Table of Contents
1
UI - 11752981
AU - Ji EK; Cho KS
TI -
Granulosa cell tumor of scrotal tunics: a case report.
SO - Korean J Radiol 2001 Apr-Jun;2(2):117-20
AD - Department of Diagnostic Radiology, Asan Medical Center, University of
Ulsan, Seoul, Korea. jiek@chamc.co.kr
We report a case of adult granulosa cell tumor arising in the scrotal
tunics. The patient was a 34-year-old man who presented with right
scrotal swelling, first noticed four months previously. Under the
initial clinical impression of epididymoorchitis, antibiotic treatment
was instituted but there was no response. The paratesticular nodules
revealed by ultrasound and magnetic resonance imaging mimicked
intratesticular lesion, and radical orchiectomy was performed. Although
several cases of adult testicular granulosa cell tumor, have been
reported, the occurrence of this entity in the paratesticular area has
not, as far as we are aware, been previously described.
2
UI - 11850529
AU - Zeeman AM; Stoop H; Boter M; Gillis AJ; Castrillon DH; Oosterhuis JW;
TI -
Looijenga LH
VASA is a specific marker for both normal and malignant human germ
cells.
SO - Lab Invest 2002 Feb;82(2):159-66
AD - Department of Pathology/Laboratory for Experimental Patho-Oncology,
University Hospital of Rotterdam/Daniel, Josephine Nefkens Institute,
Erasmus University Rotterdam, The Netherlands.
VASA is so far the only known gene in mammals whose expression is
specific for the germ cell lineage. We investigated the presence of VASA
mRNA and protein in a series of germ cell tumors of different histologic
subtypes and anatomic location, as well as in nongerm cell tumors such
as testicular lymphomas and Leydig cell tumors. We detected VASA mRNA
(by quantitative RT-PCR) and protein (by immunohistochemical staining)
in normal spermatogenesis, seminoma (both classic and spermatocytic),
carcinoma in situ (the precursor of classic seminoma and nonseminoma),
dysgerminoma, and gonadoblastoma. VASA immunostaining was relatively
weak in seminomas and dysgerminomas compared with spermatocytic
seminomas, despite similar mRNA levels, suggesting that VASA is
regulated in part by post-transcriptional mechanisms. A higher staining
intensity compared with the invasive counterparts was observed in the
precursor lesions (ie, carcinoma in situ and gonadoblastoma). No VASA
mRNA or protein was detectable in nonseminomatous germ cell tumors (such
as embryonal carcinoma, teratoma, and yolk sac tumor) and derived cell
lines, or nongerm cell tumors such as lymphoma or Leydig cell tumor.
These results provide direct evidence that some germ cell tumors retain
germ cell characteristics, whereas other tumors of germ cell origin
result from differentiation and loss of germ cell identity. Furthermore,
these findings suggest that VASA is likely to serve as a useful and
highly specific biomarker for germ cell tumors, particularly classic and
spermatocytic seminoma/dysgerminoma, including their precursor stages.
3
UI - 11855586
AU - Bhutani M; Kumar L; Seth A; Thulkar S; Vijayaraghavan M; Kochupillai V
TI -
Germ cell tumours of the testis: clinical features, treatment outcome
and prognostic factors.
SO - Natl Med J India 2002 Jan-Feb;15(1):18-21
AD - All India Institute of Medical Sciences, New Delhi.
BACKGROUND: The prognosis of patients with germ cell tumours of the
testis has Improved over the past two decades following
cisplatinum-based chemotherapy. Currently, staging and risk assessment
of the disease is crucial in order to provide curative therapy for
patients with poor risk features and not over-treat good risk patients.
METHODS: We reviewed the case records of 71 men diagnosed to have germ
characteristics, staging, treatment outcome and prognostic factors for
response and survival were analysed. RESULTS: The median age of the
patients was 30 years (range: 3-65 years); 69% were in the third and
fourth decades. Sixty-one patients (86%) had a primary testicular tumour
while in 10 (14%) the tumour was extragonadal. Histopathologically, 53
patients (75%) had non-seminomatous germ cell tumours and 15 (21%) had a
seminoma. Twenty-seven patients (62%) had evidence of metastatic disease
at the time of diagnosis. On prognostication, non-seminomatous germ cell
tumour patients could be divded into good, intemediate and poor
prognostic groups comprising 41%, 17% and 40% of patients, respectively.
All patients with a seminoma were in the good prognostic subgroup.
Fifty-eight patients were evaluable for response. Overall, 91% of
patients responded: complete response 71% and partial response 20%.
Complete response rates were signiflcantly higher for the good risk
(95%) compared to the intermediate (49%) and poor risk (47%) categories
(p< 0.003). At a median follow up of 26 months, the 2-year overall and
progression-free survival for all patients was 70% and 57%,
respectively. The predictors for decreased overall and progression-free
survival were age >35 years, presence of poor risk features and
mediastinal primary disease. CONCLUSION: The outcome for germ cell
tumours in men with good risk is excellent. A protocol consisting of
bleomycin, etoposide and cisplatin is effective. Tailoring of
chemotherapy In good risk patients to minimize toxicity and Improving
results in poor risk patients are areas that need further work.
4
UI - 11859860
AU - Oliver RT; Ravi R
TI -
Cure of testicular germ cell cancer: an index of access to healthcare.
