Non Seminomatous Mixed Germ Cell Tumor of Testis with a Large Abdominal and Retroperitoneal Extension: A Case Report

Primary testicular germ cell tumors (PGCT) can be classified as seminomatous and non-seminomatous germ-cell tumor (NSGCT) types. Mixed germ cell tumors (MGCT), a subtype of NSGCT, contain more than one germ cell components. Here, we present a rare case of a MGCT composed of yolk sack tumor and teratoma which had a continuous large abdominal and retroperitoneal extension. A 43 years old male presented with complaints of discomfort and swelling over the right inguinoscrotal region. Ultrasonography (USG) showed a large ill-defined heteroechoic mass in the right inguinoscrotal region with vascularity and without separate visualization of right testis. Subsequent contrast enhanced Computed Tomography (CT) showed large enhancing mass in the right scrotal sac which was continuous with large abdominopelvic and retroperitoneal mass through the right inguinal canal. Tru-Cut biopsy of the scrotal mass showed MGCT with yolk sac and teratoma component. Patient underwent 6 cycles of chemotherapy followed by Right Radical Inguinal Orchidectomy.

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Rare presentation of a seminoma with mixed germ cell tumor in undescended inguinal testis

International Surgery Journal ◽

10.18203/2349-2902.isj20190415 ◽

2019 ◽

Vol 6 (2) ◽

pp. 611

Author(s):

Siddhartha Verma ◽

Heeralal Jakhar

Keyword(s):

Germ Cell ◽

Germ Cell Tumor ◽

Germ Cell Tumors ◽

Testicular Tumor ◽

Cell Tumor ◽

Uneventful Recovery ◽

Predisposing Factor ◽

Rare Presentation ◽

Testicular Germ Cell ◽

Mixed Germ Cell Tumor

Cryptorchidism is the most common predisposing factor in the development of testicular germ cell tumors. Seminoma is the most common malignancy developing in a cryptorchid testis. A rare case of seminoma with mixed germ cell tumor in an undescended testis is reported here. A 35-year-old male patient presented with swelling in left inguinal region science 1.5year. This was smooth, firm to hard in consistency, restricted mobility and his left scrotum was empty. Serological markers α-FP, β-HCG, LDH were raised. Sonography and CT scan revealed a testicular tumor in undescended left inguinal testis. High inguinal orchidectomy was done. Patient had an uneventful recovery. The histopathology report of biopsy revealed a seminoma with mixed germ cell tumor. Early diagnosis and management of the undescended testicle are needed to preserve fertility and improve early detection of testicular malignancy. Therapy should begin between six months and two years of age and may consist of hormone or surgical treatment.

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Nephroblastoma Arising from Primary Testicular Germ Cell Tumor: A Case Report and Literature Review

Case Reports in Pathology ◽

10.1155/2016/7318672 ◽

2016 ◽

Vol 2016 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Houda Alatassi ◽

Brittany E. O’Bryan ◽

Jamie C. Messer ◽

Zhenglong Wang

Keyword(s):

Germ Cell ◽

Germ Cell Tumor ◽

Embryonal Carcinoma ◽

Lung Metastases ◽

English Literature ◽

Germ Cell Tumors ◽

Testicular Germ Cell Tumor ◽

Cell Tumor ◽

Testicular Germ Cell ◽

Mixed Germ Cell Tumor

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.

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Synchronous bilateral testicular cancer with discordant histopathology occurring in a 20-year-old patient: A case report and review of the literature

Urologia Journal ◽

10.1177/03915603211028556 ◽

2021 ◽

pp. 039156032110285

Author(s):

Evangelos N Symeonidis ◽

Ioannis Tsifountoudis ◽

Anastasios Anastasiadis ◽

Wilbert F Mutomba ◽

Rodoula Kotakidou ◽

...

Keyword(s):

Germ Cell ◽

Embryonal Carcinoma ◽

Germ Cell Tumors ◽

Testicular Sperm Extraction ◽

Testosterone Replacement Therapy ◽

Testicular Germ Cell ◽

Left Testis ◽

Mixed Germ Cell Tumor ◽

The Right ◽

Enhanced Computed Tomography

Introduction: Bilateral testicular tumors are very rare, accounting for 1%–5% of all testicular germ-cell tumors (TGCTs). The vast majority of primary bilateral TGCTs are metachronous, with synchronous tumors comprising approximately 0.5%–1% of all cases. Those occurring synchronously share mostly the same histological pattern, predominantly seminoma, with synchronous bilateral TGCTs (SBTGCTs) with discordant subtypes being extremely rare. Case presentation: We present the case of a 20-year-old male complaining of a palpable painless right testicular mass incidentally noticed during sexual intercourse. Ultrasonography (US) and magnetic resonance imaging (MRI) of the scrotum demonstrated bilateral testicular lesions, while staging with contrast-enhanced computed tomography (CT) exhibited normal findings. Right radical orchiectomy and left testis-sparing surgery (TSS) with concomitant onco-testicular sperm extraction (onco-TESE) were initially performed. Histology of the right testis revealed a mixed germ-cell tumor, consisting of seminoma and embryonal carcinoma, while that from the left testis disclosed embryonal carcinoma and intratubular germ-cell neoplasia unclassified (IGCNU) infiltrating the surgical margins. Hence, left orchiectomy was subsequently scheduled with histology unveiling IGCNU in the greatest part of the remaining testicular parenchyma. Following adjuvant chemotherapy, with bleomycin, etoposide, and cisplatin (BEP), the patient received testosterone replacement therapy and remained free of recurrence at an 18-month follow-up. Conclusion: This case highlights both the rarity of a bilateral testicular tumor’s synchronous appearance and its extremely infrequent discordant histopathology. A comprehensive review of the major series of SBTGCTs with discordant histology cited in the literature is additionally presented.

