Evidence for Altered Hypothalamic-Hypophyseal-Gonadal Axis in Untreated Patients with Testicular Germ-Cell Tumor

1989 ◽  
Vol 75 (5) ◽  
pp. 505-509
Author(s):  
Sergio Crispino ◽  
Gabriele Tancini ◽  
Sandro Barni ◽  
Paolo Lissoni

To investigate the function of the hypothalamic-hypophyseal-gonadal axis in testicular germ cell tumors, we evaluated gonadotropin responses to gonadotropin-releasing hormone (GnRH) in 12 untreated patients with testicular cancer (5 seminomas and 7 non-seminomas). GnRH was given i.v. at a dose of 100 μg as a bolus, and venous blood samples were collected at 0, 20, 60, and 120 min. As controls, 14 healthy males were studied. Basal levels of testosterone, estradiol and prolactin were also detected in each patient. Hormonal serum concentrations were measured by the radioimmunoassay. Mean basal testosterone, estradiol and prolactin levels were not significantly different from those of controls. Patients had a lower FSH and LH peak after GnRH than controls, without, however, any significant difference. As regards histology, nonseminoma patients lacked an FSH response to GnRH and had statistically lower mean peak levels than controls. Moreover, non-seminoma patients had statistically lower mean peak values of LH after GnRH than controls. These data show that patients with testicular germ cell tumor, and more particularly those with non-seminomas, have an altered function of the hypothalamic-hypophyseal-gonadal axis, which is already present prior to therapy. Further studies, particularly in stage I patients treated only with orchiectomy, should be performed to confirm and better define the Physiopathologic significance of the altered hypothalamic-hypophyseal-gonadal axis in testicular cancer and to clarify the alteration of fertility, which is frequently present before treatment.

2000 ◽  
Vol 86 (5) ◽  
pp. 431-433 ◽  
Author(s):  
María José Villanueva ◽  
Fátima Navarro ◽  
Antonio Sánchez ◽  
Mariano Provencio ◽  
Félix Bonilla ◽  
...  

The association between Down syndrome and testicular germ cell tumors may be more frequent than expected according to chance, but few reports have focused on this excess. We report two cases of this association and review the English medical literature.


2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Oluwaseun Shogbesan ◽  
Abdullateef Abdulkareem ◽  
Asad Jehangir ◽  
Sunila Byreddy ◽  
Sharon Swierczynski ◽  
...  

Testicular germ cell tumors (GCT) are the commonest solid tumors in young men. Typical presentation is with painless scrotal swelling; however, symptoms related to complications or metastasis may be the initial presentation. Gastrointestinal (GI) metastasis is seen in about 5% of patients with germ cell tumors and presentation is commonly with GI bleed. It is important to have GCT as a differential diagnosis of GI bleed in young men presenting with unexplained anemia as direct questioning about scrotal swelling and genital examination when appropriate will guide further investigation and facilitate prompt diagnosis. We present a case of a 26-year-old man with testicular germ cell tumor and severe anemia secondary to extension and perforation of duodenum by retroperitoneal metastasis and a review of the literature on the gastrointestinal manifestations of testicular germ cell tumors.


2019 ◽  
Vol 6 (3) ◽  
pp. 129-137
Author(s):  
T. V. Ustinova ◽  
L. V. Bolotina ◽  
A. A. Fedenko ◽  
H. S. Gevorgyan ◽  
A. A. Paichadze ◽  
...  

Testicular cancer is a rare malignant tumor. In the structure of general cancer incidence, this nosology accounts for about 1–1.5% of cases. Among this pathology, about 90–95% is due to testicular germ cell tumors. Currently, testicular cancer is a potentially treatable solid tumor with a 10-year survival rate of more than 95% upon timely diagnosis and proper treatment. In this regard, early diagnosis and treatment of this pathology is an urgent task today. The article presents a clinical observation of the treatment of a patient with a testicular germ cell tumor. The presented clinical case demonstrates the successful conduct of neoadjuvant chemotherapy and further orchifuniculectomy in the presence of distant metastases namely in case of a non-seminomic form of a testicular germ cell tumor. The approach to treating patients with testicular tumors must be individualized and take into account both the potential gain and the potential risks of the treatment being performed.