SO - Natl Med J India 2002 Jan-Feb;15(1):4-6
5
UI - 11850994
AU - La Vecchia C; Negri E; Levi F
TI -
[Tumors of the testis: a paradigm of a curable neoplasm?]
SO - Recenti Prog Med 2002 Jan;93(1):16-8
AD - Laboratorio di Epidemiologia, Istituto di Ricerche Farmacologiche Mario
Negri, Milano. lavecchia@marionegri.it
Mortality from testicular cancer has been declining in the USA since the
1970's and in western Europe since the late 1970's, and the rates in the
late 1990's were about 70% lower than in the 1970's. In Eastern Europe,
however, some decline was observed only since the late 1980's and was
substantially smaller (only approximately 20%). Consequently, a few
hundred avoidable deaths from a curable neoplasm, mainly of young
adults, are still registered in Eastern Europe. This underlines the
urgency of implementation of available and effective therapeutic schemes
for testicular cancer in Eastern Europe.
6
UI - 11213121
AU - Gietema JA; Meinardi MT; van der Graaf WT; Sleijfer DT
TI -
Syndrome X in testicular-cancer survivors.
SO - Lancet 2001 Jan 20;357(9251):228-9
7
UI - 11848466
AU - Chan A; Yousef GM; Jung K; Rajpert-De Meyts E; Diamandis EP
TI -
Identification and molecular characterization of five novel kallikrein
gene 13 (KLK13; KLK-L4) splice variants: differential expression in the
human testis and testicular cancer.
SO - Anticancer Res 2001 Sep-Oct;21(5):3147-52
AD - Department of Pathology and Laboratoty Medicine, Mount Sinai Hospital,
Toronto, Ontario, Canada.
The kallikrein gene family is comprised of genes that have either
established or potential applications in prostate and breast cancer
diagnostics. New members of the human kallikrein gene family have been
recently identified. By using the positional candidate gene approach, we
were able to clone a novel human serine protease gene that maps to
chromosome 19q13.3-q13.4, the location of the kallikrein gene family. We
named this gene KLK-L4 (now also known as KLK13). Here, we describe the
identification of five new KLK-L4 splice variants which are not
expressed in any other tissue except the human testis. We have further
established that these splice variants can be detected in normal testis
but not in the adjacent matched testicular tumors. In addition,
differential expression of the KLK-L4 gene was found in various
histological types of testicular cancer. Our results suggest that the
KLK-L4 gene is expressed in normal and cancerous testicular tissue;
however, its five variants are all expressed in normal tissue but not in
testicular tumors. The physiological relevance of these variants and the
implications of their differential expression between cancerous and
normal tissues are currently unknown.
8
UI - 11556261
AU - Geczi L; Biron P; Droz JP
TI -
[Treatment of germ cell tumors at the threshold of the third millennium]
SO - Orv Hetil 2001 Aug 5;142(31):1673-9
AD - Kemoterapia C es Klinikai Farmakologiai Osztaly, Orszagos Onkologiai
Intezet, Budapest. gelajos@oncol.hu
The aim of the authors is to present the risk factors and the risk
factors based treatment strategy of germ cell tumors. They review the
risk adapted treatment strategy of germ cell tumors using the treatment
policy of the Leon Berard Oncological Center and the current findings
published. More than of 80% germ cell tumors may be cured by standard
treatment. The treatment of stage I seminoma is lumboaortic radiotherapy
and that of stage I non seminoma is either surveillance, retroperitoneal
lymph node dissection or chemotherapy depending on the risk factors of
extratesticular involvement (pure embryonal carcinoma, vascular
invasion). The treatment of metastatic cases is chemotherapy: three
cycles of bleomycin, etoposid, cisplatin of four cycles of the similar
components without bleomycin for good risk patients, and four cycles
bleomycin, etoposid and cisplatin in poor risk cases. The overall five
year survival rates are 90 and 50% in cases of good and poor prognosis
groups respectively. The indication of retroperitoneal lymph node
dissection depends on the size of retroperitoneal spreading prior to
chemotherapy and on the efficacy of chemotherapy. The second line
salvage treatment is four cycles of a combination of vinblastin,
ifosfamide and cisplatin. After salvage chemotherapy the resection of
all residual masses is recommended. New drugs, such as gemcitabine,
taxotere, oxaliplatin and high dose chemotherapy may bring further
success, however these new treatment modalities are not available for
clinical practice in Hungary. Risk adapted treatment for germ cell
tumors decreasing the early and late toxicity's of conventional
treatment may improve the patients quality of life, and may decrease the
cost of standard treatment in Hungary. The said new medication and the
use of high dose chemotherapy may further improve the chances of
patients with poor and intermediate prognosis and of those who are
resistant to the cisplatin based standard therapy.
9
UI - 11871864
AU - Rick O; Siegert W; Beyer J
TI -
Chemotherapy in patients with metastatic or relapsed germ-cell tumours.
SO - Cancer Treat Rev 2001 Oct;27(5):283-8
AD - Klinik fur Innere Medizin m.S. Hamatologie/Onkologie,
Universitatsklinikum Charite, Campus Mitte, Humboldt Universitat,
Berlin, Germany. oliver.rick@charite.de
The optimal treatment in patients with poor prognosis germ-cell tumours
(GCT), according to the International Germ Cell Cancer Collaborative
Group (IGCCCG) classification, and in patients with refractory or
relapsed disease after cisplatin-based chemotherapy is controversial. As
the majority of patients will suffer systemic relapses, chemotherapy is
the mainstay of treatment. However, the question of whether or not to
use conventional-dose or high-dose chemotherapy (HDCT) in these patients
arises. Prognostic factors have recently been recognised to aid in this
decision. However, reliable data on chemotherapy as primary treatment in
poor prognosis patients and as the first-salvage attempt in patients
with relapsed or refractory GCT are lacking. This report reviews the
recent developments in first-line and salvage HDCT strategies and
discusses the role of predictive factors for treatment outcome.
