Spermatocytic Seminoma



Spermatocytic Seminoma


Steven S. Shen, MD, PhD

Mahul B. Amin, MD

Jae Y. Ro, MD, PhD










Low-power view of diffuse growth pattern of spermatocytic seminoma reveals no fibrovascular septae and no lymphocytic or granulomatous inflammation, typical features of classic seminoma.






This high-power photomicrograph shows the characteristic 3 cell types in SS: Small lymphocyte-like cells image with darkly stained nuclei, intermediate image and giant cells with “spireme-type” chromatin image.


TERMINOLOGY


Abbreviations



  • Spermatocytic seminoma (SS)


Definitions



  • Germ cell tumor recapitulating spermatogenic sequence composed of 3 cell types of variable sizes, ranging from 6-100 µm


ETIOLOGY/PATHOGENESIS


Cytogenetic Changes



  • Diploid or near hypodiploid, different from that of seminoma


  • Chromosomal numerical changes (most commonly gain of chromosome 9)


CLINICAL ISSUES


Epidemiology



  • Incidence



    • Extremely rare; only 2 major series reported


    • Bilaterality (up to 9%) is more common than in seminoma


    • Occurs only in testis; no ovarian counterpart, no extragonadal primary tumors


    • No race predilection as in other germ cell tumors


    • Not associated with cryptorchidism


  • Age



    • Range: 25-87 years (average: 53.6 years)


    • Rare under 30 years


Presentation



  • Painless testicular swelling and mass


  • Serum tumor markers are not elevated


Treatment



  • Radical inguinal orchiectomy alone is curative


  • Postoperative prophylactic radiation or chemotherapy do not offer additional benefit and not routinely recommended


Prognosis



  • Excellent prognosis with rare malignant behavior (less than 1%)


  • Sarcomatoid transformation is rare, but when present is associated with distant metastasis and death


MACROSCOPIC FEATURES


General Features



  • Well-circumscribed, soft mass with mucoid or gelatinous bulging cut surface


  • Lobulation, cystic change, and focal hemorrhage or necrosis may be seen

Jul 7, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Spermatocytic Seminoma
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