2019 ◽  
Vol 14 (1) ◽  
pp. 53-59 ◽  
Author(s):  
Paolo Chieffi ◽  
Marco De Martino ◽  
Francesco Esposito

Background: The most common solid malignancy of young men aged 20 to 34 years is testicular germ cell tumor. In addition, the incidence of these tumors has significantly increased throughout the last years. Testicular germ cell tumors are classified into seminoma and nonseminoma germ cell tumors, which take in yolk sac tumor, embryonal cell carcinoma, choriocarcinoma, and teratoma. There are noteworthy differences about therapy and prognosis of seminomas and nonseminoma germ cell tumors, even though both share characteristics of the primordial germ cells. </P><P> Objectives: The study is focused on different molecular mechanisms strongly involved in testicular germ cell line tumors underlying new strategies to treat this human neoplasia.Methods:Bibliographic data from peer-reviewed research, patent and clinical trial literature, and around eighty papers and patents have been included in this review.Results:Our study reveals that several biomarkers are usefully utilized to discriminate among different histotypes. Moreover, we found new patents regarding testicular germ cell tumor treatments such as the expression of claudin 6, monoclonal antibody (Brentuximab Vedotin), immune checkpoint blockade (ICB) with the FDA-approved drugs pembrolizumab and nivolumab or the oncolytic virus Pelareorep, the combination of selective inhibitors of Aurora kinase.Conclusion:Finally, the pathogenesis of testicular germ cell tumor needs to be deeply understood so that it will improve data on stem cells, tumorigenesis and disease tumor management by more selective treatment.


Cancers ◽  
2021 ◽  
Vol 13 (20) ◽  
pp. 5228
Author(s):  
João Lobo ◽  
Lieke M. J. van Zogchel ◽  
Mohammed G. Nuru ◽  
Ad J. M. Gillis ◽  
C. Ellen van der Schoot ◽  
...  

The classical serum tumor markers used routinely in the management of testicular germ cell tumor (TGCT) patients—alpha fetoprotein (AFP) and human chorionic gonadotropin (HCG)—show important limitations. miR-371a-3p is the most recent promising biomarker for TGCTs, but it is not sufficiently informative for detection of teratoma, which is therapeutically relevant. We aimed to test the feasibility of hypermethylated RASSF1A (RASSF1AM) detected in circulating cell-free DNA as a non-invasive diagnostic marker of testicular germ cell tumors, combined with miR-371a-3p. A total of 109 serum samples of patients and 29 sera of healthy young adult males were included, along with representative cell lines and tumor tissue samples. We describe a novel droplet digital polymerase chain reaction (ddPCR) method for quantitatively assessing RASSF1AM in liquid biopsies. Both miR-371a-3p (sensitivity = 85.7%) and RASSF1AM (sensitivity = 86.7%) outperformed the combination of AFP and HCG (sensitivity = 65.5%) for TGCT diagnosis. RASSF1AM detected 88% of teratomas. In this representative cohort, 14 cases were negative for miR-371a-3p, all of which were detected by RASSF1AM, resulting in a combined sensitivity of 100%. We have described a highly sensitive and specific panel of biomarkers for TGCT patients, to be validated in the context of patient follow-up and detection of minimal residual disease.


2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Houda Alatassi ◽  
Brittany E. O’Bryan ◽  
Jamie C. Messer ◽  
Zhenglong Wang

Adult extrarenal nephroblastoma is a very rare tumor. Nephroblastoma arising from primary testicular germ cell tumor is exceedingly rare. To our knowledge, only three cases have been reported in the English literature. We report a case of a 19-year-old man who presented with a large right testicle. Image studies showed a large retroperitoneal mass along with liver and lung metastases. Orchiectomy demonstrated a mixed germ cell tumor composed of yolk sac tumor, embryonal carcinoma, and mature and immature teratoma with a significant portion of nephroblastoma. The patient received chemotherapy and no recurrence was noted during six months of followup. WT-1 expression was also studied due to the lack of consistency of its expression in testicular nephroblastoma in the literature. We also present a discussion and review of the literature due to its rarity, which indicate an adverse prognosis for patients with nephroblastoma components receiving standard chemotherapeutical regimes for testicular germ cell tumors.


