Train to work in pathology there are two main training routes into a career in pathology becoming a medical doctor or becoming a clinical scientist. Testicular tumors in children and teens danafarberboston. Malignant testicular tumours belong to a gro up of rare neo plasms ob served in men, constituting most frequently 11. Tumor markers for testicular cancer and extragonadal germ. Testicular lymphatics follow the vessels of the spermatic cord through the inguinal canal and into the retroperitoneum. There are about 2,000 new cases in the uk each year. Very late relapse of testicular tumour in combination with. The world health organization who has standardized pathologic criteria for the diagnosis of testicular cancer.
Incidentally detected nonpalpable testicular tumours in. The 2016 who classification of tumours of the urinary system. In the presence of bilateral testicular tumors in an elderly. A contribution to the treatment of nonseminomatous. The 36yearold patient underwent left orchiectomy, retroperitoneal lymph node dissection, and chemotherapy, because of mixed tumor including teratoma and embryonal carcinoma. Testicular cancer is the most common solid cancer in males aged 15 to 35. This free fact sheet is available as a pdf, so it is easy to print out. Pathology outlines world health organization who 2016. While these tumors are not uncommon in the aging male rat, they are rarely found to have spread or metastasized to other organs or areas of the body. The following staging information is for germ cell tumours of the testicle, which make up more than 90% of all testicular cancers.
Most of the remaining 5% are sex cordgonadal stromal tumours derived from leydig cells or sertoli cells. Testicular tumours have an excellent overall prognosis with a 95% cure rate. The most common situation is bilateral spermatocytic or classic seminoma. Experiences obtained in the treatment of nonseminomas in 86 men are evaluated. Guidelines for the diagnosis and staging of testicular cancer. For testicular cancer there are 4 stages stage 0 followed by stages 1 to 3.
Dr d m berney, the orchid tissue laboratory, barts and the london school of medicine and dentistry, st bartholomews hospital, west smithfield, london ec1a 7be, uk. Cancer can also develop in the contralateral normally descended testis. In 71 patients retroperitoneal lymphadenectomy was performed, in 15 also nephrectomy. Teratoma and yolk sac are the most common cell types seen in children. The esur scrotal imaging subcommittee searched for original and. Testicular cancer spreads predominantly and initially through lymphatic routes. In this group of tumours, 10% will metastasise and this cannot be predicted from the histology of the testis. Combining gemcitabine, cisplatin, and ifosfamide gip is active in patients with. Testicular germ cell tumors account for 90% of primary tumors of the testes. More than 90% of all testicular cancers are germ cell tumours. Nomenclature precursor germ cell tumour gct testis cis igcnu tin cis not a carcinoma. Testicular cancer is the most common solid malignancy affecting males between the ages of 15 and 35, although it accounts for only 1 percent of all cancers in men. Click to share on twitter opens in new window click to share on facebook opens in new window. Genomic landscape of platinum resistant and sensitive.
Testicular germ cell tumors radiology reference article. Although testicular cancer can be derived from any cell type found in the testicles, more than 95% of testicular cancers are germ cell tumors gcts. Cancerous tumours are also called malignant tumours. The testicles are 2 eggshaped glands located inside the scrotum a sac of loose skin that lies directly below the penis. Trophoblastic teraloma with clearly defined syncytial and cytotrophoblastic elements haematoxylin andeosin x50. The increasing detection of small testicular lesions by ultrasound us in adults can lead to unnecessary orchiectomies. Testicular cancer is uncommon, accounting for less than 1% of all internal organ malignancies 2. It is the most common cancer in men aged 1544 years. Most types of testicular cancer develop in the spermproducing cells known as germ cells and are. Oct 24, 2015 the increasing detection of small testicular lesions by ultrasound us in adults can lead to unnecessary orchiectomies. Sep 20, 2019 testicular lymphatics follow the vessels of the spermatic cord through the inguinal canal and into the retroperitoneum. Because of their high sugar metabolism tumor cells can be visualized. These organs produce sperm and the male hormone testosterone, which is crucial. Pdf malignant testicular tumour incidence and mortality.