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Mixed Germ Cell Tumor in the Eye of a Dog

Veterinary Pathology ◽

10.1354/vp.38-6-712 ◽

2001 ◽

Vol 38 (6) ◽

pp. 712-714 ◽

Cited By ~ 10

Author(s):

J. C. Patterson-Kane ◽

F. Y. Schulman ◽

N. Santiago ◽

L. Mckinney ◽

C. J. Davis

Keyword(s):

Epithelial Cells ◽

Germ Cell ◽

Germ Cell Tumor ◽

Germ Cell Tumors ◽

Cell Tumor ◽

Tumor Type ◽

Mixed Germ Cell Tumor ◽

Prominent Component ◽

Suprasellar Region ◽

The Right

A 3-year-old female neutered Staffordshire Bull Terrier presented with a mixed germ cell tumor involving the base of the iris and the ciliary body of the right eye. The tumor mass was composed primarily of packeted vacuolated, polygonal (hepatoid) cells and small round cells; epithelial cells lining tubuloacinar structures were a less prominent component. The hepatoid and round cells stained positively for alpha-fetoprotein and cytokeratin. The epithelial cells stained positively for cytokeratin only, and some contained cytoplasmic mucin droplets. The polygonal cells were interpreted as a hepatoid variant of yolk sac tumor, and the epithelial cells were considered a teratomatous component. Trabeculae of bone were observed within the mass and may have been metaplastic or a teratomatous element. Extragonadal germ cell tumors are rare in dogs and have previously been reported only in the suprasellar region. This is the first report of this tumor type in the eye of a nonhuman species.

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A rare case of mixed germ cell tumor in a teenage girl: a case report

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20172378 ◽

2017 ◽

Vol 6 (6) ◽

pp. 2663

Author(s):

Faraz S. Vali ◽

Amit Kyal ◽

Parul I. Chaudhary ◽

Sujatha Das ◽

Aprateem Mukherjee ◽

...

Keyword(s):

Germ Cell ◽

Germ Cell Tumor ◽

Embryonal Carcinoma ◽

Germ Cell Tumors ◽

Cell Tumor ◽

Ca 125 ◽

Gestational Choriocarcinoma ◽

Mixed Germ Cell Tumor ◽

Initial Surgery ◽

Alpha Feto Protein

Germ cell tumors represent only 20% to 25% of all benign and malignant ovarian neoplasms. Mixed germ cell tumors are a rare variety of non–dysgerminomatous germ cell tumors. They contain two or more elements; the most frequent combination being a dysgerminoma and an EST (Endodermal Sinus Tumor). We present a case of malignant mixed germ cell tumor comprising of yolk sac tumor, embryonal carcinoma and choriocarcinoma. A 13-year-old girl presented with a huge 25 x 18 cm mass in abdomen with raised values of CA-125, hCG, AFP (alpha-feto protein) and LDH (lactate dehydrogenase). She underwent laparotomy followed by unilateral salpingoopherectomy and infracolic omentectomy. Histopathology report revealed malignant mixed germ cell tumor comprising predominantly of EST with elements of embryonal carcinoma and non-gestational choriocarcinoma. Following surgery, she was started on adjuvant chemotherapy (Bleomycin, Etoposide and Cisplatin regimen). Mixed germ cell tumor (YST/EST, non-gestational choriocarcinoma and embryonal carcinoma) is a very rare tumor. Careful initial surgery with adequate staging biopsies followed by combination chemotherapy can greatly improve the prognosis of these patients

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MPC-08 CLINICOPATHOLOGICAL ANALYSIS OF 12P GAIN IN INTRACRANIAL GERM CELL TUMORS

Neuro-Oncology Advances ◽

10.1093/noajnl/vdz039.105 ◽

2019 ◽

Vol 1 (Supplement_2) ◽

pp. ii23-ii23

Author(s):

Kaishi Satomi ◽

Hirokazu Takami ◽

Shintaro Fukushima ◽

Yoichi Nakazato ◽

Shota Tanaka ◽

...

