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Testisin Seminomatöz ve Seminomatöz Olmayan Germ Hücreli Tümörlerinde Histopatolojik Analiz

Yıl 2025, Cilt: 11 Sayı: 3, 357 - 363, 29.09.2025
https://doi.org/10.53394/akd.1521969

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.

Kaynakça

  • 1- Moch H, Amin MB, Berney DM, Compérat EM, Gill AJ, Hartmann A, Menon S, Raspollini MR, Rubin MA, Srigley JR, Hoon Tan P, Tickoo SK, Tsuzuki T, Turajlic S, Cree I, Netto GJ. The 2022 World Health Organization Classification of Tumours of the Urinary System and Male Genital Organs-Part A: Renal, Penile, and Testicular Tumours. Eur Urol. 2022; 82(5):458-68.
  • 2- De Martino M, Chieffi P, Esposito F. miRNAs and Biomarkers in Testicular Germ Cell Tumors: An Update. Int J Mol Sci 2021; 22(3):1380.
  • 3- Berney DM, Cree I, Rao V, Moch H, Srigley JR, Tsuzuki T, Amin MB, Comperat EM, Hartmann A, Menon S, Netto GJ, Rubin MA, Turajlic S, Raspollini MR, Tickoo SK. An introduction to the WHO 5th edition 2022 classification of testicular tumours. Histopathology 2022; 81(4):459-66.
  • 4- Kliesch S, Schmidt S, Wilborn D, Aigner C, Albrecht W, Bedke J, Beintker M, Beyersdorff D, Bokemeyer C, Busch J, Classen J, de Wit M, Dieckmann KP, Diemer T, Dieing A, Gockel M, Göckel-Beining B, Hakenberg OW, Heidenreich A, Heinzelbecker J, Herkommer K, Hermanns T, Kaufmann S, Kornmann M, Kotzerke J, Krege S, Kristiansen G, Lorch A, Müller AC, Oechsle K, Ohloff T, Oing C, Otto U, Pfister D, Pichler R, Recken H, Rick O, Rudolph Y, Ruf C, Schirren J, Schmelz H, Schmidberger H, Schrader M, Schweyer S, Seeling S, Souchon R, Winter C, Wittekind C, Zengerling F, Zermann DH, Zillmann R, Albers P. Management of Germ Cell Tumours of the Testis in Adult Patients. German Clinical Practice Guideline Part I: Epidemiology, Classification, Diagnosis, Prognosis, Fertility Preservation, and Treatment Recommendations for Localized Stages. Urol Int 2021; 105(3-4):169-80.
  • 5- Verrill C, Yilmaz A, Srigley JR, Amin MB, Compérat E, Egevad L, Ulbright TM, Tickoo SK, Berney DM, Epstein JI; Members of the International Society of Urological Pathology Testicular Tumor Panel. Reporting and Staging of Testicular Germ Cell Tumors: The International Society of Urological Pathology (ISUP) Testicular Cancer Consultation Conference Recommendations. Am J Surg Pathol. 2017; 41(6):e22-e32.
  • 6- Canete Portillo S, Rais-Bahrami S, Magi-Galluzzi C. Updates in 2022 on the staging of testicular germ cell tumors. Hum Pathol 2022; 128:152-60.
  • 7- Scandura G, Wagner T, Beltran L, Alifrangis C, Shamash J, Berney DM. Pathological predictors of metastatic disease in testicular non-seminomatous germ cell tumors: which tumor-node-metastasis staging system? Mod Pathol 2021; 34(4):834-41.
  • 8- Winter C, Zengerling F, Busch J, Heinzelbecker J, Pfister D, Ruf C, Lackner J, Albers P, Kliesch S, Schmidt S, Bokemeyer C. How to classify, diagnose, treat and follow-up extragonadal germ cell tumors? A systematic review of available evidence. World J Urol 2022; 40(12):2863-78.
  • 9- Dunphy CH, Ayala AG, Swanson DA, Ro JY, Logothetis C. Clinical stage I nonseminomatous and mixed germ cell tumors of the testis. A clinicopathologic study of 93 patients on a surveillance protocol after orchiectomy alone. Cancer 1988; 62(6):1202-6.
  • 10- Berney DM, Comperat E, Feldman DR, Hamilton RJ, Idrees MT, Samaratunga H, Tickoo SK, Yilmaz A, Srigley JR. Datasets for the reporting of neoplasia of the testis: recommendations from the International Collaboration on Cancer Reporting. Histopathology 2019; 74(1):171-83.
  • 11- Kattuoa ML, Dunton CJ. Yolk Sac Tumors. 2023. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.
  • 12- Loehrer PJ Sr, Hui S, Clark S, Seal M, Einhorn LH, Williams SD, Ulbright T, Mandelbaum I, Rowland R, Donohue JP. Teratoma following cisplatin-based combination chemotherapy for nonseminomatous germ cell tumors: a clinicopathological correlation. J Urol 1986; 135(6):1183-9.
  • 13- Ulbright TM. Germ cell neoplasms of the testis. Am J Surg Pathol 1993; 17(11):1075-91.
  • 14- Alvarado-Cabrero I, Hernández-Toriz N, Paner GP. Clinicopathologic analysis of choriocarcinoma as a pure or predominant component of germ cell tumor of the testis. Am J Surg Pathol 2014; 38(1):111-8.
  • 15- Nair LM, Krishna KMJ, Kumar A, Mathews S, Joseph J, James FV. Prognostic factors and outcomes of nonseminomatous germ cell tumours of testis-experience from a tertiary cancer centre in India. Ecancermedicalscience 2020; 14:1145.
  • 16- Powles T. Stage I nonseminomatous germ cell tumor of the testis: more questions than answers? Hematol Oncol Clin North Am 2011; 25(3):517-27,viii.
  • 17- Trevino KE, Esmaeili-Shandiz A, Saeed O, Xu H, Ulbright TM, Idrees MT. Pathological risk factors for higher clinical stage in testicular seminomas. Histopathology 2018; 73(5):741-7.

