Testicular Tumors: A 15-Year Archive Review and Histopathological Evaluation

Öz

Aim: Testicular tumors are one of the most common malignancies in men in the age group of 15-40 years, although they are rarely observed. In our study, it was aimed to evaluate their histopathological features by retrospectively examining of the cases diagnosed as testicular tumor in our department. Materials and Methods: Age, tumor localization, tumor size, pathological stage, tumor type and frozen information of 65 cases diagnosed as testicular tumor in the Department of Medical Pathology at Tokat Gaziosmanpasa University Faculty of Medicine between 2006-2020 were examined. Results: The mean age of 65 cases diagnosed as tumor was 37.9±17.73 years. Their ages ranged from 1 to 78 years. Macroscopic tumor diameter was an average of 4.6 ± 2.36 cm, 36 (55.4%) of them were located in the right and 29 (44.6%) of them were located in the left testis. Histopathological diagnosis was germ cell tumor in 53 (81.7%) cases and non-germ cell tumor in 12 (18.3%) cases. The most common tumor was seminoma with 22 (33.9%) cases and the second was mixed germ cell tumor with 19 (29.3%) cases. In components forming mixed germ cell tumors, embryonal carcinoma was the most commonly seen. Intraoperative frozen section examination was performed in 17 cases, it was determined that 10 cases were malignant and 7 cases were benign. Conclusion: The histopathological and general features of our series of testicular tumor was determined to be compatible with the literature to a great extent. Intraoperative frozen section examination is an important auxiliary diagnostic method in terms of organ preserving surgery.

Anahtar Kelimeler

• testis
• tumor
• germ cell
• frozen section examination
• testis preserving surgery

Testis Tümörleri: 15 Yıllık Arşiv Taraması ve Histopatolojik Değerlendirilmesi

Öz

Amaç: Testis tümörleri nadir görülmekle birlikte, 15-40 yaş grubundaki erkeklerde en sık görülen malignitelerden biridir. Çalışmamızda bölümümüzde testis tümörü tanısı almış olguların retrospektif olarak incelenip, histopatolojik özelliklerinin değerlendirilmesi amaçlandı. Gereç ve Yöntem: 2006-2020 yılları arasında Tokat Gaziosmanpaşa Üniversitesi Tıp Fakültesi Tıbbi Patoloji Anabilim Dalı’nda testis tümörü tanısı alan 65 olgunun yaş, tümör lokalizasyonu, tümör boyutu, patolojik evre, tümör tipi ve frozen bilgisi incelendi. Bulgular: Tümör tanısı alan 65 olgunun yaş ortalaması 37,9±17,73 yıl idi. Yaşları 1-78 yıl arasında değişmekteydi. Makroskopik tümör çapı ortalama 4,6±2,36 cm olup, 36’sı (%55,4) sağ, 29’u (%44,6) sol testis lokalizasyonluydu. Histopatolojik tanı 53 olguda (%81,7) germ hücreli tümör ve 12 olguda (%18,3) germ hücreli dışı tümördü. En sık görülen tümör 22 olgu (%33,9) ile seminom ve ikinci sıklıkta 19 olgu (%29,3) ile mikst germ hücreli tümördü. Mikst germ hücreli tümörleri oluşturan komponentlerde en sık embriyonel karsinom görüldü. İntraoperatif frozen kesit inceleme 17 olguda yapılmış olup, 10 olgunun malign, 7 olgunun benign olduğu saptandı. Sonuç: Testis tümörü serimizin histopatolojik ve genel özelliklerinin büyük oranda literatür ile uyumlu olduğu saptanmıştır. İntraoperatif frozen inceleme organ koruyucu cerrahi açısından önemli bir yardımcı tanı yöntemidir.