Copyright 2001 Harcourt Publishers Ltd.
10
UI - 11805417
AU - Dieckmann KP; Endsin G; Pichlmeier U
TI -
How valid is the prenatal estrogen excess hypothesis of testicular germ
cell cancer? A case control study on hormone-related factors.
SO - Eur Urol 2001 Dec;40(6):677-83; discussion 684
AD - Department of Urology, Albertinen-Krankenhaus Hamburg, Germany.
DieckmannKP@t-online.de
PURPOSE/AIMS: The prenatal estrogen excess hypothesis postulates
abnormally high estrogen levels during pregnancy which predispose the
developing gonad to testicular germ cell cancer (GCT) in adulthood. As
no direct measurements are possible to support this hypothesis, evidence
must come from clinical and epidemiological observations. The present
study looked to surrogate parameters that purportedly point to high
estrogenic influence in utero. METHODS/PATIENTS: In a case-control study
design, 418 cases with GCT were compared to 636 controls having
fractures, injuries or nephrolithiasis. A second comparison was done
with 120 men suffering from malignant melanoma. The following factors
were investigated: maternal and paternal age at birth of proband,
birth-order, distribution of brothers and sisters in sibs of patients,
sibship size, status of being a twin, status of being a singleton child,
handedness, and frequency of breast cancer in mothers and sisters.
RESULTS: Status of being a twin was significantly associated with GCT
risk (OR 2.41; 95% CI 1.04- 5.63) if compared to men with fractures or
stones. Comparison with melanoma controls showed only a nonsignificant
trend. Frequency of breast cancer was insignificantly higher in mothers
of GCT patients. Maternal age above 30 years was associated with
decreased risk of GCT, which is contradictory to the hypothesis. No
other parameter was significantly different in cases and controls.
CONCLUSION: The present investigation failed to produce evidence for the
estrogen excess hypothesis. Obviously, the parameters tested are only
weak indicators of estrogenic influence during embryogenesis. Thus, the
sample size and statistical power of the trial might have been too low
to show any significant association. But, assessing the negative results
of this study in light of equally negative results in previous
investigations, the estrogen excess hypothesis still remains to be
hypothetic.
11
UI - 11805420
AU - Nonomura K; Koyama T; Kakizaki H; Murakumo M; Shinohara N; Koyanagi T
TI -
Testicular-sparing surgery for the prepubertal testicular tumor.
Experience of two cases with large cell calcifying Sertoli cell tumors.
SO - Eur Urol 2001 Dec;40(6):699-704
AD - Department of Urology, Hokkaido University Graduate School of Medicine,
Sapporo, Japan. k-nonno@med.hokudai.ac.jp
PURPOSE: We review prepubertal germ cell tumors of testis in our
institute and the Japanese registry and present 2 cases with a large
cell calcifying Sertoli cell tumor (LCCSCT) and discuss the possibility
of testis-sparing surgery. MATERIALS AND METHODS: Incidence, age,
pathology and clinical stages of prepubertal germ cell tumors are
surveyed for 30 years at our department and 10 years of the malignant
tumor registry of the Japanese Society of Pediatric Surgery. Two
representative prepubertal boys with LCCSCT are presented. One of them
was treated by partial orchiectomy. RESULTS: The majority of testicular
germ cell tumors in the prepubertal age were composed of embryonal cell
carcinoma/yolk sac tumors or teratoma, occurred in preschool age, were
limited to clinical stage I and did not metastasize irrespective of
histology. Benign behavior which included recovery from hormonal
derangement, no tumor recurrence and negative antisperm antigen was
observed in 2 cases with LCCSCT who underwent either radical orchiectomy
or partial orchiectomy. CONCLUSION: Partial orchiectomy should be
considered as a standard option in prepubertal schoolboys with a
testicular mass if surgically feasible. This surgical treatment is safe
and preserves fertility and is psychologically advantageous. It is not
recommended for yolk sac tumors that may recur, however they are rare in
prepubertal boys and can be differentiated preoperatively by prudent
evaluation.
12
UI - 11849786
AU - Zouhair A; Weber D; Belkacemi Y; Ketterer N; Dietrich PY; Villa S;
TI -
Scandolaro L; Bieri S; Studer G; Delacretaz F; Girardet C; Mirimanoff
RO; Ozsahin M; Rare Cancer Network
Outcome and patterns of failure in testicular lymphoma: a multicenter
Rare Cancer Network study.
