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testicular choriocarcinoma

Tuesday 26 October 2004

Definition: Testicular choriocarcinoma is non-seminomatous germ cell tumor arising within the testis. These tumors recapitulate the placenta and are associated with an aggressive clinical course.

Unlike other testicular tumors, the most common symptom is related to metatasis rather than a testicular mass. Hemoptysis (coughing up blood) and back pain. Pure tumors are extremely uncommon with most tumors part of a mixed germ cell neoplasm. These tumors characteristically secrete hCG into the serum.

Synopsis

- polygonal cells with clear cytoplasm (cytotrophoblast).

  • cytotrophoblastic cells may be arranged in sheets or villous-like architecture in a hemorrhagic background.

- large multinucleated cells with smudged nuclear chromatin (syncytiotrophoblast)

  • syncytiotrophoblasts form a "cap" around clusters of cytotrophoblasts

- hemorrhagic and necrotic foci
- residual scar as the only evidence of prior existence of the tumor

Epidemiology

- 0.3% of testicular tumors
- Focal choriocarcinoma can be found in up to 8% of testicular germ cell neoplasms

Associations

- Pure tumors very rare
- Focal choriocarcinoma can be found in up to 8% of testicular germ cell neoplasms

Prognosis

- Pure tumors have a worse prognosis than other testicular germ cell neoplasms.
- If there is a greater amount of choriocarcinoma admixed in a germ cell tumors, it has an adverse effect on survival.
- choriocarcinoma tends to metastasize widely

  • Lungs 100%
  • Liver 86%
  • GI tract 71%
  • Adrenal gland, spleen, brain 56%

See also

- germ cell tumors

  • choriocarcinoma