoma=9.74±6.51, yolk sac tumour=7.8±7.20, teratoma=5.87±5.34, and choriocarcinoma=4.50±8.33. The PARP overexpression (QS>9) was most often detected in IGCNU (100% of specimen with PARP overexpression), seminona (52.6%), embryonal carcinoma (47.0%), yolk sac tumour (33.3%), teratoma (26.7%) and choriocarcinoma (25.0%), compared to 1.9% of normal testicular tissue specimens. There was no association between PARP expression and clinical variables.ConclusionsIn this pilot study, we showed for the first time, that PARP is overexpressed in testicular germ cell tumours compared to normal testis.

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Yolk sac tumour of ovary with fever and overt hypothyroidism: rare clinical presentation

BMJ Case Reports ◽

10.1136/bcr-2019-232114 ◽

2020 ◽

Vol 13 (1) ◽

pp. e232114

Author(s):

Megha Kansara ◽

Garima Yadav ◽

Meenakshi Gothwal ◽

Pratibha Singh

Keyword(s):

Germ Cell ◽

Clinical Presentation ◽

Early Stage ◽

Yolk Sac ◽

Gravid Uterus ◽

Overt Hypothyroidism ◽

Germ Cell Tumours ◽

High Grade Fever ◽

Fertility Sparing ◽

Yolk Sac Tumour

Yolk sac tumours of the ovary are rare and highly malignant germ cell tumours, which comprise of only 10%–15% of all malignant germ cell tumours. They have various clinical presentations most common being subacute pelvic pain and feeling of lump but sometimes high-grade fever can be one of the rare presentations. Here, we present a case report of a 26-year-old nulliparous woman with 36 weeks gravid uterus size advanced stage yolk sac tumour of one ovary with fever as main clinical presentation and overt hypothyroidism. We did staging laparotomy with total abdominal hysterectomy with bilateral salpingo-oophorectomy and omentectomy with multiple peritoneal biopsies. Postoperatively, we had started adjuvant chemotherapy. Since yolk sac tumours are highly aggressive tumours as they rapidly increase in size, their early diagnosis and appropriate surgical management is required particularly in young women where fertility sparing surgery is possible in early stage with good prognosis.

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Primary skull-based yolk-sac tumour: case report and review of central nervous system germ cell tumours

Journal of Neuro-Oncology ◽

10.1007/s11060-010-0215-8 ◽

2010 ◽

Vol 101 (1) ◽

pp. 129-134 ◽

Cited By ~ 2

Author(s):

Raman Verma ◽

Shawn Malone ◽

Christina Canil ◽

Gerard Jansen ◽

Howard Lesiuk

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Case Report ◽

Germ Cell ◽

Yolk Sac ◽

Germ Cell Tumours ◽

Yolk Sac Tumour

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RARE CASES OF MIXED GERM CELL TUMOUR OF TESTIS- A REPORT OF TWO CASES WITH UNCOMMON COMBINATIONS AND REVIEW OF LITERATURE.

10.36106/paripex/8001581 ◽

2021 ◽

pp. 41-42

Author(s):

Anshu Jamaiyar ◽

Joyeeta Mandal ◽

Anupriya Anupriya

Keyword(s):

Germ Cell ◽

Embryonal Carcinoma ◽

Germ Cell Tumour ◽

Immature Teratoma ◽

Cell Tumour ◽

Germ Cell Tumours ◽

Review Of Literature ◽

Different Types ◽

Yolk Sac Tumour ◽

Rare Category

Mixed germ cell tumours of testis represent a comparatively rare category of testicular tumour where different types of both seminomatous and non-seminomatous tumours can be present in varied proportions. We report two cases of mixed germ cell tumours, one consisting of seminoma, embryonal carcinoma and post-pubertal teratoma in the testis of a 22-year-old male and second consisting of a yolk sac tumour and immature teratoma in the testis of a 19-year-old male. We report theses case due to the rare combination and for documentation

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CDX2 immunostaining in primary and metastatic germ cell tumours of the testis

Journal of International Medical Research ◽

10.1177/0300060516665472 ◽

2016 ◽

Vol 44 (6) ◽

pp. 1323-1330 ◽

Cited By ~ 1

Author(s):

Fatma Oz Atalay ◽

Berna Aytac Vuruskan ◽

Hakan Vuruskan

Keyword(s):

