Uropathology
Fereshteh Ameli; Pooneh Panahi; Vahid Soleimani
Abstract
Germ cell teratomas belong to nonseminomatous germ cell tumors and account for 95% of malignant testicular tumors. Regarding the current World Health Organization (WHO) criteria, testicular teratomas are divided into prepubertal and postpubertal subtypes based on patients’ age. The term “burned-out ...
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Germ cell teratomas belong to nonseminomatous germ cell tumors and account for 95% of malignant testicular tumors. Regarding the current World Health Organization (WHO) criteria, testicular teratomas are divided into prepubertal and postpubertal subtypes based on patients’ age. The term “burned-out testicular tumor” is a very rare condition referring to a regressed testicular tumor which presents with its metastases without any clinical finding in the testicle. Metastasis can be the presentation of postpubertal teratoma in 22-37% of cases. In scar associated teratoma (burn-out component), the metastasis rate is 66%. We reported a rare case of postpubertal teratoma in a 34-year-old male who presented with multiple liver masses initially. Liver biopsy revealed poorly differentiated adenocarcinoma probably from gastrointestinal (GI) tract. The upper and lower GI endoscopy were normal. Scrotal ultrasonography showed a hypoechoic cystic intratesticular lesion in the left testis. He underwent radical orchiectomy and the histopathology examination revealed postpubertal teratoma with burned out component. He underwent proper treatment and is still under follow up. As a result, in a young male patient who presented with a retroperitoneal mass or poorly differentiated carcinomas of an unknown primary site, using light microscopy and immunohistochemical profiling alone may be inadequate. Therefore, scrotal screening and physical examination of the scrotum and bilateral testis should be considered to exclude possibility of a metastatic progression from a testicular germ cell neoplasia.
Shahla Ansari; Parvaneh Vossogh; Ali Tabarok
Volume 2, Issue 1 , January 2007, , Pages 29-32
Abstract
Background and Objective: Germ cell tumor (GCT) accounts for approximately 2-3% of all malignancies in children. In this respect, about 20% of patients with GCT are still resistant to therapy. Materials and Methods: The cross-sectional strategy of this survey was undertaken on 57 patients with germ cell ...
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Background and Objective: Germ cell tumor (GCT) accounts for approximately 2-3% of all malignancies in children. In this respect, about 20% of patients with GCT are still resistant to therapy. Materials and Methods: The cross-sectional strategy of this survey was undertaken on 57 patients with germ cell tumor who admitted to Ali Asghar Children hospital during the years 1990- 2003. In this study, information regarding sex, age, pathological findings, clinical signs, treatment, and survival (event-free survival) were gathered in order to have better treatment and follow-up. The obtained data were analyzed using SPSS software. Results: The findings showed that the mean age of patients was 4.9 ± 0.1 years (1 months-14 years). Meanwhile, 54% and 46% of patients were male and female respectively with a ratio of 1.1. Regarding site of involvement, 57.8% and 42% of patients had sacrococcygeal and gonadal tumors respectively. In addition, regarding their pathological typing, 61.4%, 12.2%, 14%, and 10.5% of them had yolk sac tumor, dysgerminoma, malignant teratoma, and embryonal carcinoma respectively. The most common clinical signs were buttock mass, testicular mass, an abdominal mass, and abdominal pain in 31.5%, 28%, 17.5%, and 10.5% of patients respectively. All of the patients were treated with chemotherapy (bleomycin, vinblastin, cisplat). Mean duration of followup was 48.4 months. In this regard, 31.5% of the patients were alive, no information was available for 15.7% of them, and 52.6% of cases were expired. Meanwhile, 70% of the patients had tumor relapse. In this regard, event-free survival (EFS) for patients was 42%. Conclusion: The analysis of the treated patients showed that extragonadal location of primary tumor (especially sacrococcygeal), level of AFP above 10 ng/ml in patients, an age equal to or greater than 6 months, and metastatic disease were the most unfavorable factors for overall survival .
