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At least 19 recordsLinked to original sources
PubMed1981

[Primary mediastinal seminoma. Case reports of 4 pure seminomas and 1 teratoma with seminoma involvement].

From 1957 till 1980 48 operations for mediastinal tumors with 5 primary seminomas seating in the thymus gland, one deriving from a teratoma. No seminoma of the testes during the following long-term observation. In two cases the diagnosis of a primary seminoma was confirmed by post-mortem examination. One of the other patients died 4 years after the operation from bone metastases. The cachectic patient showed no signs of retroperitoneal or testicular tumor. One case has been nephrectomized transperitoneally two years after the chest operation of a renal metastasis: no second tumor and no retroperitoneal metastasis in the lymph glands. One case is symptom-free 17 years after the operation. In the last ten years a crescent number of cases has been published. - Review of the theory of intrathoracic localization of primary seminomas based on the embryonal aberration of gonocytes by Friedmann. The therapy consists in the resection of the tumor, local postoperative radiotherapy and adjuvant cytotoxic chemotherapy.

Dysgerminoma↗
PubMed2000

Clues to the aetiological heterogeneity of testicular seminomas and non-seminomas: time trends and age-period-cohort effects.

BACKGROUND: Most previous epidemiological studies have treated testicular cancer as a single entity. However, some investigators suggest that testicular seminomas and non-seminomas may have different risk profiles. We examine the time trends in incidence of the two main histological types separately. METHODS: From 1970 through 1995, 7296 cases of testicular cancer were registered in the Canadian provinces of Ontario, Saskatchewan and British Columbia. In addition to analyses of the secular trends by age group and birth cohort, an age-period-cohort (APC) model with standard Poisson assumptions was fitted to the data to assess the time effects. RESULTS: The age-adjusted incidence rate for seminomas increased by 53%, from 1.5 per 100 000 males in 1970-1971 to 2.3 per 100 000 males in 1994-1995. Non-seminomas increased by 91%, from 1.1 to 2.1 per 100 000 males over the same period. Non-seminomas were more frequent at young ages whereas seminomas dominated in older ages. In contrast to seminomas, non-seminomas occurred predominantly among adolescent men (15-19 years), with a fourfold increase between 1970-1971 and 1994-1995. Age-period-cohort modelling showed that the increase in the risk of both seminomas and non-seminomas followed a birth cohort pattern, but with differences in birth cohorts in addition to significantly distinct age patterns. CONCLUSIONS: Our findings support the hypothesis postulating aetiological heterogeneity in the development of seminomas and non-seminomas. We suggest that epidemiological studies of testicular cancer treat seminomas and non-seminomas separately.

Adolescent↗
PubMed1993

Immunohistochemical comparison between anaplastic seminoma and typical seminoma.

In order to study the possible biological differences between anaplastic and typical seminoma, the following factors were studied in 11 cases of anaplastic seminoma and 15 cases of typical seminoma: mitotic activity, proliferating cell nuclear antigen (PCNA) expression, immunohistochemical analyses for cytokeratin, vimentin, placental alkaline phosphatase (PLAP), beta-human chorionic gonadotropin (beta-hCG), alpha-fetoprotein (AFP) and c-myc oncoprotein. Anaplastic seminoma was classified according to Mostofi's criteria, which is primarily based on the mitotic activity of the tumor. Mitotic activity was evaluated by both mitotic count and rate. Statistically significant correlations were observed between mitotic count and mitotic rate (R = 0.891), and between the mitotic count and PCNA labeling index (R = 0.792), in both typical and anaplastic seminomas. Immunostaining patterns for cytokeratin, vimentin, PLAP, beta-hCG, AFP and c-myc oncoprotein were not significantly different between typical and anaplastic seminoma. The present data indicated that no apparent clinicopathologic and immunohistochemical parameters discerning anaplastic seminoma from typical seminoma were present, when identifying anaplastic seminoma on the basis of high mitotic count. Anaplastic seminoma may therefore simply represent seminoma with high proliferative activity.

Adolescent↗
PubMed2002

Testicular seminoma: a clinicopathologic and immunohistochemical study of 105 cases with special reference to seminomas with atypical features.