Germ Cell ◽

Staining Intensity ◽

Yolk Sac ◽

Unknown Primary ◽

Metastatic Tumour ◽

Germ Cell Tumours ◽

Tissue Samples ◽

Pure Seminoma ◽

Yolk Sac Tumour ◽

Immunohistochemical Techniques

Objective To evaluate the immunohistochemical staining pattern of caudal type homeobox 2 (CDX2) protein in germ cell tumours (GCTs) of the testis. Methods This study reassessed archival tissue samples collected from patients diagnosed with primary and metastatic testicular GCTs for CDX2 immunoreactivity using standard immunohistochemical techniques. Positive nuclear immunostaining was evaluated with regard to both the staining intensity and the extent of the staining. Results Tissue sections from primary and metastatic testicular GCTs ( n = 104), germ cell neoplasia in situ (GCNis) ( n = 5) and benign testicles ( n = 15) were analysed. The GCNis and benign testicular tissues showed no immunoreactivity for CDX2. Strong and diffuse staining of CDX2 was demonstrated only in the mature colonic epithelium of teratomas in both primary and metastatic GCTs. CDX2 positivity in other tumours (one pure yolk sac tumour, one yolk sac component of a mixed GCT and one pure seminoma) was infrequent, and was only weak and focal. Conclusions CDX2 immunostaining should be interpreted based on both the staining intensity and the extent of staining so as not to cause misdiagnosis. Teratomas with colonic-type epithelium should be considered in the differential diagnosis if a metastatic tumour with an unknown primary shows prominent CDX2 immunostaining.

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Germ-Cell Tumours

Oxford Textbook of Cancer in Children ◽

10.1093/med/9780198797210.003.0029 ◽

2020 ◽

pp. 253-261

Author(s):

Gabriele Calaminus ◽

James C. Nicholson

Keyword(s):

Germ Cell ◽

Age Groups ◽

Treatment Strategies ◽

Yolk Sac ◽

Germ Cell Tumours ◽

Histological Subtypes ◽

Close Observation ◽

New Treatment ◽

Resected Stage ◽

Yolk Sac Tumour

Germ-cell tumours (GCT) comprise a heterogeneous group of tumours, occurring mainly in children, adolescents, and young adults, which vary by site, range of histological subtypes, and behaviour. Gonadal sites, testes, and ovaries account for around two thirds of extracranial GCT, the remainder occurring at extragonadal sites. Histological components range from mature benign teratoma to malignant subtypes, germinoma, yolk sac tumour, choriocarcinoma, and embryonal carcinoma. Raised levels of the tumour marker alphafetoprotein (AFP) in yolk sac tumours, and human chorionic gonadotrophin (HCG) in choriocarcinoma and, to lower levels, in germinoma/dysgerminoma/semi-noma, assist with diagnosis and are useful for monitoring response to treatment and in follow-up. Genomic and transcriptomic analysis provide some insight into the nature of GCT, with common patterns of chromosomal imbalance identified, and distinguish between adult and paediatric GCT with respect to their messenger RNA-expression patterns. Patterns of microRNA expression, common to malignant GCT, across all age groups and histological subtypes, have also been identified in both tumour and serum, where they have potential for use in non-invasive diagnostics and monitoring. Management of teratoma is surgical, and completely resected stage 1 malignant GCT can also be managed with resection followed by close observation. Higher-stage malignant tumours warrant adjunctive chemotherapy following diagnosis. Unresectable tumours may be managed with neoadjuvant chemotherapy and delayed resection. Chemotherapy strategies employ platinum-containing combinations. Outcomes are excellent in the majority of cases, so the goal of new treatment strategies is mainly focused on minimizing late effects of treatment. Many relapses can be salvaged with further chemotherapy.

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10.1093/med/9780199651870.003.0014 ◽

2017 ◽

Author(s):

Claire Alapetite ◽

Takaaki Yanagisawa ◽

Ryo Nishikawa

Keyword(s):

Germ Cell ◽

Embryonal Carcinoma ◽

Young Male ◽

Immature Teratoma ◽

Germ Cell Tumours ◽

Eastern Asia ◽

Adults And Children ◽

Yolk Sac Tumour ◽

Mixed Tumours ◽

Comprehensive Discussion

Central nervous system germ cell tumours are mysterious tumours, which are common in young male adults in eastern Asia, and include germinoma, mature and immature teratoma, teratoma with malignant transformation, yolk sac tumour, embryonal carcinoma, choriocarcinoma, and mixed tumours of these components. The aetiological mechanism why they mostly develop in the pineal and neurohypophyseal region is still unknown. Their treatment is also a challenge; surgery is demanding, and sometimes biopsy would be preferred. Radiotherapy is effective, but its dose and field would be better reduced for young adults and children. Chemotherapy is effective but not enough for especially non-germinomatous tumours. This chapter presents a comprehensive discussion about those challenging diseases.

