Burned-out testicular tumor: Two case reports

2021 ◽  
Vol 2 (5) ◽  
Author(s):  
Castillo C ◽  
◽  
Camejo N ◽  
Centurion D ◽  
Carzoglio J ◽  
...  
Keyword(s):  
Germ Cell ◽  
Spontaneous Regression ◽  
Clinical Course ◽  
Case Reports ◽  
Germ Cell Tumors ◽  
Testicular Tumor ◽  
Tumor Patients ◽  
Testicular Germ Cell ◽  
Immunologic Factors ◽  
Tumor Metastases

Spontaneous regression of a testicular tumor or burned-out testicular tumor is a rare phenomenon in patients with testicular germ cell tumors. The condition is characterized by tumor metastases, suspicious findings of the testicular tumor on ultrasound imaging, and partial or total histological regression of the primary testicular tumor after orchiectomy without treatment. Clinically, patients present with a disseminated tumor with symptoms related to the metastatic site without a palpable testicular tumor. Patients may also present with elevated levels of tumor biomarkers, depending on the histology. The etiopathogenesis of this phenomenon remains unclear and may involve immunologic factors as well as necrosis due to tumor growth beyond the available blood supply. We report here two clinical cases of patients treated at our center, both presenting with symptoms caused by retroperitoneal lymph node dissemination but different histologiesas well as a different clinical course. Keywords: germ cell tumor; testicular cancer; spontaneous regression.

scholarly journals Simultaneous intracranial and testicular germ cell tumors: illustrative case

2021 ◽  
Vol 1 (3) ◽  
Author(s):  
Lei Han ◽  
Jie Lu ◽  
Luxiong Fang ◽  
Songtao Qi ◽  
Ye Song
Keyword(s):  
Germ Cell ◽  
Mature Teratoma ◽  
Germ Cell Tumors ◽  
Testicular Tumor ◽  
Cystic Teratoma ◽  
Pineal Region ◽  
Illustrative Case ◽  
Testicular Germ Cell Tumors ◽  
Testicular Germ Cell ◽  
First Case

BACKGROUNDSimultaneous intracranial and testicular germ cell tumors (GCTs) are extremely rare, leading to a lack of adequate experience in their treatment. Therefore, the authors report a case of this kind of GCT.OBSERVATIONSA 5-year-old boy was admitted to the hospital with headache and vomiting. Computed tomography and magnetic resonance imaging suggested the possibility of a GCT in the pineal region. The value of the serum tumor marker alpha-fetoprotein (AFP) was 5,396.1 μg/L, and β-human chorionic gonadotropin levels were within the normal range. Subsequently, the tumor was removed, and the final pathological result was a mixed GCT. Therefore, chemotherapy and radiation were added. However, the authors found a testicular tumor on ultrasound at the same time, and pathology after surgery suggested a mature cystic teratoma. Following treatment, the patient recovered well, and AFP levels dropped to normal values.LESSONSTo the authors’ knowledge, this report is the fourth case of simultaneous intracranial and testicular GCTs and the first case of a simultaneous mixed GCT in the pineal region and mature teratoma of the testis. A combination of surgery, chemotherapy, and radiation therapy for mixed GCTs in the pineal region and surgical excision for testicular reproductive cell tumors are effective in these patients, but long-term monitoring is required.

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

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.

scholarly journals Testicular Germ Cell Tumors: Serological and Immunohistochemical Diagnosis

2021 ◽  
Vol 50 (1) ◽  
pp. 58
Author(s):  
Ivan Damjanov
Keyword(s):  
Germ Cell ◽  
Tumor Markers ◽  
Germ Cell Tumors ◽  
Testicular Tumor ◽  
Published Data ◽  
Routine Practice ◽  
Testicular Germ Cell Tumors ◽  
Testicular Tumors ◽  
Testicular Germ Cell ◽  
Immunohistochemical Markers

<p>This review deals with serologic and immunohistochemical tumor markers used in clinical laboratories for the diagnosis of testicular germ cell tumors. Time tested serologic markers such as alpha-fetoprotein, human chorionic gonadotropin, and lactate dehydrogenase are routinely used in the work-up of patients with testicular tumors. Professional organizations regulating the practice of medicine in most countries worldwide require that the laboratory values for these serologic reactants be included in the pathology reports on testicular tumors as part of the tumor staging process. Immunohistochemical markers of testicular germ have been identified and widely tested during the first two decades of the XXI century. We have selected the most useful immunohistochemical markers from a few of these markers and discussed them in this review.</p><p><strong>Conclusion</strong>. Published data show that testicular tumor markers are widely used in routine practice. The study of tumor markers has improved the pathologic and clinical diagnosis of testicular germ cell tumors and has thus contributed to their treatment.</p>

scholarly journals Burned-Out Testicular Cancer: Really a Different History

2017 ◽  
Vol 10 (3) ◽  
pp. 846-850 ◽  
Author(s):  
Claudia Mosillo ◽  
Simone Scagnoli ◽  
Giulia Pomati ◽  
Salvatore Caponnetto ◽  
Maria Laura Mancini ◽  
...  
Keyword(s):  
Testicular Cancer ◽  
Germ Cell ◽  
Histopathological Examination ◽  
Mature Teratoma ◽  
Germ Cell Tumors ◽  
Testicular Tumor ◽  
Testicular Germ Cell ◽  
Abdominal Lymph Node ◽  
Cell Components ◽  
Histological Regression

