China
Africa
Explore chapters and articles related to this topic
Germ-cell cancer of the testis and related neoplasms
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2014
The presence of vascular invasion is an independent prognostic factor in stage 1 non-seminomas. On active surveillance, 48% of patients with vascular invasion will develop metastatic disease. In contrast, only 14%-22% of patients without this feature go on to develop metastases.48 Other less consistently demonstrable prognostic indicators include a high proliferation rate and a larger percentage of embryonal carcinoma.
Testis Cancer
Published in Anthony R. Mundy, John M. Fitzpatrick, David E. Neal, Nicholas J. R. George, The Scientific Basis of Urology, 2010
Danish Mazhar, Michael Williams
To define the clinical stage of a patient with a gonadal GCT the TNM classification of the UICC should be used (115). In addition, most patients with metastatic disease are classified according to the classification of IGCCCG (57), which is also incorporated into the TNM classification. The individual treatment strategy is based on both the TNM classification and the IGCCCG prognostic factor–based classification which includes histology, location of primary tumor, location of metastases and level of AFP, β-HCG and LDH as prognostic markers to categorize patients into “good,” “intermediate,’’ and “poor” prognosis groups (Table 1). For patients presenting with primary extragonadal GCTs, a different prognostic outcome model has been developed (124) but is not in routine use. For clinical stage 1 seminoma, although no prognostic classification system has been prospectively validated so far, there is evidence that the size of the primary tumor (<4 cm vs. ≥4 cm) and the infiltration of the rete testis are independent prognostic indicators for occult metastases (125). Patient age (<34 vs. ≥34 yr) and the presence of vascular invasion (VI) are of equivocal prognostic relevance (125–128). For clinical stage 1 nonseminoma, infiltration of the primary tumor by venous blood vessels or lymphatic infiltration (vascular invasion, VI) are the most important prognostic indicators for occult metastases (129–134). Without adjuvant treatment 48% of patients with VI will develop metastases while only 14% to 22% of those without will relapse (135). The proliferation rate, as well as the percentage of embryonal carcinoma in relation to the total tumor volume, are further prognostic indicators (133, 135, 136). However, these markers do not contribute independent prognostic information in addition to the factor of vascular invasion.
Primary Mediastinal Germ Cell Tumors (PMGCT): A Real-world Analysis From A Tertiary Cancer Care Center in India
Published in Cancer Investigation, 2023
Aparna Sharma, Rohit Reddy, Raja Pramanik, Ranjit Kumar Sahoo, Seema Kaushal, K.P. Haresh, Sunil Kumar, Lalit Kumar, Atul Sharma, Atul Batra
Patients with primary extra gonadal germ cell tumors (EGGCT), a less commonly encountered subset of germ cell tumors, present with a mediastinal tumor in the absence of a gonadal primary (1). EGGCT is an uncommon entity and constitutes only around 1–5% of all germ cell tumors (2). Patients with EGGCT present as midline tumors extending variably from the pineal gland to the coccyx; the most common primary site being anterior mediastinum (50–70%) followed by retroperitoneum (30–40%) (3) and intracranial locations. Moreover, extragonadal GCTs are frequent in young children (sacrococcyx location). Furthermore, primary mediastinal germ cell tumors (PMGCT) constitute 12–16% of all mediastinal malignancies (4). They are broadly classified into two subtypes: seminomatous germ cell tumor, and nonseminomatous germ cell tumor (NSGCT) subtype that includes embryonal carcinoma (EC), teratomas (mature or immature), yolk sac carcinoma (YST) and choriocarcinoma and mixed histologies (2). Though EGGCT appear morphologically similar to the gonadal counterparts, they are clinically, molecularly and embryological distinct (5).
18-Year-old patient with Klinefelter syndrome (47, XXY) and complete androgen insensitivity syndrome (CAIS) – case report
Published in Gynecological Endocrinology, 2021
Karolina Skalska, Maciej Ziółkowski, Adrian Skoczylas, Marta Teleon, Monika Grymowicz, Agnieszka Pollak, Roman Smolarczyk, Rafał Płoski, Błażej Męczekalski
Since there is no causal treatment [5], the most important management in patients with CAIS is bilateral gonadectomy due to a greater risk of germ cell tumors (GCT) associated with the presence of the Y chromosome. Such tumors include gonadomas, seminomas, teratomas, yolk sac tumors, choriocarcinomas, and embryonal carcinoma from stem cells. The precancerous conditions that precede these tumors are termed benign germ cell neoplasia in situ (GCNIS). In this patient, however, neither germ cell tumors nor GCNIS were found. Although, in the case of complete androgen insensitivity syndrome, the risk of neoplasm is much lower than in the partial form, it is not insignificant [5]. An additional factor related to the higher risk of other neoplasms in this patient is the coexistence of Klinefelter syndrome, as the peripheral conversion of the excessive androgens to estrogens is primarily favorable for breast cancer [17]. Thus, the removal of the gonads is an additional protective factor.
The role of radiological surveillance in the conservative management of incidental small testicular masses: A systematic review
Published in Arab Journal of Urology, 2021
Dominic Brown, Georgios Tsampoukas, Elenko Petkov Popov, Zaid Aldin, Mohamad Moussa, Athanasios Papatsoris, Noor N.P. Buchholz
Infertility was the main indication for US leading to the diagnosis of an incidental STM followed by scrotal or testicular pain, epididymitis, and contralateral cyst or tumour [11–16]. The dominant modality for radiological surveillance was US, whilst surveillance protocol was similar across studies consisting mostly of repeat US at 3-monthly intervals with follow-up durations ranging from 1 month to 16 years. During the follow-up period, 37 (12.6%) patients underwent explorative surgery of which 10 (3.4%) were subsequently diagnosed with malignant tumours. Surgery was performed in these cases either due to an increase in mass size or a new mass, the detection of extragonadal disease, an increase in internal vascularity, or in six cases due to patient preference [12]. All reported malignancies were germ cell tumours; predominantly seminomas with one case of embryonal carcinoma. Only two of the 10 malignant tumours were metastatic; one anaplastic seminoma, and one embryonal carcinoma. Data from the included studies are presented in Table 1 [11–16].