Anahtar Kelimeler

• testis
• tümör
• germ hücre
• frozen kesit inceleme
• testis koruyucu cerrahi

Kaynakça

1. 1. Shanmugalingam T, Soultati A, Chowdhury S, Rudman S, Hemelrijck MV. Global incidence and outcome of testicular cancer. Clin Epidemiol 2013; 5:417-427.
2. 2. Kalan Farmanfarma KH, Mahdavifar N. Mohammadian-Hafshejani A, Salehiniya H. Testicular cancer in the world: an epidemioological review. WCRJ 2018; 5(4): e1180.
3. 3. Moch H, Humphrey PA, Ulbright TM, Reuter VE. WHO Classification of Tumours of the Urinary System and Male Genital Organs. 4th ed. IARC. Lyon, 2016.
4. 4. Smith ZL, Werntz RP, Eggener SE. Testicular Cancer Epidemyology, Diagnosis and Management. Med Clin North Am 2018 Mar; 102(2):251-264.
5. 5. Yalçınkaya U, Çalışır B, Uğraş N, Filiz G, Erol O. Testis tümörleri: 30 yıllık arşiv tarama sonuçları. Türk Patoloji Dergisi 2008;24(2);100-106.
6. 6. Che M, Tamboli P, Ro JY, Park DS, Ro JS, Amato RJ et al. Bilateral testicular germ cell tumors twenty-year experience at M.D. Anderson Cancer Center. Cancer 2002; 95:1228-33.
7. 7. Moch H, Cubilla AL, Humphrey PA, Reuter VE, Ulbright TM. The 2016 WHO Classification of Tumours of the Urinary System and Male Genital Organs-Part A: Renal, Penile and Testicular Tumours. European Urology 2016 Jul;70(1):93-105.
8. 8. Baird DC, Meyers GJ. Testicular Cancer: Diagnosis and Treatment. American Family Physician 2018 Feb 15;97(4):261-268.

9. 9. Yörükoğlu K. Testis tümörlerinde prognozu belirleyen histopatolojik parametreler. Üroonkoloji Bülteni 2011 Eylül:3;91-94.
10. 10. Willamson SR, Delahunt B, Magi-Galluzi C, Algaba F, Egevad L, Ulbright TM et al. The World Health Organization 2016 classification of testicular germ cell tumours: a review and update from the International Society of Urological Pathology Testis Consultation Panel. Histopathology 2017; 70:335-346.
11. 11. Yörükoğlu K, Sarsık B. Testis, Spermatik kord ve testis ekleri. In Yörükoğlu K, Tuna. Üropatoloji. İzmir, Kongre Kitabevi 2016;475-611.
12. 12. Alvarado-Cabrero I, Hernandez -Toriz N, Paner GP. Clinicopathologic Analysis os Choriocarcinoma as a Pure or Predominant Component of Germ Cell Tumor of Testis. Am J Surg Pathol 2014; 38:111-118.
13. 13. Onuk Ö, Yanaral F, Gezmiş T, Demir K, Aydın M, Nuhoğlu B. A rare testicular tumor: epidermoid cyst. The New Journal of Urology 2016;11(3):46-49.
14. 14. Cornejo KM, Young RH. Sex cord-stromal tumors of the testis. Diagnostic Histopathology Special Issue: Nephrourology 2019;25(10):398-407.
15. 15. Chen B, Cao DH, Lai L, Guo JB, Chen ZY, Huang Y et al. Adult primary testicular lymphoma: clinical features and survival in a series of patients treated at a high-volume institution in China. BMC Cancer 2020; 20:220:1-11.
16. 16. Amin W, Parwani AV. Adenomatoid Tumor of Testis. Clinical Medicine: Pathology 2009;2;17-22.
17. 17. Silverio PC, Schoofs F, Iselin CE, Tille JC. Fourteen-year experience with the intraoperative frozen section examination of testicular lesion in a tertiary university center. Annals of Diagnostic Pathology 2015;19(3);99-102.
18. 18. Giannarini G, Dieckman KP, Albers P, Heidenreich A, PizzocaroG. Organ-Sparing Surgery for Adult Testicular Tomours: A Systematic Review of the Literature. European Urology 2010; 57:780-790.
19. 19. Bıçakçı Ü, Demirel D, Hancıoğlu S, Arıtürk E, Bernay F. Childhood testicular tumors. J Contemp Med 2018;8(1):34-36.