Two or more histological types characterize more than 60% of testicular germ cell tumors (GCTs). Burned-out testicular tumor refers to partial or complete histological regression of the primary testicular lesions. The most frequent GCT type involved in this kind of histological regression is choriocarcinoma, followed by embryonal carcinoma. To our knowledge, there are no cases of the burned-out phenomenon in teratoma. We report a case of a 19-year-old man presenting to our institute with a right testicular lesion, evidence of mediastinal and abdominal lymph node metastasis, and high levels of GCT serum biomarkers. After orchiectomy, the histopathological examination showed a mixed GCT: mature teratoma, immature teratoma, and histological features of testicular cancer regression (burned-out phenomenon). The patient underwent first-line chemotherapy (BEP regimen) which resulted in a complete instrumental and biochemical response after 4 cycles. Teratoma is considered a less aggressive type of GCT. In this particular case, metastatic disease seems to result from non-germ cell components which underwent early spontaneous regression.

Discontinuous Involvement of Spermatic Cord Soft Tissue in Testicular Germ Cell Tumors: A Multi-Institution Experience

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S155-S156
Author(s):  
A Ali ◽  
J So ◽  
F Khani ◽  
M Kvetoslava ◽  
H Miyamoto ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Germ Cell ◽  
Tumor Size ◽  
Spermatic Cord ◽  
Statistical Significance ◽  
Germ Cell Tumors ◽  
Testicular Tumor ◽  
Distant Metastases ◽  
Testicular Germ Cell Tumors ◽  
Testicular Germ Cell

Abstract Introduction/Objective In the 8th Edition AJCC Cancer Staging Manual, discontinuous involvement of spermatic cord soft tissue (DISC) by testicular germ cell tumors (GCT) is regarded as metastatic deposit (pM1), placing the patient in clinical prognostic stage group (CPSG) III. We conducted a multi-institution study to corroborate or refute the current recommendations. Methods: Thirty-eight cases of GCT with spermatic cord involvement were collected from 13 institutions in Europe, Phillipines and America. Clinical and pathologic data was obtained. Results Tumors included 28 (73%) non-seminomatous and 10 (26%) seminomatous GCTs. Mean testicular tumor size was 6.6 cm (range 1.3-18). After review by an uropathologist, cases were classified as cord LVI [T2] (n=3), continuous cord involvement (CCI) [T3] (n=13), and DISC (n=22). Mean cord tumor size for DISC was 0.9 cm (range 0.1-4.5). CPSG was available for 33 and follow-up (FU) for22 patients with a mean length of FU of 38 months (range 2-144). Seven (39%) DISC patients were CPSG II (regional LN metastases), and 11 (61%) CPSG III (distant metastases). On FU, 5 (45%) DISC patients had no evidence of disease (NED); 6 (55%) were alive with disease (AWD). Three (25%) CCI patients were CPSG I (local disease), 6 (50%) CPSG II, and 3 (25%) CPSG III. On FU, 6 (60%) CCI patients were NED, 4 (40%) AWD. Cord LVI patients were one in each CPSG. One cord LVI patient was NED, the others were lost at FU. All DISC (100%) patients with available CPSG had advanced disease (CPSG II or III), compared to 75% of CCI, and 67% of cord LVI patients. Conclusion Although it did not reach statistical significance (p=0.054; Fisher’s exact test), DISC patients were more likely to have CPSG II and III compared to CCI patients. Our findings suggest a worse behavior in patients with DISC, supporting a higher pathologic stage than CCI.

scholarly journals Burned-Out Testicular Tumors in Adolescents: Clinical Aspects and Outcome

2021 ◽  
Vol 9 ◽  
Author(s):  
Giorgio Persano ◽  
Alessandro Crocoli ◽  
Maria Debora De Pasquale ◽  
Raffaele Cozza ◽  
Rita Alaggio ◽  
...  
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumors ◽  
Clinical Manifestations ◽  
Testicular Tumor ◽  
Clinical Aspects ◽  
Testicular Germ Cell Tumors ◽  
Testicular Tumors ◽  
Testicular Germ Cell ◽  
Visceral Metastases ◽  
Systemic Symptoms