Author(s):  
Michael Risk

This chapter reviews a pivotal, single-armed observational study of consecutive patients with metastatic testicular germ cell tumor treated with a combination of bleomycin, vinblastine, and cisplatin. This study established that cisplatin-based combination chemotherapy resulted in a much better prognosis in patients with metastatic testicular cancer than historically observed with any other treatment and also resulted in high response rates.


2020 ◽  
Vol 5 (1) ◽  
pp. 45-50
Author(s):  
Dharmendra Singh ◽  
Pritanjali Singh ◽  
Avik Mandal

Background: Malignant testicular neoplasm constitutes about 1% of all cancers in male, but malignant germ cell tumors are most common tumors in adolescents and young adult males. In this study we report our experience of testicular germ cell tumors presenting at All India Institute of Medical Sciences, Patna, a tertiary referral centre, with respect to epidemiology, histopathology, management and outcome. Methods: This study was conducted in department of Radiotherapy, All India Institute of Medical Sciences, Patna from August 2014 to September 2019. It was single institution based retrospective study in which data was retrieved from the recorded files & analysed. The study focused on epidemiology and survival outcomes. Results: In this study we analysed, 38 histologically confirmed cases of testicular germ cell tumor. Seminoma and nonseminoma were 50% (19) and 50% (19) respectively. The median age was 31 years. The most common affected age group was 31 to 40 years. Metastasis was present in 50% of patients at presentation. At diagnosis the stage III, II and I were found in 50%, 28.9% and 21.1% respectively. Patients in good risk, intermediate risk and high risk were in 65.8%, 13.2% and 21.1% respectively. The median recurrence free survival (RFS) and overall survival (OS) was 52 months and 71 months respectively. Conclusion: Most of the cases presented with advanced stage and majority of them had undergone high inguinal orchidectomy. The high nodal burden disease at presentation was associated with partial response to standard chemotherapy. It seems that there is the need of alternative chemotherapy regimen especially in nonseminomatous germ cell tumors. Patients presenting with disease confined to locoregional lymph nodes or local disease showed good prognosis.  


2019 ◽  
Vol 26 (10) ◽  
pp. 1794-1798
Author(s):  
Jawed Iqbal ◽  
Shahnaz Imdad Kehar ◽  
Nazish Jaffer ◽  
Farah Asad

Objectives: To assess the frequency of various histopathological types of testicular germ cell tumor in our study population. The prime identification of testicular germ cell tumor is important to prevent the advance stage of cancers. The present study was design to assess the frequency of different morphological types of testicular germ cell tumor which have a mirror effect on the treatment and prognosis of tumor. Study Design: Cross sectional study. Setting: Department of pathology, Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre Karachi. Period: 10 years period from 1st January 2006 to 31st December 2015. Material and Methods: A 34 cases of testicular germ cell tumor were studied for morphological features using all properly formalin fixed, paraffin embedded surgical pathological testicular specimens received during the above period. All relevant clinical information was recorded on designed proformas. Section were taken and stained with hematoxylin and eosin. Data entered and analysed through computer software SPSS version 21. Results: The result of study showed that the frequency of testicular germ cell tumor was 0.80% among all malignancy in male. Out of 36 cases of testicular tumor, 34 (94.5%) were germ cell tumors and remaining 02 (5.5%) cases were sex cord stromal tumor.  Among 34 cases of germ cell tumor 12 (35.2%) cases of mixed germ cell tumor found which was the most common between them, followed by seminoma 10 (29.4%) cases. However 05(14.7%) of yolk sac tumor, 04 (11.6%) of teratoma and 03(8.8%) of embryonal tumor were found. Conclusion: Results revealed that frequency of different types of testicular germ cell tumor in this study were in accordance to national and international studies. However the incidence of tumor varies noticeably in different geographical areas. Different pattern of seminomas and non – seminomas also may be emerging.


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