In spite of the high curability rates, rare cases of testicular seminoma behave in an unexpectedly aggressive manner. No effective markers are currently available that can predict such uncommon behavior. We studied 105 cases of testicular seminoma on whom the primary resection was performed at the Memorial Sloan-Kettering Cancer Center, New York, to investigate any relationship between morphology, immunohistochemical features, and clinical/pathological stages. Fifty-nine percent of the cases presented with pT stage 1 and 74 percent with American Joint Committee on Cancer (AJCC) stage I. In univariate analysis, tumor size, mitotic count, and presence of necrosis showed significant associations with pT stage (p = 0.0001, 0.0001, and 0.04, respectively), and the presence of vascular invasion (p = 0.0001, 0.0001, and 0.02, respectively). In multivariate analysis, both the tumor size and mitotic counts were independent predictors of pT stage (p = 0.0004 and 0.0001) and vascular invasion (p = 0.0004 and 0.0001). When tumors were separated on the basis of architectural and/or cytological atypia into "usual seminomas" and "seminomas with atypia", these were significantly associated with AJCC stage (p = 0.02), and c-kit protein (p = 0.0005) and CD30 expression (p = 0.02). In addition, "seminomas with atypia" also tended to show a higher proliferation activity as judged by Ki67 reactivity (p = 0.06), as well as express the marker of epithelial differentiation, Cam 5.2 (p = 0.09). In summary, we find that the morphologic features in testicular seminomas are associated with factors of clinical relevance. Also, "seminomas with atypia" differ from "usual seminomas" morphologically, present at a higher AJCC stage, and possibly represent an early step in transformation of seminomas toward a more aggressive phenotype. While not proposing a new entity, we suggest that when these atypical features are encountered in an otherwise classical seminoma, investigations must be performed to exclude an early carcinomatous differentiation or even earlier changes toward such a differentiation, such as lack of c-kit protein expression.

Adult↗
PubMed1994

Seminomas of the canine testis. Counterpart of spermatocytic seminoma of men?

BACKGROUND: Dogs develop germ cell tumors of the testis at a relatively high rate. It is not known to what degree these tumors resemble various human testicular neoplasms. EXPERIMENTAL DESIGN: The epidemiology and morphology of a series of spontaneous canine testicular tumors, collected between 1985 and 1991, was analyzed, and compared with human testicular germ cell tumors. DNA content analysis of representative samples was performed using flow cytometry and image cytometry. Eight human spermatocytic seminomas were studied in parallel. RESULTS: All canine tumors had the histopathologic features reported as typical for dog testis seminomas. These tumors could show both an intratubular and an invasive component. Most of them were pure (78%), while they could be combined with a Leydig cell tumor, a Sertoli cell tumor, or both. No somatic, placental or yolk sac cells were identified, and there was no carcinoma in situ (CIS). A bimodal age distribution, with a peak around 1 year of age and between 4 and 16 years of age, was found for all pure and mixed testicular tumors, except for those composed of a Leydig cell and a seminoma component. These tumors were all present in dogs older than 7 years, being significantly more older (p < 0.01) than dogs with a pure tumor of either type. All Sertoli cell and Leydig cell tumors were diploid. No consistent peritriploid DNA content, characteristic of human testicular germ cell tumors, was found for canine seminomas, which most often had a diploid DNA content. Human spermatocytic seminomas always contained diploid tumor cells, and showed a relatively low number of high ploidy cells, comparable to canine seminomas of the testis. CONCLUSIONS: The so-called seminomas of the testis are tumors of old age. Histologically, these tumors are composed of a single cell type with some variation without evidence of differentiation. It is proposed that canine seminoma correspond to human spermatocytic seminomas. It is thought that the Leydig elements in these tumors represent a reactive change rather than biphasic differentiation of a single stem cell capable of germinal and sex-cord cell development.

Animals↗
PubMed1993

Anaplastic seminoma and spermatocytic seminoma--a retrospective analysis.

