Testicular germ cell tumors

Question 1

Testicular germ cell tumors:

Answer 1

95% of all testicular tumors
Most often maligant
Can present as mixed germ cell tumors

Question 2

Testicular germ cell tumors: types

Answer 2

1) seminoma
2) yolk sac (endodermal sinus) tumor
3) choriocarcinoma
4) teratoma
5) embryonal carcinoma

Question 3

Testicular germ cell tumors:

Seminoma

Answer 3

Malignant
Painless, homogeous testicular enlargement
Most common
Age 15-35
Fried egg apperance
placental alk phos (PLAP)
radiosensitive

Late metastasis
Excellent prognosis
(no hCG or AFP elevation)

Question 4

Testicular germ cell tumors:
Yolk sac (endodermal sinus) tumor

Answer 4

Yellow, mucinous
Analogous to ovarian yolk sac tumor

Schiller-Duval bodies: primitive glomeruli
Increase AFP

Question 5

Testicular germ cell tumors:

Choriocarcinoma

Answer 5

Malignant,
High hCG
Disordered syncytiotrophoblastic and cytotrophoblastic elements

Hematogenous spread to lung
May produce gyneocomastia (hCG is LH analog)

Question 6

Testicular germ cell tumors:

Teratoma

Answer 6

Unlike in females,
mature teratoma in adults male more malignant
Benign in children.

High hCG and/or AFP in 50% of cases

Question 7

Testicular germ cell tumors:

Embryonal carcinoma

Answer 7

Malignant; PAINFUL;
worse prognosis than seminoma
Often glandular/papillar.

Pure embryonal carcinoma is rare;
most mixed with other tumor types;

High hCG
(normal AFP if pure, elevated if mixed)