Testicular tumours are rare but important because they occur in the young. Nonseminomatous testicular tumours include embryonal carcinoma, teratoma, yolk sac carcinoma, chorioncarcinoma, and various combinations of. Germ cell tumors derived from germ cell neoplasia in situ germ cell tumors unrelated to germ cell neoplasia in situ sex cord stromal tumors tumor containing both germ cell and sex cord stromal elements. Stages of testicular cancer canadian cancer society. Men who have had 1 testicular germ cell tumour tgct increase their risk of developing a contralateral tgct by 17. Testicular tumors can be both benign or metastatic. The peak incidence for nsgct is between 20 and 30 years and for seminoma between 30 and 40 years. The risk of bilaterality rises to 15% if both testes are undescended. Thorax there was a haemorrhagic tumour of the right parietal pleura and the hilar lymph nodes were.
Radiotherapy as initial treatment for bulky stage ii testicular seminomas. Doctors assign the stage of the cancer by combining the t, n, and m. The original and primary source for this information is the ajcc cancer staging manual. Nonseminomatous testicular tumours include embryonal carcinoma, teratoma, yolk sac carcinoma, chorioncarcinoma, and various combinations of these cell types. London cancer guidelines for the management of testicular tumours. Lymphoma of the testis usually occurs in the over 60s. Tumor markers in advanced nonseminomatous testicular cancer. Review papers have been published in the society scientific journal european urology, the latest version dating to 2011 1. London cancer guidelines for the management of testicular. This document presents a limited update of the 2014 publication. Testicular cancer is a disease in which malignant cancer cells form in the tissues of one or both testicles. Treatment may result in infertility risk factors include an undescended testis, family history of the disease, and previous history of testicular cancer. Problems of interpretation of serum concentrations of alphafoetoprotein afp in patients receiving cytotoxic chemotherapy for malignant germ cell tumours. Germ cell tumors gcts account for 95 percent of testicular cancers.
Spread may then occur along the thoracic duct to the supraclavicular nodes, especially on the left side. June 7, 2010to help doctors give their patients the best possible care, the american society of clinical oncology asco asks its medical experts to develop evidencebased recommendations for testing blood levels of tumor markers for germ cell tumors. Pdf malignant testicular tumour incidence and mortality trends. We report a case of late relapse of a testicular tumour combined with a renal cancer and their successful removal with retroperitoneoscopy. If you continue browsing the site, you agree to the use of cookies on this website. Other mesenchymal tumors of the spermatic cord and testicular adnexa. Testicular germ cell tumours tgcts are the most common cancer affecting young men, with peak incidence at age 3036 years 1,2.
Testicular cancer is the most prevalent neoplasm in canadian males aged 20 to 39, affecting on average 48. Leydig cell tumour, also leydig cell tumor us spelling, testicular interstitial cell tumour and testicular interstitial cell tumor us spelling, is a member of the sex cordstromal tumour group of ovarian and testicular cancers. We also suggest recommendations to help characterization and management. They are the most common nonhaematologic malignancy in men 1549 years old. The initial combination consisted of vincristin, bleomycin and cisplatin, the maintenance chemotherapy of vincristin, methotrexate and leukeran chlorambucil. The most common staging system for testicular cancer is the tnm system. The first page of the pdf of this article appears above. While cure rates for tgcts are generally high due to their. Around half of all cases occur in men aged under 35 but testicular cancer rarely occurs before puberty. Thorax there was a haemorrhagic tumour of the right parietal pleura and the hilar lymph nodes were enlarged and haemorrhagic on both sides.
The 2016 who classification of tumours of the urinary. The 8th edition of the ajcc staging manual was implemented on. Hemangioma desmoplastic round cell tumor metastatic tumors. Gonadal stromal tumours account for less than 5% of adult testicular tumours, but up to 20% of childhood testicular tumours. Testicular cancer or tumors are primarily found to arise from primordial germ cells undeveloped or seed cells that develop into sperm.
The main types are leydig cell tumours and sertoli cell tumours. The testicles are held within the scrotum by the spermatic cord, which also contains the vas deferens and vessels and nerves of the testicles. Testicular cancer represents 5% of urological tumours affecting mostly younger males. The world health organization 2016 classification of. Testicular germ cell tumours clinical practice guidelines. This type of cancer starts in germ cells, which are the cells that make sperm. There is also evidence to suggest that the overall incidence of testicular tumours has increased. This is an update of the previous european association of urology testis cancer guidelines published in 2011, which included. Nov 24, 2014 tumours can also start in the supportive and hormoneproducing tissues of the testicles. Pdf germ cell tumours of the testis are the commonest malignancy in men aged 2040 years. For example, clinical stage ii testicular cancer means that the retroperitoneal. Testicular cancer is often divided into two main categories. This gamma radiation is detected and mostly merged with mri or ct scan. Cancerous tumours of the testicle canadian cancer society.
