Spermatocytic seminoma at the National Institute of Oncology in Morocco

Abstract

BackgroundSpermatocytic seminoma (SS) is a distinct testicular germ cell tumor, representing less than 1% of testicular cancers. The clinical features that distinguish ss from classical seminoma are an older age at presentation and a reduced propensity to metastasize. The aim of our work is to underline the epidemiological, clinical, histological, therapeutical and prognostic features of this tumor.FindingsA retrospective analysis of patients referred to the national institute of oncology with seminoma, identified from the institutional tumor registry, between January 1996 and February 2009, was performed. Information reviewed included demographics, clinical, pathological staging, surgical management, adjuvant treatment and last follow-up. We studied four cases of spermatocytic seminoma, which represented 1% of testicular tumor and 6,4% of all seminoma treated at our institution during the study period. Median age at diagnosis was 45 years (range: 42-48). Mean delay before consulting was 9 months and the mean tumor size was 13,75 cm (10-18 cm). No patient had a history of maldescended testis. The main clinical complaint was unilateral testis mass with low progression. Pathology showed that tumors had a polymorphic appearance with small, intermediate and large cells. In all cases, the tumor was limited to the testis. immunohistochemical studies showed that tumors were negative for all the classical antibodies tested (LCA, cytokeratins, PLAP, lymphoid markers, CD117). Thoraco-abdomino-pelvic CT scan and tumor markers (AFP and hCG) were normal. All patients were Stage I. Treatment consisted on an orchidectomy associated with adjuvant radiotherapy in one patient. After a median follow-up of 6 years ranging from 2 to 15 years, we did not note any relapse or metastasis.ConclusionThe diagnosis of spermatocytic seminoma must be considered in all patients aged of more than 50 with testicular tumor. With only three cases of metastatic disease confirmed in the literature, this is a subgroup of patients in whom radiotherapy can safely be omitted.

A rare case of bilateral sequential spermatocytic seminoma

“…Positive c-Kit (also known as CD117) staining is controversial. While Raiss and colleagues showed four cases of SS were all negative for CD117 [11], Decaussin and colleagues found c-Kit was expressed in 100% of seven SS cases [26]. C-Kit positivity was also shown by Dundr and colleagues [6] and Narang and colleagues [21].…”

“…An extensive literature review revealed that the incidence of SS varies between 1.1 and 12% of all seminomas [4,10] and 1% of all testicular neoplasms [11]. The incidence of bilaterality, either synchronous or metachronous, is nearly 10% of cases [12].…”

“…Specifically, Chung and colleagues reported the median age of patients with SS was 62 years (range 32 to 77 years) [10]. Raiss and colleagues found the median age to be 45 years [11] and Carrière and colleagues found SS occurred just as frequently in young men as in older men (median age 54 years) [5]. Our review indicated the median age of bilateral SS was 55.1 years (range 28 to 77 years), with only one patient presenting at the much younger age of 28 years of age [16].…”

Elucidating human male germ cell development by studying germ cell cancer

“…Type III GCTs, the spermatocytic tumor are detected in the 5th-6th decade of life and are a rare GCT (<1% of testicular tumors) (Looijenga & Oosterhuis 1999, Oosterhuis & Looijenga 2005, Raiss et al 2011 (Fig. 1A).…”

Erratum to: Spermatocytic seminoma at the national institute of oncology in Morocco

“…Following the publication of our article [1], we realised that we did not give correct attribution to our previous publication [2]:…”