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Germ-Cell Cancer of the Testis and Related Neoplasms
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
A recognized feature of early germ-cell cancers in adults is the histological precursor of intratubular germ cell neoplasia unclassified (IGCNU)11—the presence of atypical intratubular germ cells (Figure 17.1). The development of IGCNU is not fully understood. It has been hypothesized that intrauterine hormonal imbalance (by intrinsic or extrinsic factors) may result in a disturbance in the fetal programming of gonadal development. Either way, the current view is that IGCNU develops early in life and factors including puberty and environmental exposure may lead to the development of cancer.11 In adults, it can be found adjacent to recognizable cancer in the majority of resected testes containing malignant germ-cell cancer.
The urinary tract and male reproductive system
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
Luis Beltran, Daniel M. Berney
The precursor lesion of most testicular GCTs is germ cell neoplasia, in situ (GCNIS). It has previously been described as carcinoma in situ and intratubular germ cell neoplasia, unclassified. These cells are recognizable histologically. GCNIS is seen in seminiferous tubules adjacent to most testicular germ cell tumours, and it has also been seen in biopsies taken from cryptorchid testes of patients who have subsequently developed a tumour in the same testis (Figure 17.5).
Prune belly syndrome
Published in Prem Puri, Newborn Surgery, 2017
Salvatore Cascio, Hideshi Miyakita, Prem Puri
In fetuses with prune belly syndrome, testicular histology revealed reduced spermatogonia and Leydig cell hyperplasia.39,40 Testicular biopsy samples of infant testes in prune belly syndrome demonstrate atypical germ cells with large nuclei and prominent nucleoli, and intense alkaline phosphatase staining localized to the cytoplasmic membrane.40 The similarity of histological appearance of these testes to those in intratubular germ cell neoplasia suggests that long-term follow-up of these patients for the development of invasive germ cell tumors is important. A few cases of malignancy in the testes of patients with prune belly syndrome have been reported.41–43
Unusual presentation of epidermoid cyst from testis in an aging male
Published in The Aging Male, 2020
Today, testicular sparing surgery is the routine treatment of the testicular epidermoid cysts [3]. It has less negative effects on fertility, sexual hormones and physiosocial situation. All non-tumoral lesions could be detected in the frozen-sections during the testicular sparing surgery, whereas the skipping ratio is 3.5% for tumoral lesions [11]. In the literature, a testicular epidermoid cyst concurrent with intratubular germ cell neoplasia was reported as well as a pure seminoma which developed after 5 years from the testicular sparing surgery due to a testicular epidermoid cyst which was reported in the frozen-sections [12,13]. Aggressive treatments might be considered given the malignancy of 95% of the testicular tumors after puberty and inability of excluding the malignancies with clinical findings and imaging studies.
Promising novel therapies for relapsed and refractory testicular germ cell tumors
Published in Expert Review of Anticancer Therapy, 2021
Kristyna Kozakova, Michal Mego, Liang Cheng, Michal Chovanec
The PTEN tumor suppressor gene is highly expressed in normal testicular germ cells. The loss of its expression appeared to be linked to the transition of intratubular germ cell neoplasia into the invasive GCT and tumor progression [6]. PTEN inactivation is linked to the deregulation of the PI3K/AKT pathway and eventually leads to increase of mammalian target of rapamycin (mTOR).