Through the years 1968-1990, 10 patients with anaplastic seminoma and 7 patients with spermatocytic seminoma were referred to the Northern Israel Oncology Center, Haifa, Israel. These patients represent 20% of a total of 85 seminoma patients referred for treatment and follow-up. All patients underwent orchiectomy. Metastatic work-up revealed stage I disease in all patients. Sixteen patients received postoperative prophylactic radiation therapy to the para-aortic lymph nodes and the ipsilateral iliac region, dose range 25-30 Gy (daily fractionation 200 cGy). With a mean follow-up of 98 months, 15 patients are alive with no evidence of disease or long-term side-effects of treatment. One patient died of ischaemic heart disease without evidence of recurrent tumour. One patient with anaplastic seminoma died from progressive disease. In the light of our experience and a review of the literature, it is suggested that treatment of stage I non-pure seminoma should be based on the extent of disease alone and not on the degree of histological differentiation. Stage I non-pure seminoma has the same good long-term survival and low complication rate as typical seminoma when treated with adjuvant radiotherapy. Prospective, randomised trials are required to evaluate the role of a surveillance policy alone in stage I non-pure seminoma.

Adult↗
PubMed2000

Comparative genomic hybridization of microdissected samples from different stages in the development of a seminoma and a non-seminoma.

Human testicular germ cell tumours (TGCTs) of adolescents and adults, both seminomas and non-seminomas, originate from intratubular germ cell neoplasia (IGCN). Comparative genomic hybridization (CGH) was applied to microdissected samples from different stages of the development of a seminoma and a mixed non-seminoma, including IGCN of both. The different stages of the seminoma development, namely IGCN, intratubular and invasive seminoma, showed a very similar pattern of chromosomal imbalances, including gains of parts of 7, 8, 12,14, and X, and losses of parts of 3, 4, 5, 10, 11, 12q, 16, 18, 22, and Y. A more heterogeneous pattern was found for the non-seminoma. Some aberrations were present only in IGCN, or in IGCN and in all invasive components (gains of parts of 1q, 17, 19p, 20q, and 22, and losses of parts of 4, 5, 9p, 13, and 18q), while others were present in a less consistent pattern. These are the first reported CGH data from different stages in the development of TGCTs. Although only two cases were studied, the results suggest that particular numerical changes of (parts of) chromosomes are involved in the early development and progression of this cancer.

Adolescent↗
PubMed1999

Prognostic factors in seminomas with special respect to HCG: results of a prospective multicenter study. Seminoma Study Group.

OBJECTIVE: In a prospective multicenter trial, it was our intention to elucidate clinical prognostic factors of seminomas with special reference to the importance of human chorionic gonadotropin (HCG) elevations in histologically pure seminomas. METHODS: Together with 96 participating urological departments in Germany, Austria, and Switzerland, we recruited 803 seminoma patients between 1986 and 1991. Out of 726 evaluable cases, 378 had elevated, while 348 had normal HCG values in the cubital vein. Histology was reviewed by two reference pathologists. HCG levels were determined in local laboratories and in a study laboratory. Standard therapy was defined as radiotherapy in stages I (30 Gy) and IIA/B (36 Gy) to the paraaortal and the ispilateral (stage I) and bilateral (stage IIA/B) iliac lymph nodes; higher stages received polychemotherapy and surgery in case of residual tumor masses. Statistics included chi-square tests, linear Cox regression, and log-rank test. RESULTS: The HCG elevation is associated with a larger tumor mass (primary tumor and/or metastases). HCG-positive and HCG-negative seminomas had no different prognostic outcome after standard therapy. The overall relapse rate of 6% and the survival rate of 98% after 36 months (median) indicate an excellent prognosis. The calculation of the relative risk of developing a relapse discovered only stage of the disease and elevation of the lactate dehydrogenase concentration and its prolonged marker decay as independent prognostic factors for seminomas. A more detailed analysis of the prognostic significance of the stage revealed that the high relapse rate in stage IIB seminomas after radiotherapy (24%) is responsible for this result. CONCLUSIONS: We conclude that HCG-positive seminomas do not represent a special entity. Provided standard therapy is applied, HCG has no influence on the prognosis. Patients with stage IIB disease should be treated with chemotherapy because of the demonstrated higher relapse rate outside the retroperitoneum.

