Spermatocytic seminoma. Clinicopathological study of 22 cases

Abstract

Twenty-two cases of spermatocytic seminoma are reported. This neoplasm comprises 4.4% of all seminomas seen during the period under study. Nineteen patients were older than 40 years. Painless testicular enlargement was the presenting symptom in 19 patients. The duration of symptoms was more than six months in 12 patients. Macroscopically the tumor was soft, friable, grey, and edematous. Microscopically it is characterized by cellular pleomorphism, round cells and nuclei, scanty stroma, and absence of lymphocytes and granulomas. In none of the cases was the tumor associated with other neoplastic germ cell elements or with classical seminoma. Metastases were not encountered in any of the cases. Apart from 3 patients who died from unrelated causes, all the patients were alive and well for periods varying from two months to 27 years. Spermatocytic seminoma is a distinctive clinicopathological entity. It is unique among germ cell neoplasms because it occurs only in the testis and is not associated with other neoplastic germ cell elements. It has good prognosis and is not associated with metastases. Orchidectomy is the treatment of choice and there is no good evidence indicating that it should be followed by radiotherapy.

Cancer testis antigen expression in testicular germ cell tumorigenesis

“…Spermatocytic seminoma is an uncommon testicular germ cell tumor accounting for only 1-2% of all testicular tumors and also occurs in older men. 42 It is important to distinguish spermatocytic seminoma from classic seminoma, because spermatocytic seminoma almost never metastasizes (except if there is a sarcomatous component). 43,44 Patients usually do not benefit from an adjuvant therapy after orchiectomy.…”

Germ cell tumors of the gonads: a selective review emphasizing problems in differential diagnosis, newly appreciated, and controversial issues

“…[94][95][96][97] This tumor is limited to the male gonad and has a number of fascinating aspects. Although most patients with spermatocytic seminoma are older (mean, 55 years) 98 than those with usual seminoma (mean, 40 years), 4 there is considerable overlap. Grossly, spermatocytic seminoma often has a more gelatinous quality than the typically uniformly fleshy nature of usual seminoma.…”

Human testicular germ cell tumours express inhibin subunits, activin receptors and follistatin mRNAs

“…These components originate from pluripotent embryonal carcinoma cells (Andrews et al, 1987) and may occur as the only cell type or may be intermixed. In contrast to the non-seminomas and the classical seminoma, the spermatocytic seminoma does not originate from CIS Skakkebaek et al, 1987) but is thought to arise from neoplastic germ cells at a stage of maturation between spermatogonia and spermatocytes (Talerman, 1980;Muller et al, 1987;Eble, 1994). Spermatocytic seminoma represents 1-2% of all testicular tumours, generally occurs in men over 50 years of age and rarely metastasizes (Muiller et al, 1987;Eble, 1994).…”