Testisin Seminomatöz ve Seminomatöz Olmayan Germ Hücreli Tümörlerinde Histopatolojik Analiz

Öz

Giriş: : Testis tümörlerinin yaklaşık %90’ı germ hücrelerinden köken alır. Germ hücreli tümörlerde tümör boyutu, lenfovasküler invazyon, spermatik kord invazyonu, epididim invazyonu, tunika vajinalis ve hiler yumuşak doku invazyonu evreleme için önemli parametrelerdir ve bu parametreler prognozla ilişkilidir. Materyal ve method: Testis germ hücreli tümör tanılı 80 olgu retrospektif olarak analiz edildi. Hastalar yaş, tümör boyutu, invazyon özellikleri, tümör odaklarının sayısı, tümör alttipleri ve komponentlerin oranları kayıt edildi. Sonuçlar: Olguların, 40’ı (%50) seminom, 32’si (%40) mikst germ hücreli tümör, 6’sı (%7,5) embriyonal karsinom and 2’si (%2,5) postpubertal tip teratom. 80 olgunun, %48,75’inde rete testis invazyonu, %5’inde epididim invazyonu, %18,75’inde hiler yumuşak doku invazyonu, %10’unda spermatik kord invazyonu, %52,5’inde lenfovasküler invazyon, %3,75’inde tunika vajinalis invazyonu ve %2,5’inde spermatik kord cerrahi sınır invazyonu vardı. Tümör boyutu ve bütün invazyonlar arasında istatistiksel olarak anlamlı bir ilişki saptandı. Yolk sak tümör komponenti ile epididim, hiler yumuşak doku, spermatik kord ve lenfovasküler invazyon arasındaki ilişki de istatistiksel olarak anlamlı bulundu. Ayrıca embriyonal karsinom komponenti ile epididim ve spermatik kord invazyonu arasındaki ilişki de istatistiksel olarak anlamlı bulundu. Tartışma: Testisin germ hücreli tümörlerinde makroskobik değerlendirme ve mikroskobik tümör boyutu ve invazyon alanları prognozu belirlemede önemlidir. Ek olarak, Tümör alttiplerinin de tümörün yayılımını belirlemek için bir faktör olabileceği akılda bulundurulmalıdır.

Anahtar Kelimeler

• germ hücreli tümör
• seminom
• patolojik evre
• testis tümörü
• tümör boyutu
• invazyon

Histopathological Analysis of Seminomatous and Non-Seminomatous Germ Cell Tumors of the Testis

Abstract

Introduction: Approximately 90% of testicular tumors originate from germ cells. Tumor size, lymphovascular invasion, spermatic cord invasion, epididymal invasion, tunica vaginalis and hilar soft tissue invasion are important parameters for staging and prognosis in germ cell tumors of the testis and these parameters are related to prognosis. Materials and methods: Therefore, 80 cases diagnosed with testicular germ cell tumors were retrospectively analyzed. The patients’ age, tumor size, invasion characteristics, tumor focus numbers, tumor subtypes and percentage amounts of the components were documented. Results: Of the cases, 40 (50%) were seminoma, 32 (40%) were mixed germ cell tumors, 6 (7,5%) were embryonal carcinomas and 2 (2,5%) were postpubertal type teratomas. Of these 80 cases, 48,75% had rete testicular invasion, 5% had epididymal invasion, 18,75% had hilar soft tissue invasion, 10% had spermatic cord invasion, 52,5% had lymphovascular invasion, 3,75% had tunica vaginalis invasion and 2,5% had spermatic cord surgical margin invasion. A statistically significant correlation was found between tumor size and all invasion sites. The correlation between yolk sac tumor component and epididymis, hilar soft tissue, spermatic cord and lymphovascular invasions was found to be significant. There was also a statistically significant correlation between embryonal carcinoma component and epididymis and spermatic cord invasions. Conclusion: It is important to evaluate macroscopically and microscopically the tumor size and invasion sites is which are determinants of prognosis in germ cell tumors of the testis. Additionally, it should be kept in mind that tumor subtypes may also be a factor determining the extent and site of invasion.

Keywords

• Germ cell tumor
• seminoma
• pathological stage
• testicular tumor
• tumor size
• invasion

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