Biomarkers, Tumor↗
PubMed2001

Somatostatin receptor expression profile as a potential criterion for discrimination between seminoma and non-seminoma testicular tumors.

The expression of five (sst1-sst5) somatostatin (SRIF) receptor mRNAs was compared between normal and tumoral testicular samples diagnosed as either seminoma or non-seminoma. Reverse transcriptase-polymerase chain reaction (RT-PCR) analysis indicated that all testicular tissues studied (total of 24) contained sst5 receptor transcripts, whereas the sst2 was absent in all of them. In contrast to the normal tissue samples, both types of tumors (total of 12) did not contain sst4 transcripts. sst3 mRNA was expressed in normal and non-seminoma samples, but not in seminomas. sst1 transcripts were not found in normal and seminoma tissues. However, all studied non-seminomas contained this mRNA. Our data thus points to a specific pattern of SRIF receptor mRNA expression in each type of the samples analyzed. Moreover, they further indicate that the presence of sst1 and sst3 transcripts might be used as an additional criterion to distinguish between seminoma and nonseminoma tumors.

Adolescent↗
PubMed1979

Seminoma with syncytiotrophoblastic giant cells. A special form of seminoma.

Testicular seminomas may occur in various forms, of which the classical and spermatocytic are distinct, the anaplastic or atypical seminomas, however, less clearly defined. Lately, a separate group of particular clinical significance, comprising seminomas with syncytiotrophoblastic giant cells (STGC), has been specified. Although this type of seminoma had been recognized morphologically long ago, recent investigations have shown its ability to secret HCG, a fact that raises serious difficulties in its differential diagnosis with combined seminomas and choriocarcinomas. Two cases of seminomas with STGC are presented and pertinent clinical and morphologic problems discussed.

Adult↗
PubMed1998

[Comparison of prognosis between inguinal cryptorchic seminoma and scrotal seminoma].

OBJECTIVE: To analyse the prognosis of patients with inguinal cryptorchic seminoma. METHODS: From 1985 through 1991, 43 patients with inguinal seminoma of undescended testis were treated and the therapeutic effect retrospectively reviewed. There were 33 patients in stage I, 8 in stage II, 1 in stage III, and 1 in stage IV. All patients had inguinal orchiectomy. Patients in stage I and II were primarily treated with radiotherapy, whereas one patient in stage III and another in stage IV were treated with radiotherapy or chemotherapy. RESULTS: The 5- and 10-year overall survival was 93.0% and 90.3%, respectively. The corresponding disease-free survival was 88.1% and 85.3%, respectively. The overall 5- and 10-year survival by stage was 100% and 100% for stage I, 75.0% and 60.0% for stage II, respectively. Two patients relapsed and were successfully treated with radiotherapy. CONCLUSION: Prognosis for inguinal cryptorchic seminoma is as good as that of scrotal testicular seminoma. Postorchiectomy radiotherapy encompassing para-aortic and ipsilateral iliac nodes is effective for stage I and early stage II inguinal crytorchic seminoma. The inguinal nodes should be included in the treatment ports only when they are involved or if there is obvious involvement of surrounding tissues by the primary tumor.

Adolescent↗
PubMed1985

Human chorionic gonadotropin-positive seminoma: is this a special type of seminoma with a poor prognosis?

Prognosis and treatment of HCG-positive seminomas with syncytiotrophoblastic giant cells are still a matter of discussion. Between 1977 and 1982 the serum HCG and alpha-feto protein levels were determined in a prospective study of a total of 51 patients presenting with histologically proven pure seminomas. A total of 13 of the 51 patients with pure seminoma had elevated serum HCG levels, but all of them were negative for alpha-feto protein. On clinical examination six patients had tumor Stage I, six had had tuor Stage II A-B and one patient had a tumor Stage III. The clinical stage was not found to correlate with HCG levels. In six patients presenting with tumors of clinical Stage II who underwent orchiectomy and subsequently radiation therapy there was a decrease in HCG levels following therapy. Five patients were followed for five years after therapy had been discontinued. There is no indication of a relapse in four patients, and the patients are negative or HCG. One patient suffering from a tumor, Stage IIB died three years later as a result of cirhosis of the liver. Autopsy did not reveal any signs of a residual tumor; the serum HCG levels were negative. For the time being HCG-positive seminomas should be classified and treated as a special morphologic form of seminoma.