SO - Int J Radiat Oncol Biol Phys 2002 Mar 1;52(3):652-6
AD - Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
PURPOSE: To assess the outcome and patterns of failure in patients with
testicular lymphoma treated by chemotherapy (CT) and/or radiation
therapy (RT). METHODS AND MATERIALS: Data from a series of 36 adult
patients with Ann Arbor Stage I (n = 21), II (n = 9), III (n = 3), or IV
(n = 3) primary testicular lymphoma, consecutively treated between 1980
and 1999, were collected in a retrospective multicenter study by the
Rare Cancer Network. Median age was 64 years (range: 21-91 years). Full
staging workup (chest X-ray, testicular ultrasound, abdominal
ultrasound, and/or thoracoabdominal computer tomography, bone marrow
assessment, full blood count, lactate dehydrogenase, and cerebrospinal
fluid evaluation) was completed in 18 (50%) patients. All but one
patient underwent orchidectomy, and spermatic cord infiltration was
found in 9 patients. Most patients (n = 29) had CT, consisting in most
cases of cyclophosphamide, doxorubicin, vincristine, and prednisolone
(CHOP) with (n = 17) or without intrathecal CT. External RT was
delivered to scrotum alone (n = 12) or testicular, iliac, and
para-aortic regions (n = 8). The median RT dose was 31 Gy (range: 20-44
Gy) in a median of 17 fractions (10-24), using a median of 1.8 Gy
(range: 1.5-2.5 Gy) per fraction. The median follow-up period was 42
months (range: 6-138 months). RESULTS: After a median period of 11
months (range: 1-76 months), 14 patients presented lymphoma progression,
mostly in the central nervous system (CNS) (n = 8). Among the 17
patients who received intrathecal CT, 4 had a CNS relapse (p = NS). No
testicular, iliac, or para-aortic relapse was observed in patients
receiving RT to these regions. The 5-year overall, lymphoma-specific,
and disease-free survival was 47%, 66%, and 43%, respectively. In
univariate analyses, statistically significant factors favorably
influencing the outcome were early-stage and combined modality
treatment. Neither RT technique nor total dose influenced the outcome.
Multivariate analysis revealed that the most favorable independent
factors predicting the outcome were younger age, early-stage disease,
and combined modality treatment. CONCLUSIONS: In this multicenter
retrospective study, CNS was found to be the principal site of relapse,
and no extra-CNS lymphoma progression was observed in the irradiated
volumes. More effective CNS prophylaxis, including combined modalities,
should be prospectively explored in this uncommon site of extranodal
lymphoma.
13
UI - 11825120
AU - Florentine BD; Roscher AA; Garrett J; Warner NE
TI -
Necrotic seminoma of the testis: establishing the diagnosis with Masson
trichrome stain and immunostains.
SO - Arch Pathol Lab Med 2002 Feb;126(2):205-6
AD - Keck School of Medicine, University of Southern California, Los Angeles,
CA, USA.
We describe an infarcted mass in the testis containing "ghost" cells
suspicious for neoplasm. The entire lesion was necrotic. A Masson
trichrome stain greatly improved nuclear and cytologic detail,
confirming the suspicion of neoplasm. Placental alkaline phosphatase
revealed specific membrane staining of the neoplastic cells and
established a diagnosis of seminoma. Masson trichrome plus selected
immunostains offer a promising approach to the diagnosis of certain
necrotic neoplasms.
14
UI - 10672054
AU - Delahunt B; Eble JN; King D; Bethwaite PB; Nacey JN; Thornton A
TI -
Immunohistochemical evidence for mesothelial origin of paratesticular
adenomatoid tumour.
SO - Histopathology 2000 Feb;36(2):109-15
AD - Departments of Pathology, Wellington School of Medicine, University of
Otago, New Zealand. bd@wnmeds.ac.nz
AIMS: To investigate the histogenesis of paratesticular adenomatoid
tumour by use of immunohistochemical markers for a variety of carcinomas
and mesothelioma. METHODS AND RESULTS: Immunohistochemical staining of
sections from 12 cases of paratesticular adenomatoid tumour was
undertaken using primary antibodies to antigens expressed by benign
epithelial cells and carcinoma (cytokeratin AE1/AE3, cytokeratin
34ssE12, epithelial membrane antigen, MOC-31, Ber-EP4, CEA, B72.3,
LEA.135, Leu M1), stromal and vascular markers (vimentin, CD34, factor
VIII), and mesothelioma-associated antigens (thrombomodulin, HBME-1, OC
125) and p53 protein. There was absence of immunohistochemical
expression of epithelial/carcinoma markers MOC-31, Ber-EP4, CEA, B72.3,
LEA.135, Leu M1 and to factor VIII and CD34. All tumours expressed
cytokeratin AE1/AE3, epithelial membrane antigen and vimentin, with weak
expression of cytokeratin 34ssE12 in 25% of tumours. Each tumour showed
expression of thrombomodulin, HBME-1 and OC 125 in a membranous
distribution. p53 protein expression was not detected. CONCLUSIONS: The
immunohistochemical profile of paratesticular adenomatoid tumour is
strongly supportive of a mesothelial cell origin.
15
UI - 11119138
AU - Isotalo PA; Yazdi HM; Perkins DG; Mai KT
TI -
Immunohistochemical evidence for mesothelial origin of paratesticular
adenomatoid tumour.
SO - Histopathology 2000 Nov;37(5):476-7
16
UI - 11750296
AU - Nazareth I; Lewin J; King M
TI -
Sexual dysfunction after treatment for testicular cancer: a systematic
review.
