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

2016 ◽  
Vol 44 (6) ◽  
pp. 1323-1330 ◽  
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.

Germ cell tumours

2010 ◽  
pp. 461-467
Author(s):  
George Samandouras
Keyword(s):  
Germ Cell ◽  
Embryonal Carcinoma ◽  
Yolk Sac ◽  
Germ Cell Tumours ◽  
Yolk Sac Tumour

Chapter 8.14 covers germ cell tumours, including germinoma, embryonal carcinoma, yolk sac tumour, choriocarcinoma, and teratomas.

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

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.

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

2010 ◽  
Vol 101 (1) ◽  
pp. 129-134 ◽  
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

PARP expression in germ cell tumours

2013 ◽  
Vol 66 (7) ◽  
pp. 607-612 ◽  
Author(s):  
Michal Mego ◽  
Zuzana Cierna ◽  
Daniela Svetlovska ◽  
Dusan Macak ◽  
Katarina Machalekova ◽  
...  
Keyword(s):  
Germ Cell ◽  
Embryonal Carcinoma ◽  
Expression Patterns ◽  
Testicular Tissue ◽  
Parp Inhibitors ◽  
Yolk Sac ◽  
Germ Cell Tumours ◽  
Testicular Germ Cell ◽  
Testicular Germ Cell Tumours ◽  
Yolk Sac Tumour

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.

Germ-Cell Tumours

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.

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

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.

scholarly journals Gonadal malignant germ cell tumors express immunoreactive inhibin/activin subunits

2001 ◽  
pp. 779-784 ◽  
Author(s):  
L Cobellis ◽  
P Cataldi ◽  
FM Reis ◽  
G De Palo ◽  
F Raspagliesi ◽  
...  
Keyword(s):  
Germ Cell ◽  
Transforming Growth Factor Beta ◽  
Transforming Growth Factor ◽  
Ovarian Tissue ◽  
Germ Cell Tumors ◽  
Yolk Sac ◽  
Yolk Sac Tumor ◽  
Positive Staining ◽  
Tissue Samples ◽  
Malignant Germ Cell Tumors

OBJECTIVE: Inhibin and activin are proteins produced by ovarian granulosa cells and testicular Sertoli cells and are members of the transforming growth factor-beta superfamily. Since increased circulating levels of immunoreactive inhibin were detected in women with malignant ovarian tumors, they were proposed as tumor markers for ovarian carcinoma. Immunohistochemical studies later confirmed the presence of inhibin and activin subunits in granulosa cell tumors and epithelial ovarian cancer, as well as in Sertoli and Leydig cell testicular cancer. However, there is discrepant information on the detection of inhibin and activin in malignant germ cell tumors (MGCT). The aim of the present study was to evaluate the immunohistochemical expression of the inhibin/activin alpha, betaA and betaB subunits in ovarian and testicular MGCT specimens using polyclonal antisera. METHODS: The ovarian tissue samples were composed of 19 MGCT, including dysgerminoma (n=18) and yolk sac tumor (n=1). The testis specimens included classic seminomas (n=20), embryonal carcinomas (n=7), choriocarcinomas (n=2), and yolk sac tumor (n=1). RESULTS: Ovarian and testicular malignant germ cell tumors expressed positive staining for inhibin/activin alpha, betaA and betaB subunits, with some variations between and within individual tumors: while ovarian dysgerminomas were diffusely positive for alpha, betaA and betaB, testicular tumors expressed alpha and betaB subunits, whereas betaA staining was weak. CONCLUSIONS: The present results show positive staining for inhibin/activin subunits in ovarian and testicular MGCT, suggesting a possible role in tumorigenesis with the resultant clinical implication.

scholarly journals DIAGNOSIS OF GERM CELL TUMORS OF EXTRAGONADAL LOCALIZATION IN TERMS OF ALGORITHMS FOR DETECTING METASTASIS OF CARCINOMAS OF UNKNOWN PRIMARY LOCALIZATION

