12th Ljudevit Jurak International Symposium on
Comparative Pathology
June 1-2, 2001

B. Krušlin, 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.
Poster Presentation