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

Yıl 2025, Cilt: 11 Sayı: 3, 357 - 363, 29.09.2025
https://doi.org/10.53394/akd.1521969

Öz

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.

Kaynakça

  • 1- Moch H, Amin MB, Berney DM, Compérat EM, Gill AJ, Hartmann A, Menon S, Raspollini MR, Rubin MA, Srigley JR, Hoon Tan P, Tickoo SK, Tsuzuki T, Turajlic S, Cree I, Netto GJ. The 2022 World Health Organization Classification of Tumours of the Urinary System and Male Genital Organs-Part A: Renal, Penile, and Testicular Tumours. Eur Urol. 2022; 82(5):458-68.
  • 2- De Martino M, Chieffi P, Esposito F. miRNAs and Biomarkers in Testicular Germ Cell Tumors: An Update. Int J Mol Sci 2021; 22(3):1380.
  • 3- Berney DM, Cree I, Rao V, Moch H, Srigley JR, Tsuzuki T, Amin MB, Comperat EM, Hartmann A, Menon S, Netto GJ, Rubin MA, Turajlic S, Raspollini MR, Tickoo SK. An introduction to the WHO 5th edition 2022 classification of testicular tumours. Histopathology 2022; 81(4):459-66.
  • 4- Kliesch S, Schmidt S, Wilborn D, Aigner C, Albrecht W, Bedke J, Beintker M, Beyersdorff D, Bokemeyer C, Busch J, Classen J, de Wit M, Dieckmann KP, Diemer T, Dieing A, Gockel M, Göckel-Beining B, Hakenberg OW, Heidenreich A, Heinzelbecker J, Herkommer K, Hermanns T, Kaufmann S, Kornmann M, Kotzerke J, Krege S, Kristiansen G, Lorch A, Müller AC, Oechsle K, Ohloff T, Oing C, Otto U, Pfister D, Pichler R, Recken H, Rick O, Rudolph Y, Ruf C, Schirren J, Schmelz H, Schmidberger H, Schrader M, Schweyer S, Seeling S, Souchon R, Winter C, Wittekind C, Zengerling F, Zermann DH, Zillmann R, Albers P. Management of Germ Cell Tumours of the Testis in Adult Patients. German Clinical Practice Guideline Part I: Epidemiology, Classification, Diagnosis, Prognosis, Fertility Preservation, and Treatment Recommendations for Localized Stages. Urol Int 2021; 105(3-4):169-80.
  • 5- Verrill C, Yilmaz A, Srigley JR, Amin MB, Compérat E, Egevad L, Ulbright TM, Tickoo SK, Berney DM, Epstein JI; Members of the International Society of Urological Pathology Testicular Tumor Panel. Reporting and Staging of Testicular Germ Cell Tumors: The International Society of Urological Pathology (ISUP) Testicular Cancer Consultation Conference Recommendations. Am J Surg Pathol. 2017; 41(6):e22-e32.
  • 6- Canete Portillo S, Rais-Bahrami S, Magi-Galluzzi C. Updates in 2022 on the staging of testicular germ cell tumors. Hum Pathol 2022; 128:152-60.
  • 7- Scandura G, Wagner T, Beltran L, Alifrangis C, Shamash J, Berney DM. Pathological predictors of metastatic disease in testicular non-seminomatous germ cell tumors: which tumor-node-metastasis staging system? Mod Pathol 2021; 34(4):834-41.