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MIXED GERM CELL TERATOMATOUS TUMOUR OF TESTIS IN ADULTS: DIAGNOSTIC CHALLENGES FOR A HISTOPATHOLOGIST (case report)

International Journal of Medicine and Medical Research ◽

10.11603/ijmmr.2413-6077.2018.1.8676 ◽

2018 ◽

Author(s):

D. Aden ◽

M. Shadan ◽

I. D. Khan ◽

F. Alam ◽

M. Naim ◽

...

Keyword(s):

Germ Cell ◽

Germ Cell Tumour ◽

Yolk Sac ◽

Germ Cell Tumours ◽

Male Population ◽

Testicular Tumours ◽

Total Cancer ◽

Β Hcg ◽

Yolk Sac Tumour ◽

Indian Male

Background. Testicular tumours account for approximately 1-2 % of the total cancer cases in the male population globally and show higher incidence in the younger male age group of up to 15 years. The majority (~98 %) of testicular tumours are observed to be of the germ-cell origin which can either be of seminomatous type or non-seminomatous type. The non-seminomatous germ cell neoplasm may be pure or of mixed subtype. Objective was to emphasize the rare case of mixed germ cell teratomatous tumour of testis in adult man.Methods. A mixed germ cell teratomatous tumour of testis comprising of yolk sac tumour and embryonal carcinoma in an adult Indian male is reported in the research.Results. A 45 year-old Indian male presented with enlargement of right testis which was found to be an encapsulated right testicular tumour on exploratory surgery which was followed by radical orchiectomy. Serum AFP and β-hCG levels were elevated to 380 ng/ml and 590 mg/ml respectively. Histopathology revealed a mixed germ cell teratomatous tumour of testis comprising of yolk sac tumour and embryonal carcinoma.Conclusions. In adults teratomas occur usually as a component of mixed germ cell tumours. However in the present case teratomatous embryoid yolk sac germ cell tumour of testis was observed in an Indian adult male. The prognosis of embryoid germ cell tumours of testis is generally poor. The possibility of this condition should always be considered in all cases that present with a testicular lump.

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Mediastinal mixed germ cell tumor: A case report and literature review

Open Medicine ◽

10.1515/med-2021-0293 ◽

2021 ◽

Vol 16 (1) ◽

pp. 892-898

Author(s):

Xianwen Hu ◽

Dandan Li ◽

Jinhua Xia ◽

Pan Wang ◽

Jiong Cai

Keyword(s):

Germ Cell ◽

Germ Cell Tumor ◽

Embryonal Carcinoma ◽

Yolk Sac ◽

Immature Teratoma ◽

Cell Tumor ◽

Yolk Sac Tumor ◽

Medical Attention ◽

Ct Guided ◽

Mixed Germ Cell Tumor

Abstract Mixed germ cell tumor (MGCT) mainly occurs in young women’s ovaries and men’s testicles and rarely occurs outside the gonad. Fewer than 10 cases of mediastinal MGCT are available in PubMed, Embase, and other databases in English, while mediastinal MGCT with three pathological components, such as yolk sac tumor, immature teratoma, and embryonal carcinoma, has not been reported previously. A 12-year-old male sought medical attention for chest discomfort and underwent a computed tomography (CT) scan. A large soft tissue mass occupying most of the left thoracic cavity and mediastinum was detected. A CT-guided biopsy was performed, and an MGCT was diagnosed with pathological components, including yolk sac tumor, immature teratoma, and a small amount of embryonal carcinoma. Due to the large size of the tumor, the patient was treated with an EP regimen (etoposide + cisplatin) and paclitaxel + ifosfamide + cisplatin interstitial chemotherapy. The patient was followed up for 6 months and was alive with the disease. To the best of our knowledge, this is the 10th patient with MGCT in the mediastinum. The incidence of mediastinal MGCT is low, but it should still be considered one of the differential diagnoses of isolated pleural fibroma and neurogenic tumors.

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