Purpose: Testicular germ cell tumors are the fourth most common neoplasm in adolescents, accounting for 8% of all tumors in the age group 15–19 years. On rare instances, the primary testicular lesion is not clinically or radiologically evident while nodal or visceral metastases represent the clinical manifestations of the disease. This phenomenon is described as “burned-out testicular tumor.” In this paper, the authors report a single-institution experience with burned-out testicular tumors in adolescents and discuss their clinical implications.Patients and Methods: All the patients diagnosed with metastatic testicular germ cell tumors at Bambino Gesù Children Hospital between January 1, 2010, and June 30, 2020, were included in the study. Patients were categorized into two groups: “primary testicular” and “burned out.” All the patients were staged and treated according to the AIEOP–TCGM 2004 protocol.Results: Eleven patients were classified as “primary testicular,” and five patients were classified as “burned out.” “Burned-out” tumors were associated with the presence of systemic symptoms compared to “primary testicular” tumors (80 vs. 0%; p = 0.0027) and higher aFP, hCG, and LDH levels (p &lt; 0.00001). The “burned-out” population had a statistically significant higher incidence of relevant toxicity than the “primary testicular” population (80 vs. 18%; p = 0.0357) and a worse outcome in terms of both mean overall survival (15 vs. 43 months; p = 0.0299) and mean event-free survival (12 vs. 38 months; p = 0.0164).Conclusion: “Burned-out” testicular tumors seem to be a well-distinct clinical entity with a high treatment-related toxicity and poor prognosis. Further studies are needed to clarify the “burned-out phenomenon” and to identify more effective therapeutic strategies for these patients.

scholarly journals Frequency and morphological study of testicular germ cell tumor.

2019 ◽  
Vol 26 (10) ◽  
pp. 1794-1798
Author(s):  
Jawed Iqbal ◽  
Shahnaz Imdad Kehar ◽  
Nazish Jaffer ◽  
Farah Asad
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumor ◽  
Germ Cell Tumors ◽  
Testicular Tumor ◽  
Testicular Germ Cell Tumor ◽  
Clinical Information ◽  
Cell Tumor ◽  
International Studies ◽  
Testicular Germ Cell ◽  
Cross Sectional

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.

Prevalence of testicular microlithiasis association with testicular and extragonadal germ cell tumors in a Latin American population.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 331-331
Author(s):  
Silvia P. Neciosup ◽  
Jose Quesada ◽  
David Callacondo ◽  
Ivan Aguilar
Keyword(s):  
Germ Cell ◽  
Latin American ◽  
Tertiary Care ◽  
Germ Cell Tumors ◽  
Testicular Tumor ◽  
Testicular Microlithiasis ◽  
Testicular Germ Cell ◽  
History Of ◽  
The Relationship ◽  
Extragonadal Germ Cell Tumors

331 Background: Testicular microlithiasis (TM) is a entity characterized by multiple areas of increased echogenicity on scrotal ultrasonography (U.S.). Studies have reported association between TM and testicular germ cell tumors (TGCT). However, a study assessing the association of TM and extragonadal germ cell tumors (EGCT) has not been performed. Methods: Scrotal U.S. were reviewed in 441 men randomly selected from our computerized database during the period 1998 and 2010 at our tertiary-care cancer hospital. The association of U.S. findings with medical records and a history of germ cell tumors (GCT) were evaluated. The type of tumor was confirmed at histology after surgery or biopsy. Exclusion criteria included age <15 years and history of orchidectomy. Results: The median age was 32 years (range 15 – 88). TM was present in 95 patients (22%) and GCT were found in 130 patients (29%). 105 of these had TGCT (seminoma, n=56 and no seminoma, n=49) and 25 had EGCT (mediastinal, n=16, retroperitoneal, n=6 and CNS, n=3). Concurrent diagnosis of a TGCT was more prevalent in TM patients than in patients without TM (36/95 [38%] versus 69/346[20%] OR 2.45 95% CI 1.49–4.0; p<0.0001) while a diagnosis of an EGCT was present in 13 patients with TM and 12 patient without TM (13/95 [14%] versus 12/346 [3%] OR 4.41 95% CI 1.94–10.03; p<0.0001). No statistical differences were found for histology type. Conclusions: The prevalence in Latin American of TM is higher than previous reports and strongly associated with TCGT and EGCT. The clinical impact of the relationship between EGCT and TM is yet unknown and further studies are needed to clarify its role in the management. We suggest that young high-risk referral patients with TM should undergo scrotal U.S. annually; when a testicular tumor is not evident by U.S., investigations to rule out an EGCT, as thoracic or abdominal CT scans, should be considered individually in each case.

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