  • 8- Winter C, Zengerling F, Busch J, Heinzelbecker J, Pfister D, Ruf C, Lackner J, Albers P, Kliesch S, Schmidt S, Bokemeyer C. How to classify, diagnose, treat and follow-up extragonadal germ cell tumors? A systematic review of available evidence. World J Urol 2022; 40(12):2863-78.
  • 9- Dunphy CH, Ayala AG, Swanson DA, Ro JY, Logothetis C. Clinical stage I nonseminomatous and mixed germ cell tumors of the testis. A clinicopathologic study of 93 patients on a surveillance protocol after orchiectomy alone. Cancer 1988; 62(6):1202-6.
  • 10- Berney DM, Comperat E, Feldman DR, Hamilton RJ, Idrees MT, Samaratunga H, Tickoo SK, Yilmaz A, Srigley JR. Datasets for the reporting of neoplasia of the testis: recommendations from the International Collaboration on Cancer Reporting. Histopathology 2019; 74(1):171-83.
  • 11- Kattuoa ML, Dunton CJ. Yolk Sac Tumors. 2023. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.
  • 12- Loehrer PJ Sr, Hui S, Clark S, Seal M, Einhorn LH, Williams SD, Ulbright T, Mandelbaum I, Rowland R, Donohue JP. Teratoma following cisplatin-based combination chemotherapy for nonseminomatous germ cell tumors: a clinicopathological correlation. J Urol 1986; 135(6):1183-9.
  • 13- Ulbright TM. Germ cell neoplasms of the testis. Am J Surg Pathol 1993; 17(11):1075-91.
  • 14- Alvarado-Cabrero I, Hernández-Toriz N, Paner GP. Clinicopathologic analysis of choriocarcinoma as a pure or predominant component of germ cell tumor of the testis. Am J Surg Pathol 2014; 38(1):111-8.
  • 15- Nair LM, Krishna KMJ, Kumar A, Mathews S, Joseph J, James FV. Prognostic factors and outcomes of nonseminomatous germ cell tumours of testis-experience from a tertiary cancer centre in India. Ecancermedicalscience 2020; 14:1145.
  • 16- Powles T. Stage I nonseminomatous germ cell tumor of the testis: more questions than answers? Hematol Oncol Clin North Am 2011; 25(3):517-27,viii.
  • 17- Trevino KE, Esmaeili-Shandiz A, Saeed O, Xu H, Ulbright TM, Idrees MT. Pathological risk factors for higher clinical stage in testicular seminomas. Histopathology 2018; 73(5):741-7.
Toplam 17 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Patoloji , Üroloji
Bölüm Araştırma Makalesi
Yazarlar

Neşe Yeldir 0000-0002-3812-6245

Aslı Çakır 0000-0003-0128-6947

Taha Cumhan Şavlı 0000-0001-7036-9813

Bahar Muezzinoglu 0000-0001-6080-0673

Erken Görünüm Tarihi 22 Eylül 2025
Yayımlanma Tarihi 29 Eylül 2025
Gönderilme Tarihi 24 Temmuz 2024
Kabul Tarihi 20 Kasım 2024
Yayımlandığı Sayı Yıl 2025 Cilt: 11 Sayı: 3

Kaynak Göster

Vancouver Yeldir N, Çakır A, Şavlı TC, Muezzinoglu B. Histopathological Analysis of Seminomatous and Non-Seminomatous Germ Cell Tumors of the Testis. Akd Tıp D. 2025;11(3):357-63.