12th Ljudevit Jurak
International Symposium on
June 1-2, 2001
|ASSESSMENT OF DIFFERENT COMPONENTS OF NONSEMINOMATOUS
TESTICULAR GERM CELL TUMORS
M. Turèiæ, I. Novosel, *A. Reljiæ, H. Èupiæ,
*B. Ružiæ, M. Belicza
Ljudevit Jurak University Department
of Pathology and *University Department of Urology, Sestre milosrdnice
University Hospital, Zagreb,Croatia
|Background: Nonseminomatous tumors account for approximately
50% of all testicular germ cell tumors. The majority of these tumors are
composed of different components. The presence of some elements appears
to modify the behavior of other components.
The aim of the study was to review all cases of nonseminomatous testicular
germ cell tumors diagnosed during a nine-year period to determine the presence,
frequency and type of different components.
Patients and methods: Surgical pathology computer-based registry was
canvassed for the period from 1992 2000 to find all patients with
nonseminomatous testicular germ cell tumors. Two independent observers
reviewed all hematoxylin-eosin stained slides in order to identify various
components. In some cases immunohistochemical analysis using primary antibodies
against cytokeratin, PLAP, hPL, ?-fetoprotein, hCG and CD30 were performed.
Results: In the above mentioned period there were 67 patients
with testicular nonseminomatous germ cell tumors aging from 16-59 years
(mean 27.2 years). The most frequent component observed was embryonal carcinoma
in 59 cases, teratoma in 46 cases, yolk sac tumor in 25 cases, seminoma
in 20 and choriocarcinoma in 7 patients. However, our review revealed 20
components that were not described in the initial biopsy findings. The
20 components consisted of embryonal carcinoma in 9 cases, yolk sac tumor
in 6, teratoma in 3 and seminoma within 2 additional cases. The most frequent
pattern found in 24 tumors was composed of teratoma and embryonal carcinoma.
Conclusions: Our review suggests that additional slides should
be analyzed to identify all components of nonseminomatous testicular germ
cell tumors. Immunohistochemical analysis could be employed to recognize
some minor components. The influence of such components on the prognosis
of mixed germ cell tumors should be further analyzed on larger groups of
patients with long-term follow-ups.