Adult↗
PubMed1989

HLA-antigen distribution in seminoma, HCG-positive seminoma and non-seminomatous tumours of the testis.

Histocompatibility antigens play a certain role in the development of testicular tumours. 151 patients with testicular cancer (86 non-seminomatous germ cell tumours--NSGCT--and 65 pure seminoma) were typed for the HLA-antigens of the A, B, C and DR locus. 24 patients of the pure seminoma group and 50 patients of the NSGCT group had an elevated serum HCG level preoperatively. The antigen DR-5 was elevated in the seminoma group whereas the incidence of B-13 was increased in the NSGCT group. In terms of antigen distribution HCG-positive seminoma resembles seminomatous tumours rather than NSGCT.

Chorionic Gonadotropin↗
PubMed1989

Seminoma testis with elevated serum beta-HCG--a category of germ-cell cancer between seminoma and nonseminoma.

Serum beta-HCG was elevated in 10 of 83 consecutive patients with histologically pure seminoma (12%). Six patients with diagnostic stage I were successfully treated by radiation therapy. One patient with state IIc suffered a mediastinal relapse following retroperitoneal radiotherapy. Two other patients with high tumour burden achieved complete remission after induction chemotherapy followed by surgery and radiotherapy, respectively. One patient with retroperitoneal bulky disease reached permanent complete remission after radiation therapy alone. Beta-HCG-positive seminomas constitute a distinct category of germ-cell tumours on the basis of morphological and clinical features. Corresponding to the intermediate histological position between seminoma and nonseminoma, safe treatment of beta-HCG-positive seminoma can be achieved by radiotherapy in stage I, by retroperitoneal lymphadenectomy plus adjuvant chemotherapy in stages IIa, b and by induction chemotherapy in stages IIc and III.

Adult↗
PubMed1993

Cytometric analysis of testicular seminoma and spermatocytic seminoma.

DNA analysis of testicular seminoma (typical seminoma [TS] and anaplastic seminoma [AS]) and spermatocytic seminoma (SS) was performed to evaluate the relationship between the proliferative activity and clinical outcome, and also to determine the proliferative characteristics of SS. Nuclear DNA contents of 15 cases of TS, 17 of AS and three of SS were measured by flow cytometry. Cytofluorometric DNA analysis was performed on three cases of every tumor. All 35 cases showed aneuploidy in the flow cytometry. In comparison with TS, AS tended to have a higher percentage of G2M phase in one cell cycle, having more cell cycle numbers and containing cells of various DNA values. Many mitotic figures with larger atypical cells that characterize AS could be explained by these results. In SS, the diploid formation by the small cells and the appearance of large cells with a maximum DNA value of 40C were demonstrated. These ploidy characteristics were considered to result in the morphological expression of large, small and intermediate cells. The application of both flow cytometry and cytofluorometry to the same cases was beneficial.

Adult↗
PubMed1998

Treatment of stage I seminoma: should beta-HCG positive seminoma be treated aggressively?

To assess the prognostic value of beta-HCG positive stage I seminoma, clinical records of 122 patients with testicular germ cell tumour were reviewed. Fifty-five patients (mean age 38.7 years) of 122 (45.1%) had stage I seminoma. Preorchiectomy beta-HCG level was determined in 54 patients. Twenty-nine patients of 54 (53.7%) had elevated preorchiectomy beta-HCG level. No significant relationship was found in the rate of locally progressive cancer between beta-HCG positive and negative cases. Treatment consisted of radiotherapy after inguinal orchiectomy for beta-HCG negative cases, and chemotherapy or radiotherapy for beta-HCG positive cases. Tumour recurrence was found in one patient with normal beta-HCG level. Our limited series demonstrated that preorchiectomy elevated beta-HCG had no significant relationship to local tumour invasion or prognostic value. Therefore, infradiaphragmatic radiation therapy may be useful for beta-HCG positive stage I seminoma.

Adult↗