2019 ◽  
Vol 19 (2) ◽  
pp. 128-133
Author(s):  
О.V. Poslavska
Keyword(s):  
Differential Diagnosis ◽  
Germ Cell ◽  
Germ Cells ◽  
Morphological Characteristics ◽  
Unknown Primary ◽  
Positive Staining ◽  
Morphological Parameters ◽  
Germ Cell Tumours ◽  
Immunohistochemical Investigation ◽  
Primary Localization

The analysis of cases of extragonadal teratomas makes it clear that tumours derived from germ cells and mainly characteristic of adult gonads can also occur in other areas, such as the anterior mediastinum (thymus) and midline brain (germinomas of the epiphysis and the area above the Turkish saddle), that requires differential diagnosis with metastases of carcinomas of other origin. Accurate diagnosis of estrogenic germ-cell tumours by only routine staining with haematoxylin-eosin requires high expertise and experience due to their non-specific clinical symptoms and variability of morphological characteristics. Tumour morphologists consider that immunohistochemical investigation plays an important role in accurate histological diagnosis of these tumours. The goal of this study is to explore the expression features of immunohistochemical markers and morphometric parameters of the area, perimeter and "roundness" of the nuclei in various types of extragonadal germ-cell tumours compared to similar primary ovarian / testicular tumours in order to improve diagnostic algorithms. A study was conducted on biopsy or postoperative samples taken from 8 patients (group 1) with extragonadal germ-cell tumours and from 16 patients with primary germ cell tumours of testicles / ovaries (group 2). The diagnoses were confirmed by immunohistochemical investigation on the basis of the pathologic department of the “Pharmacy of Medical Academy” Diagnostic Centre for 2015 to 2018. PLAP and CD117 had the highest percentage of expression in seminomas and gerninomas of both studied groups; morphological parameters were 3-fold higher in area and ̴2-fold higher around the perimeter then the values of normal lymphocytes (p<0.05). Expression of markers CD30, EMA and CK AE1/3 was diagnostically significant in samples of embryonic carcinoma, and morphological parameters ̴were  ̴ 2.1 times higher in area and ̴ 1.7 along the perimeter that exceeded the values of normal lymphocytes (p<0.05). αFP-positive staining was indicative of yolk sac tumours, which morphological parameters were more than ̴ 1.7 times higher in the area and ̴ 1.5 times higher along the perimeter compared with the normal lymphocytes (p<0.05). Taking into account the variability of morphological characteristics and the possibility of extragonadal location of tumours derived from germ cells, immunohistochemical research supported by morphometry is an important tool in the differential diagnosis of carcinomas of unknown primary localization.

scholarly journals A Huge Intraabdominal Lump in a Male Patient of 32 Year with Congenital Absence of Left Testis - A Case Report

2019 ◽  
Vol 10 (2) ◽  
pp. 115-117
Author(s):  
Nadim Ahmed ◽  
Muhammad Anowar Hossain ◽  
Mohammad Rashedul Hasan ◽  
Mansurul Islam ◽  
Afrida Tasnim ◽  
...  
Keyword(s):  
Undescended Testis ◽  
Germ Cell Tumour ◽  
Testicular Tumor ◽  
Yolk Sac ◽  
Unknown Primary ◽  
Testicular Neoplasm ◽  
Rare Presentation ◽  
Left Testis ◽  
Pediatric Age Group ◽  
Yolk Sac Tumour

Undescended testis is a common risk factor for the testicular neoplasm. The risk of malignancy in an undescended testis is highest when the testis lies in the abdomen. It usually presents with a painless intraabdominal lump. Seminoma is the most common adult germ cell tumour of testis whereas Yolk sac tumour in seen in the pediatric age group. Pure yolk sac testicular tumor in an adult is extremely uncommon. Here we present a case where an adult male presented to us with a painless left sided intraabdominal lump with undescended testis on the same side was previously diagnosed as metastatic adenocarcinoma of unknown primary. In a private hospital he received three cycles of chemotherapy; but the lump did not reduce in size and he was reffered to our care for better management. The lump was excised and histopathological report revealed yolk sac tumour of left testis which is a rare presentation in adult. J Shaheed Suhrawardy Med Coll, December 2018, Vol.10(2); 115-117

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