Human pathology

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testicular germ cell tumors

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Testicular embryonal carcinoma Testicular embryonal carcinoma Testicular embryonal carcinoma

Testicular germ cell tumors are divided into two broad categories, seminoma and nonseminomatous germ cell tumors (NSGCT), which are theorized to arise from the seminomatous epithelium (germinal epithelium) of the testis.

Tumors containing both of the major types exist, and it is probably best to call these "mixed seminoma and NSGCT," with the type or a list of the types of NSGCT present and their approximate percentages.

The type of NSGCT, particularly choriocarcinoma (which has an aggressive course), determines the prognosis in these cases. Seminomas (the male analogue of the ovarian dysgerminoma) comprise 30-40% of all testicular tumors, and are divided into the classic and spermatocytic catagories.

Types

- testicular teratomas

- testicular seminoma
- testicular yolk sac tumor
- testicular embryonic carcinoma
- testicular choriocarcinoma
- malignant mixed germ cell tumor

Variants

- Wilms tumor (nephroblastoma) in a testicular germ cell tumor (15105660)
- embryonal rhabdomyosarcoma in a testicular germ cell tumor
- familial testicular germ cell tumor (15803215)

Association

- Hodgkin disease
- colorectal adenocarcinoma

Evolution

- metastasis
- spontaneous regression (16819328)

  • Spontaneous regression of testicular germ cell tumors (GCTs) is a well-recognized phenomenon but has been incompletely characterized. Many pathologists are not familiar with the findings that support a diagnosis of a "burnt-out" primary in a patient with metastatic GCT. (16819328)

Cytogenetics

Testicular germ cell tumors of adolescent and young adult men (TGCTs) generally have near triploid and complex karyotypes.

- 12p rearrangements

  • gain of 12p sequences
  • isochromosome i(12p)

CGH (17167184, 14697636)

CGH gains

- 12p gains
- 7p15.2 gains (17167184)
- 21q22.2 gains (17167184)
- CHr.X (14697636)
- 1q gains (14697636)
- 20q gains (14697636)

CGH losses

- 4p16.3 losses (17167184)
- 22q13.3 losses (17167184)
- Chr.4 (14697636)
- Chr.18 (14697636)
- 2q (14697636)
- 9q (14697636)
- 13q (14697636)

Highly over-expressed genes

- CCND2, CD9, GAPD, GDF3, NANOG, and TEAD4 (17167184)

Integration of DNA copy number information to gene expression profiles

- BRCC3, FOS, MLLT11, NES, and RAC1 may act as novel oncogenes in TGCT. (17167184)
- DDX26, ERCC5, FZD4, NME4, OPTN, and RB1 were both lost and under-expressed genes, and are putative TGCT suppressor genes. (17167184)

See also

- germ cell tumors

References

- Zynger DL, Dimov ND, Luan C, Teh BT, Yang XJ. Glypican 3: a novel marker in testicular germ cell tumors. Am J Surg Pathol. 2006 Dec;30(12):1570-5. PMID: 17122513

- Balzer BL, Ulbright TM. Spontaneous regression of testicular germ cell tumors: an analysis of 42 cases. Am J Surg Pathol. 2006 Jul;30(7):858-65. PMID: 16819328

- Oosterhuis JW, Looijenga LH. Testicular germ-cell tumours in a broader perspective. Nat Rev Cancer. 2005 Mar;5(3):210-22. PMID: 15738984

- Michael H, Lucia J, Foster RS, Ulbright TM. The pathology of late recurrence of testicular germ cell tumors. Am J Surg Pathol. 2000 Feb;24(2):257-73. PMID: 10680894

- Ulbright TM. Germ cell neoplasms of the testis. Am J Surg Pathol. 1993 Nov;17(11):1075-91. PMID: 8214253