SO - J Psychosom Res 2001 Dec;51(6):735-43
AD - Department of Primary Care and Population Sciences, Royal Free and
University College London Medical School, University College London,
Rowland Hill Street, London NW3 2PF, UK. i.nazareth@pcps.ucl.ac.uk
OBJECTIVES: We aimed to assess the nature and risk of sexual dysfunction
in men after treatment for testicular cancer. METHOD: Systematic review
of sexual dysfunction in men treated for testicular cancer. The odds
ratio or proportions of subjects with reduced sexual drive, erectile
dysfunction or orgasmic/ejaculatory dysfunction was calculated. RESULTS:
A detailed review of 79 of the 227 citations was conducted. The highest
level of evidence found, were controlled studies. Six controlled studies
examined sexual function in 709 patients after they had received
treatment. Seven uncontrolled studies examined sexual function in 337
subjects before and after treatment for testicular cancer. Most studies
were limited by low response rates, use of unvalidated questionnaires
and inclusion of a variety of treatment modalities. Few assessed
psychological function and none examined its possible interaction with
sexual dysfunction. Meta-analysis of the controlled studies indicated
significantly reduced or absent orgasm (OR=4.62, 95% CI=2.47-8.63)
together with erectile (OR=2.47, 95% CI=1.54-3.96) and ejaculatory
dysfunction (OR=28.57, 95% CI=1.75-464.78) up to 2 years after
treatment. Effects on sexual function were less consistent in the
uncontrolled studies. CONCLUSIONS: The controlled studies indicate that
sexual dysfunction persists for up to 2 years after treatment. However,
better evidence is needed in studies that control for the impact of the
testicular cancer, the treatment modality and psychological reactions to
both.
17
UI - 11786573
AU - Ferrari A; Bisogno G; Casanova M; Meazza C; Piva L; Cecchetto G; Zanetti
TI -
I; Pilz T; Mattke A; Treuner J; Carli M
Paratesticular rhabdomyosarcoma: report from the Italian and German
Cooperative Group.
SO - J Clin Oncol 2002 Jan 15;20(2):449-55
AD - Pediatric Oncology and Pediatric Surgery Units, Istituto Nazionale
Tumori, Milan, Italy. ferrari@istitutotumori.mi.it
PURPOSE: We report the experience of the German-Italian Cooperative
Group with 216 pediatric patients with paratesticular rhabdomyosarcoma
treated over 20 years. PATIENTS AND METHODS: At diagnosis, 198 patients
had localized disease and 18 had distant metastases. Among the
nonmetastatic patients, complete tumor resection was performed in 83% of
cases. Evaluation of the retroperitoneal lymph nodes changed over the
years from routine surgical staging to radiologic assessment. All
patients received chemotherapy, which was reduced in intensity and
duration for patients with low-risk features in subsequent protocols.
Radiotherapy was administered to 10% of patients. RESULTS: Among 72
patients with a negative retroperitoneal computed tomography (CT) scan,
surgical assessment detected nodal involvement in only one case. Among
23 patients with enlarged nodes on CT scans, surgery confirmed nodal
spread in 65% of patients. No differences in the rate of nodal
involvement were observed over the years. With a median follow-up of 110
months, 5-year survival was 85.5% for the series as a whole, 94.6% for
patients with localized disease, and 22.2% for metastatic cases.
Retroperitoneal nodal recurrence was the major cause of treatment
failure. Univariate analysis revealed the prognostic value of tumor
invasiveness, size, and resectability, as well as of nodal involvement
and age, in patients with localized tumor. CONCLUSION: The outcome for
patients with localized paratesticular rhabdomyosarcoma is excellent,
despite the reduction in chemotherapy over the years: an alkylating
agent-free and anthracycline-free regimen is adequate treatment for
low-risk patients. Surgical assessment of the retroperitoneum must be
reserved for patients with enlarged nodes on CT scans. Children over 10
years old carry a higher risk of nodal involvement and relapse.
18
UI - 11799147
AU - Leroy X; Augusto D; Leteurtre E; Gosselin B
TI -
CD30 and CD117 (c-kit) used in combination are useful for distinguishing
embryonal carcinoma from seminoma.
SO - J Histochem Cytochem 2002 Feb;50(2):283-5
AD - Department of Pathology, University Hospital, Lille, France.
x-leroy@chru-lille.fr
Germ-cell tumors are the most common malignant neoplasms of the testis.
Seminomatous and non-seminomatous tumors must be differentiated because
the treatment and the prognosis are different. In light microscopic
examination, seminoma may sometimes be difficult to distinguish from the
solid pattern of embryonal carcinoma (EC). Although studies have shown
that CD30 was a good marker of embryonal carcinoma and that c-kit was
regularly expressed in seminoma, none has described the value of CD30
and CD117 (c-kit) in combination for the differential diagnosis between
EC and seminoma. We selected 25 pure seminomas, seven pure ECs, and
seven mixed germ-cell tumors composed of seminoma and EC from our
archives and studied their immunoreactivity for CD30 and CD117. We
observed that 27/35 seminomas were CD117+/CD30-; none of the seminoma
was CD117-/CD30+. Conversely, 11/14 ECs were CD30+/CD117- and none was
CD30-/CD117+. Our findings suggest that CD117 and CD30
immunohistochemistry used in combination represents a valuable tool for
distinguishing seminoma from EC.
19
UI - 11844806
AU - Vaughn DJ; Meadows AT
TI -
Cancer survivorship research: the best is yet to come.
SO - J Clin Oncol 2002 Feb 15;20(4):888-90
20
UI - 11855889
AU - Fleckenstein GH; Gunawan B; Brinck U; Wuttke W; Emons G
TI -
Simultaneous sertoli cell tumor and adenocarcinoma of the tunica
vaginalis testis in a patient with testicular feminization.