Keyword(s):

Germ Cell ◽

Germ Cell Tumor ◽

Copy Number ◽

Mature Teratoma ◽

Methylation Status ◽

Germ Cell Tumors ◽

Copy Number Variations ◽

Cell Tumor ◽

Testicular Germ Cell ◽

Intracranial Germ Cell Tumor

Abstract BACKGROUND Gain of short arm of chromosome 12 (12p) is commonly observed in testicular germ cell tumors (tGCTs). 12p gain is also frequently seen in intracranial GCTs (iGCTs). However, little is known about the clinical significance of 12p gain in iGCTs. MATERIALS AND METHODS We have collected over 200 fresh frozen tissue samples of iGCTs through the Intracranial Germ Cell Tumor Genome Analysis Consortium in Japan. Firstly, we analyzed DNA methylation status in 83 iGCTs, 3 seminomas and 6 normal control samples using Infinium Human Methylation 450K BeadChip array (Illumina, CA). Idat files were processed using R (Version 3.5.3) and minfi package (1.30.0) to generate copy number variations. Compared with average genome-wide copy number level, 12p gain was determined. Then, 58 iGCTs with clinicopathological information were analyzed for progression-free survival (PFS) and overall survival (OS). Those tumors that consist of only either germinoma and/or mature teratoma components were classified as Favorable Histology (FH) and all the others that contains malignant histological components were classified as Unfavorable Histology (UFH). RESULT 12p gain was observed in 100% (3/3) of seminoma, 13.6% (3/22) of germinoma, 16.7% (1/6) of mature teratoma, 25% (1/4) of immature teratoma, 55% (11/20) of mixed germ cell tumor, 100% (4/4) of yolk sac tumor, 100% (1/1) of embryonal carcinoma, and 100% (1/1) of choriocarcinoma. In total, 44.6% (37/83) of iGCT showed 12p gain. Regarding histological classification, the 12p gain rate in UFH (72%, 18/25) was significantly higher than that in FH (12.1%, 4/33, P<0.01). Both PFS and OS were significantly worse in iGCTs with 12p gain (PFS: P=0.027, OS: P=0.0012). DISCUSSION 12p gain can be a molecular marker to predict prognosis and histological malignancy in iGCTs.

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Testicular Germ Cell Tumor and down Syndrome

Tumori Journal ◽

10.1177/030089160008600514 ◽

2000 ◽

Vol 86 (5) ◽

pp. 431-433 ◽

Cited By ~ 4

Author(s):

María José Villanueva ◽

Fátima Navarro ◽

Antonio Sánchez ◽

Mariano Provencio ◽

Félix Bonilla ◽

...

Keyword(s):

Down Syndrome ◽

Germ Cell ◽

Germ Cell Tumor ◽

Medical Literature ◽

Germ Cell Tumors ◽

Testicular Germ Cell Tumor ◽

Cell Tumor ◽

Testicular Germ Cell Tumors ◽

Testicular Germ Cell ◽

English Medical Literature

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.

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

Tumori Journal ◽

10.1177/030089168907500523 ◽

1989 ◽

Vol 75 (5) ◽

pp. 505-509

Author(s):

Sergio Crispino ◽

Gabriele Tancini ◽

Sandro Barni ◽

Paolo Lissoni

Keyword(s):

Testicular Cancer ◽

Germ Cell ◽

Germ Cell Tumor ◽

Venous Blood ◽

Germ Cell Tumors ◽

Testicular Germ Cell Tumor ◽

Cell Tumor ◽

Testicular Germ Cell Tumors ◽

Testicular Germ Cell ◽

Significant Difference

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.

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Mixed Germ Cell Tumor of Testis with Isolated Scapular Metastasis: A Case Report and Review of the Literature

Case Reports in Urology ◽

10.1155/2015/205297 ◽

2015 ◽

Vol 2015 ◽

pp. 1-3

Author(s):

Dipti Rani Samanta ◽

Chaitali Bose ◽

Roopesh Krishnappa ◽

Saumyaranjan Mishra ◽

Sulagna Mohanty ◽

...

Keyword(s):

Bone Metastasis ◽

Germ Cell ◽

Germ Cell Tumor ◽

Testicular Germ Cell Tumor ◽

Serum Markers ◽

Cell Tumor ◽

Testicular Germ Cell ◽

Mixed Germ Cell Tumor ◽

Nonseminomatous Germ Cell Tumor ◽

Poorly Differentiated

Bone metastasis is a rare entity in germ cell tumor of testis and is a poor prognostic site. It is usually associated with synchronous metastasis at other sites. Till now very few cases of isolated bone metastasis of germ cell tumor of testis have been reported but none have reported scapular metastasis. We are reporting a case of nonseminomatous germ cell tumor of right testis that was operated eight months ago and now presented with isolated scapular metastasis. Histopathology of the scapular tissue revealed rhabdomyosarcoma or poorly differentiated synovial sarcoma. Immunohistochemistry with serum markers concluded it to be metastatic germ cell tumor. To the best of our knowledge this is the first reported case of scapular metastasis of testicular germ cell tumor. This case is being reported here due to dilemmatic way of presentation and also to emphasize that histopathology may sometimes misguide and immunohistochemistry is necessary in such cases.

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