Mixt Germ Cell Tumor of Testes with Thorochal and Neck Metastasis

Abstract

Testis tumors can arise from several different cells within the testicle. The most common and aggressive type of testis tumor are germ cell tumors. Germ cell tumors may be either seminomas or non-seminomatous tumors . Non-seminomatous germ cell tumours of the testicles primarily present in young men The tumors are identified as pure form (those of one histologic type) and mixed form (more than one histologic type). The most common mixed germ cell tumor is the combination of teratoma, embryonal carcinoma,yolk sac tumor. Yolk sac tumor is the most common germ cell tumor in infants and children, accounting for approximately 65% of germ cells tumors but it is rare adult men. A case of testicular mixed germ cell tumor in a 36-year-old man who presented for with widespread metastatic mass is reported here. Thorax and abdomen computed tomography (CT) scans revealed extensive mass including lateral cervical region, anterior mediastinum and abdomen. A biopsy was performed mass in the lateral cervical region. Suspected clinical diagnosis was lymphoma. Biopsy demonstrated that the mass was mixed germ cell tumor (teratom and yolk sac) of testis©2008, Firat University, Medical Faculty

Keywords

• -

Toraks ve Boyun Metastazı Yapan Mikst Germ Hücreli Testis Tümörü

Öz

Testis tümörleri değişik hücre tiplerinden gelişir. En sık ve agresif testis tümör tipi germ hücreli tümörlerdir. Germ hücreli tümörler seminomlar ya da nonseminomatöz tümörler şeklinde olabilir. Testisin non-seminomatöz germ hücreli tümörleri primer olarak genç erkeklerde görülür. Bu tümörler saf (tek bir histolojik tip) ve mikst form ( birden fazla histolojik tip) olabilir. En sık görülen mikst germ hücreli tümör kombinasyonu teratom, embriyonal karsinom, yolksac tümördür. Yolk sac tümörü infant ve çocuklarda en sıktır ve germ hücreli tümörlerin yaklaşık %65' ini oluşturur. Fakat yetişkinlerde nadir görülür. Burada 36 yaşında, yaygın metastatik kitlesi bulunan testiküler mikst germ hücreli tümör olgusu sunulmuştur. Toraks ve abdominal bilgisayarlı tomografide lateral servikal bölgede, anterior mediastende ve abdomende yaygın kitle saptanmış olup klinik olarak şüpheli tanısı lenfomadır. Kitleden yapılan biyopsi ile testisin mikst germ hücreli tümörü (teratom ve Yolk sac) tanısı verilmiştir.©2008, Fırat Üniversitesi, Tıp Fakültesi

Anahtar Kelimeler

• Matür teratom, yolk sac tümörü, testis

References

1. Sesterhenn IA, Davis CJ. Pathology of Germ Cell Tumors of the Testis. Cancer Control 2004; 11: 374-387.
2. Fujimura T, Yamada Y, Nasu M, ve ark. Different transformation of mature teratoma in a patient with germ cell tumor of the testis. Int J Urol 2005; 12: 588-590.
3. Rabbani F, Mohseni HF, Leon A, Motzer RJ, ve ark. Clinical outcome after retroperitoneal lymphadenectomy of patients with pure testicular teratoma. J Urol 2003; 62:1092-1096.
4. Sella A, Naggar AE, Ro JY ve ark. Evidence of malignant features in histological mature teratoma. J Urol 1991; 146: 1025- 1028.
5. Logothesis CJ, Samuels ML, Trindade A, Johnson DE. The growing teratoma syndrome. Cancer 1982; 50: 1629-1635.
6. Motzer RJ, Amsterdam A, Prieto V ve ark. Teratoma with malignant transformation: diverse malignant histologies arising in men with germ cell tumors. J Urol 1998; 159: 133-138.
7. Little JS, Foster RS, Ulbright TM, Donohue JP. Unusual neoplasms detected in testes cancer patients undergoing post- chemotherapy retroperitoneal lymphadenectomy. J Urol 1994; 152: 1144-1149.
8. Ahmed T, Bosl GJ, Hajdu SI. Teratoma with malignant transformation in germ cell tumors in men. Cancer 1985; 56: 860- 863.

9. Ahlgren AD, Simrell CR, Triche TJ, Ozols R, Barsky SH. Sarcoma arising in a residual testicular teratoma after cytoreductive chemoteraphy. Cancer 1984; 54: 2015-2018. 10. Waples MJ, Messing EM. Redo retroperitoneal
10. lymphadenectomy for germ cell tumor. Urology 1993; 42: 31-34.
11. Sexton WJ, Wood CG, Kim R, Pisters LL. Repeat retroperitoneal lymph node dissection for metastatic testis cancer. J Urol 2003; 169: 1353-1356.
12. McKierman JM, Sheinfeld J, Bacik J, ve ark. Reoperative RPLND for germ cell tumor; initial presentation, complications and outcome. J Urol Suppl 2001;165:153.
13. Donadio AC, Motzer RJ, Bajorin DF ve ark. Chemotheraphy for teratoma with malignant transformation. J. Clin. Oncol. 2003; 21: 4285-4291.
14. Oosterhuis JW, Rammeloo RH, Cornelisse CJ ve ark. Ploidy of malignant mediastinal germ-cell tumors. Hum Pathol. 1990; 21: 729-732
15. Kabul Tarihi: 18.06.2007