SO - Gynecol Oncol 2002 Mar;84(3):460-3
AD - Department of Gynecology and Obstetrics, Georg-August-University of
Gottingen, Gottingen, D-37075, Germany.
BACKGROUND: The association of testicular feminization with late
diagnosis in a patient with a large Sertoli cell tumor and a
metastasizing adenocarcinoma of the tunica vaginalis testis is unusual.
CASE: Testicular feminization was diagnosed in a 72-year-old patient,
who was admitted with a large lower abdominal mass. Histologically, we
found a well-differentiated Sertoli cell tumor and an adenocarcinoma of
the tunica vaginalis testis with metastases in the sigmoid colon,
rectum, and omentum. Explorative laparotomy revealed a large pelvic
tumor mass and extensive peritoneal carcinosis. After debulking surgery
to optimal residual disease and four courses of chemotherapy (cisplatin
and etoposide), there was no evidence of disease (clinically) for 24
months before an intraabdominal and inguinal relapse occurred. Due to
the unwillingness of the patient to receive salvage chemotherapy or
palliative abdominal surgery, the disease progressed rapidly and she
died 27 months after the initial operation. CONCLUSION: This is the
first reported case of an advanced carcinoma of the tunica vaginalis
testis occurring simultaneously with a large Sertoli cell tumor in a
patient with testicular feminization. Surgical debulking and
platinum-based chemotherapy rendered the patient clinically free of
disease for 2 years.
21
UI - 11847026
AU - Houlgatte A; Dourthe LM; Bernard O
TI -
[Update on about testicular cancer]
SO - Bull Cancer 2002 Jan;89(1):47-56
AD - Service d'urologie, Hopital du Val-de-Grace, 74, boulevard de
Port-Royal, 75230 Paris Cedex 05, France. vdg.urologie1@libertysurf.fr
The last two years publications are mainly concerning the following
themes: the detection of testicular tumor for high risk patients. The
treatment of stage one non seminomatous germ cell tumors is also
detailed with reference to the three therapeutic options. The surgical
treatment is evoked through laparoscopic surgery, surgery of residual
masses and salvage surgery. Recent acquisitions in chemotherapy matters
allow a simplification of protocols. They induced an improvement in the
patient's quality of life with an equivalent efficiency. The salvage
chemotherapy is evaluated and its results are assessed. The innovations
in imaging are essentially focused on position emission tomography in
the evaluation of these tumours but also on magnetic resonance imaging.
22
UI - 11856111
AU - Spermon JR; De Wilde PC; Hanselaar AG; Schaafsma HE; Ruijter TE; Witjes
TI -
JA; Van Moorselaar RJ
alpha-Catenin expression pattern and DNA image-analysis cytometry have
no additional value over primary histology in clinical stage I
nonseminomatous testicular cancer.
SO - BJU Int 2002 Feb;89(3):278-84
AD - Department of Urology, University Medical Centre Nijmegen, The
Netherlands. r.spermon@uro.azn.nl
OBJECTIVE: To determine whether the alpha-catenin expression pattern and
DNA content have additional value over primary tumour histology,
including information on vascular invasion and tunica albuginea
invasion, in detecting occult metastasis in patients with clinical stage
I nonseminomatous germ cell tumours of the testis (NSGCT). PATIENTS AND
METHODS: Fifty consecutive patients with clinical stage I NSGCT
underwent retroperitoneal lymphadenectomy (RPLND) between 1986 and 1992.
The orchidectomy specimens were histopathologically reviewed and
immunohistochemically stained with mouse monoclonal anti-alpha-catenin
antibody. The presence of an aberrant or negative staining in >10% of
the malignant cells was defined as abnormal; in all other cases tumours
were classified as normal. Furthermore, intact nuclei were isolated from
50 microm thick paraffin sections of the primary tumour, Feulgen
stained, and analysed with an image-analysis system. RESULTS: Of the 50
patients, 14 had positive retroperitoneal nodes (stage IIa, 28%), one
pathologically staged I patient developed a lung metastasis (stage IV)
within 3 months of RPLND. Univariate analysis showed that the presence
of embryonal cell carcinoma, vascular invasion and tunica albuginea
invasion were predictive for occult metastases. In multivariate logistic
regression analysis only vascular and tunica albuginea invasion were
significant. All 11 patients with no embryonal cell carcinoma in the
primary tumour were classified as having pathological stage I disease.
Also, the tumours which were DNA-diploid (three) or DNA-polyploid (two)
were pathologically stage I. In screening for occult metastases the DNA
content and the alpha-catenin expression pattern had no additional
value. CONCLUSION: Vascular and tunica albuginea invasion have
prognostic value in identifying patients with clinical stage I NSGCT at
high risk for occult retroperitoneal disease. In contrast, the absence
of embryonal cell carcinoma could predict all patients at low risk for
metastasis. The DNA-ploidy also identified patients at low risk. Other
DNA-analyses and the alpha-catenin expression pattern provided no
additional information. Further studies are recommended to identify
patients who are at low or high risk for metastasis.
23
UI - 11852358
AU - Baldet P
TI -
[Germ cell tumors of testis, current concepts]
SO - Ann Pathol 2001 Oct;21(5):399-410
AD - Service d'Anatomie et Cytologie Pathologiques, Hopital Gui de Chauliac,
80, avenue A.-Fliche, 34295 Montpellier cedex 5, France.