Epidemiological risk factors for the development of testicular tumours are. The demographics of affected individuals depends on the age of the histology of the tumor. Tumours that appear to have a seminoma histology but that are accompanied by elevated serum levels of afp should be treated as nonseminomas. Histologic classifications, grading systems, and staging evaluations have traditionally provided a major clinical basis for therapeutic decisions.
Appendix 4 who classification of tumours of the testis. On the left, it is on top of and lateral to the aorta. Clinical practice guideline gu001 version 7 page 2 of 23 background testicular germ cell tumours gcts account for about 1% of all new cancer cases in men agestandardized incidence rate of 5. Chest ct is recommended if the chest xray is abnormal, or if metastatic disease in the thorax is strongly suspected clinically. Of the 403 case reports indexed in medline under both the mesh. Leydig cell tumours are relatively rare, representing just 3% of testicular neoplasms. Testicular cancer urology associates of northeast florida. Spermatocytic tumor, shown in the image, is an example of which of the following categories of testicular tumors. The 2 main types of germ cell tumours that develop in. Bilaterality bilateral testicular involvement by germ cell tumors is seen in 1.
Testicular cancer is cancer that develops in the testicles, a part of the male reproductive system. Nov 11, 20 testicular tumours and there rare variants with histology slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Symptoms may include a lump in the testicle, or swelling or pain in the scrotum. Germ cell tumors are masses of tissue formed by immature cells that normally would have developed into mature eggs in a female or sperm in a male.
Thank you for your interest in spreading the word about the bmj. This excess risk is decreased or eliminated if orchiopexy is done before 10 years of age. Once the diagnosis of testicular cancer is made, a highresolution computed tomography ct scan of the abdomen and pelvis and a chest xray are ordered as part of the initial staging workup. Sex cordgonadal stromal tumours, mixed forms 85921. Combining gemcitabine, cisplatin, and ifosfamide gip is active in patients with relapsed. Testicular cancer is a cancer that arises from a testicle testis. Testicular neoplasms in children are rare, accounting for 12 % of all pediatric solid tumors. The gcnisderived tumours have comparable epidemiologic associations and usually occur in a background of perturbed testicular development that has recognizable morphologic features. Feb 27, 2019 the testicles are the two male reproductive organs located in the scrotum and sitting on either side of the penis. On the right, lymphatic drainage is between the aorta and the inferior vena cava. Coppack s, newlands es, dent j, mitchell h, goka g, bagshawe kd. The tumor markers recommended in this guide are based on the results of clinical trials of patients with germ cell tumors. Dataset for the histological reporting of testicular neoplasms. Testicular cancer genitourinary disorders merck manuals.
The histopathology of testicular tumors is presented, em phasizing new, unusual, or. Late relapse of a testicular cancer is an uncommon occurrence. Clemmesen 1969 has reported that in denmark between the years 1943 and 1962, the ageadjusted incidence rate of testicular tumours increased in copenhagen from 3. This document addresses germcell tumours and sex cordgonadal stromal tumours. Testicular tumours have an excellent overall prognosis with a. Over 90% of all tumors of the testes are primary germ cell tumors, and as such young adults are the overall most frequently involved group. Testicular tumors in children and teens danafarber. Clemmesen 1969 has reported that in denmark between the years 1943 and 1962, the ageadjusted incidence rate of testicular tumours increased in copenhagen from. These tumours arise from cells producing testosterone and occur in a slightly older age group, with a mean age of 36 years. The role of 18fluoro2deoxyglucose positron emission tomography in initial staging and restaging after chemotherapy for testicular germ cell tumours. These are germ cell tumors that can present as either benign noncancerous or malignant cancerous. The 2 main types of germ cell tumours that develop in the testicles are seminomas and nonseminomas. The most common type is germ cell tumors which are divided. We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail.
110 494 435 319 210 916 516 648 1273 1233 1623 1306 1650 522 1568 1112 28 623 782 872 1014 918 780 1537 1314 341 180 466 466 703 846 228 1233 1501 347 535 754 554 680 91 913 90 307 1311 635 1022 759 386