Histological pleomorphism of testicular germ cell tumors complicates
diagnosis. These tumors share highly specific differentiation properties
ranging from intra-tubular neoplasia to classical infiltrating lesions.
This general review presents the histopathological features and
diagnostic criteria of typical forms and atypical variants. In current
practice, distinction between seminoma and non-seminomatous germ cell
tumors is fundamental for treatment. Histological typing of
non-seminomatous tumors may be problematical, especially in "mixed"
forms. Vitelline tumor variants and atypical embryonic carcinoma are
described. Unlike scattered isolated syncytiotrophoblastic cells, true
chorio-carcinoma is rare and must be carefully identified. Such cells
are frequently associated with seminoma, embryonic carcinoma and
vitelline tumors. Intra-tubular germ-cell neoplasia and gonadoblastoma,
are pre-invasive lesions associated with cryptorchidism and gonadal
dysgenesis. Teratomatous elements usually occur in mixed germ cell
tumors. Rare pure teratoma are benign in children. On the contrary,
post-pubertal forms have an unpredictable evolution.
24
UI - 11851774
AU - Kirkali Z; Tuzel E; Canda AE; Mungan MU
TI -
Testis sparing surgery for the treatment of a sequential bilateral
testicular germ cell tumor.
SO - Int J Urol 2001 Dec;8(12):710-2
AD - Dokuz Eylul University, School of Medicine, Department of Urology,
Izmir, Turkey. ziya.kirkali@deu.edu.tr
Standard therapy of sequential bilateral testis cancer is generally
considered to be orchiectomy. We present a case of sequential bilateral
testicular germ cell tumor treated with testis sparing surgery. The
patient was disease free 50 months after surgery without local
recurrence or distant metastases. Testis sparing surgery provides a
better quality of life and may be considered a safe, feasible
alternative in the treatment of carefully selected patients with
bilateral testicular germ cell tumor.
25
UI - 11851777
AU - Gohji K; Watsuji T; Ubai T; Ueda H; Katsuoka Y
TI -
Embryonal carcinoma of the testis associated with prostate cancer in a
72-year-old man.
SO - Int J Urol 2001 Dec;8(12):719-21
AD - Department of Urology, Osaka Medical College, Takatsuki, Japan.
A 72-year-old Japanese man presented with a painless swollen left
scrotal mass with elevated levels of serum alpha-fetoprotein and
prostate specific antigen. The patient underwent high orchiectomy under
diagnosis and a final pathological examination revealed embryonal
carcinoma of the left testis. A systematic needle prostate biopsy under
guidance of transrectal ultrasound revealed prostate cancer (Gleason
score, 8) on the left lobe (T2aN0M0). Systemic chemotherapy was given
for retroperitoneal lymph node metastasis of testicular cancer and
hormonal therapy (LH-RH analog) was given for prostate cancer. The
patient was well with no evidence of metastasis from the testicular
cancer or prostate cancer and with no elevation of serum
alpha-fetoprotein or prostate specific antigen 26 months after the
orchiectomy.
26
UI - 11832253
AU - Fossa SD; Dahl AA
TI -
Short Form 36 and Hospital Anxiety and Depression Scale. A comparison
based on patients with testicular cancer.
SO - J Psychosom Res 2002 Feb;52(2):79-87
AD - Department of Medical Oncology and Radiotherapy, The Norwegian Radium
Hospital, University of Oslo, Montebello, 0310, Oslo, Norway.
s.d.fossa@klinmed.uio.no
BACKGROUND: The aim of this study was to compare the scorings of anxiety
and depression assessed by the Hospital Anxiety and Depression Scale
(HADS-A [Anxiety] and HADS-D [Depression]) with the scorings on the
eight subscales of Short Form 36 (SF-36) and the Physical (PCS) and
Mental Component Summary (MCS) assessed by the same patients. METHOD: In
a cross-sectional study 736 long-term survivors after treatment for
testicular cancer (TC) completed HADS and SF-36. Pearson's correlation
coefficients were calculated on item and scale level to assess the
associations between the HADS and the SF-36 scales and, in particular,
between HADS and PCS and MCS, respectively. Independent predictors for
PCS and MCS were identified by linear regression analysis. RESULTS:
HADS-A and HADS-D were significantly associated with the SF-36 summary
scales. HADS-A explained 5% of the variance of PCS and 49% of the
variance of MCS. The comparable figures for HADS-D were 10% and 45%,
respectively. In the multivariate analysis the HADS-D scoring
independently predicted the level of PCS together with the patients'
educational level, long-lasting working disability and age (variance:
30%). Both HADS-D and HADS-A remained independent parameters for MCS
(variance: 58%) together with the patient's civil status. HADS-D item D4
("slowed down") was similarly associated with both PCS and MCS.
CONCLUSION: In univariate analyses HADS-D and HADS-A were statistically
associated with PCS and MCS. The highest r values were observed for the
associations between HADS and MCS, in particular between HADS-A and MCS.
In the multivariate analyses HADS-D, but not HADS-A, contributed to PCS,
whereas both HADS-A and HADS-D were associated with MCS. This pattern of
different predictions of the summary scales of SF-36 supports a clinical
practice that anxiety and depression should be assessed separately.
Additional use of a self-rating instrument for depression and anxiety,
such as HADS, is recommended when SF-36 is used for quality of life (QL)
assessment.
27
UI - 11870436
AU - Kebapci M; Can C; Isiksoy S; Aslan O; Oner U
TI -
Burned-out tumor of the testis presenting as supraclavicular
lymphadenopathy.
SO - Eur Radiol 2002 Feb;12(2):371-3
AD - Department of Radiology, Osmangazi University School of Medicine,
Meselik, 26480 Eskisehir, Turkey.
Burned-out tumor of the testis is a rare clinical entity. It generally
presents with metastases and is nonpalpable in testicular palpation. We
present a case of testicular burned-out tumor having supraclavicular and
retroperitoneal lymph node metastases. Imaging findings of such tumors
have insufficiently been documented in radiology literature. Scrotal
sonography is crucial in detecting the regressed tumors especially in
patients with extragonadal metastasis of a testicular primary.
28
UI - 11675930
AU - Boivin JF
TI -
[Very high alpha-fetoprotein in a cirrhotic patient. Some comments]
SO - Presse Med 2001 Sep 29;30(27):1368
29
UI - 11781632
AU - Korfel A; Fischer L; Foss HD; Koch HC; Thiel E
TI -
Testicular germ cell tumor with rhabdomyosarcoma successfully treated by
disease-adapted chemotherapy including high-dose chemotherapy: case
report and review of the literature.
SO - Bone Marrow Transplant 2001 Oct;28(8):787-9
AD - Department of Hematology, Oncology and Transfusion Medicine, Klinikum
Benjamin Franklin, Freie Universitat, Berlin, Germany.
Treatment and prognosis have not been well characterized in germ cell
tumors (GCT) with a malignant nongerm cell component. Patients with a
mediastinal tumor, neural or rhabdomyosarcomatous differentiation and
distant metastases have the poorest prognosis. We report a rare case of
mixed GCT composed of seminoma, teratoma and rhabdomyosarcoma with the
rhabdomyosarcomatous component metastasized into the liver and bone
marrow (BM) causing hypercalcemia. The patient was treated with
differentiation-tailored chemotherapy (CHT) including a disease-adapted
high-dose (HD) CHT regimen with purified autologous PBSCT (APBSCT) and
pamidronate. To date, remission has lasted for 4 years. Tumor-adapted
CHT including HD-CHT with APBSCT can induce long term remissions in
high-risk patients with transformed GCT. A review of the literature is
given.
30
UI - 11870528
AU - Bokemeyer C; Kollmannsberger C; Oechsle K; Dohmen BM; Pfannenberg A;
TI -
Claussen CD; Bares R; Kanz L
Early prediction of treatment response to high-dose salvage chemotherapy
in patients with relapsed germ cell cancer using [(18)F]FDG PET.
SO - Br J Cancer 2002 Feb 12;86(4):506-11
AD - Department of Hematology/Oncology, University of Tuebingen Medical
Center, Otfried-Mueller-Str 10, 72076 Tuebingen, Germany.
carsten.bokemeyer@med.uni-tuebingen.de
To assess the ability of [(18)F]fluorodeoxyglucose positron emission
tomography for the early prediction of response in patients with
relapsed metastatic germ cell tumours undergoing salvage high-dose
chemotherapy. The role of positron emission tomography was compared with
established means of tumour response assessment such as CT scans/MRI and
serum tumour marker changes. In addition, positron emission tomography
was compared with a current prognostic score which differentiates three
prognostic groups with failure-free survival rates ranging from 5-50%.
[(18)F]fluorodeoxyglucose uptake of metastases from germ cell tumours as
well as CT scans and serum tumour marker were acquired after 2-3 cycles
of induction chemotherapy but before the start of high-dose chemotherapy
and CT scans/serum tumour marker were compared with the baseline
examinations in 23 patients with relapsed germ cell tumours. To evaluate
the validity of early response prediction by positron emission
tomography, radiological monitoring and serum tumour marker decline,
histopathologic response after resection of residual masses and/or the
clinical course over 6 months after the end of treatment (relapse vs
freedom of progression) were used. Overall, 10 patients (43%) achieved a
marker-negative partial remission, three (13%) a marker-positive partial
remission, five (22%) a disease stabilization and five (22%) progressed
during treatment. Nine patients (39%) remained progression-free over 6
months following treatment, whereas 14 (61%) progressed. The outcome of
high-dose chemotherapy was correctly predicted by positron emission
tomography/CT scan/serum tumour marker in 91/59/48%. Eight patients with
a favourably predicted outcome by CT scans plus serum tumour marker but
a positive positron emission tomography prior to high-dose chemotherapy,
failed treatment. This results in the following
sensitivities/specificities for the prediction of failure of high-dose
chemotherapy: positron emission tomography 100/78%; radiological
monitoring 43/78%; serum tumour marker 15/100%. The positive and
negative predictive values of positron emission tomography were 88 and
100%, respectively. As compared with the prognostic score, positron
emission tomography was correctly positive in all patients of the three
risk groups who failed treatment. In addition, a negative positron
emission tomography correctly predicted a favourable outcome in the good
and intermediate group. [(18)F]fluorodeoxyglucose positron emission
tomography imaging can be used to assess response to chemotherapy in
patients with relapsed germ cell tumours early in the course of
treatment and may help to identify patients most likely to achieve a
favourable response to subsequent high-dose chemotherapy. In patients
with response to induction chemotherapy according to CT scans or serum
tumour marker evaluation, positron emission tomography seems to add
information to detect patients with an overall unfavourable outcome. It
may also be a valuable addition to the prognostic model particularly in
the good and intermediate group for further selection of patients who
will profit from high-dose chemotherapy.
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