National Cancer Institute®
Last Modified: November 21, 2001
UI - 21336428
AU - Gurbuz YS; Muezzinoglu B; Cimen K; Dillioglugil O
TI - Synchronous occurrence of bladder carcinosarcoma and testicular seminoma.
SO - Int J Urol 2001 Jul;8(7):404-7
AD - Department of Pathology, Kocaeli University Medical School, Kocaeli, Turkey.
We report a case of urinary bladder carcinosarcoma with simultaneous testicular seminoma. A 60-year-old male presented with painless gross hematuria and a left testicular mass. The bladder tumor was deeply infiltrating muscular tissue and had histologic features of both carcinoma and sarcoma. Testicular tumor was diagnosed as classical seminoma. Radical cystectomy, pelvic and left-modified retroperitoneal lymphadenectomy were performed. The lymph nodes did not show metastasis. At the 26 months follow-up, the patient is free of disease.
UI - 21340683
AU - Schrader M; Heicappell R; Muller M; Krause H; Straub B; Goessl C; Miller
TI - K Molecular markers in testicular germ cell tumors--objects of clinical research or close to becoming clinical tools?
SO - Onkologie 2001 Apr;24(2):144-8
AD - Klinik und Poliklinik fur Urologie, Universitatsklinikum Benjamin Franklin, Berlin. firstname.lastname@example.org
The aim of this short review is to critically evaluate hitherto investigated molecular markers for testicular germ cell tumors. Molecular parameters have been clinically established as diagnostic and prognostic markers for a number of tumors; this has not yet been achieved for germ cell tumors. There are interesting prospects, however. Studies on the ribonucleoprotein telomerase, for example, have demonstrated a correlation between enzyme activity and chemotherapeutic drug sensitivity. Moreover, innovative treatment approaches target this reverse transcriptase via telomerase antisense RNA. Another potential diagnostic marker is the detection of circulating tumor cells, which correlated with an increased relapse rate in initial studies. There are also interesting possibilities for the germ-cell-tumor-specific isochromosome [i(12)p], which is helpful in the differential diagnosis of mediastinal masses. Here initial studies demonstrated a correlation between the copy number and resistance against chemotherapeutic drugs. Without prospective studies to validate data obtained thus far, neither these nor other parameters can be assessed as diagnostic and prognostic factors. Irrespective of their immediate clinical applicability, however, investigations on molecular alterations in testicular germ cell tumors will become the basis for a molecular-diagnostically oriented subclassification of tumors as well as for novel therapeutic approaches. Copyright 2001 S. Karger GmbH, Freiburg
UI - 21340689
AU - Kormann KU
TI - Treatment of testicular cancer--is quality management possible?
SO - Onkologie 2001 Apr;24(2):177-9
AD - Urologische Klinik, Universitatsklinikum Mannheim.
The incidence of testicular cancer has continuously increased during the last decades, especially in the developed countries. The prognosis for a great number of young patients with this terminal illness was dramatically improved to a cure rate of 95% through the introduction of Cisplatin chemotherapy in the late seventies. Einhorn demonstrated the excellent efficacy of Cisplatin in 1977 [see 1]. At that time, germ cell tumors were the cause of death in 400 males per year in Germany. The propagation of chemotherapy could have reduced the number of deaths to 100 per year, but in 1996 there were still 200 deaths from this type of cancer . This fact demonstrates, firstly, that in general practice, the excellent results gained on the efficacy of new agents only asserted themselves slowly, and secondly, that even after 20 years, the success rates derived from study evaluations on testicular cancer have still not been achieved in practice. Although it is accepted that the results of study evaluation are not representative for the general population, improved treatment strategies that were confirmed as a result of study evaluation have to be implemented more rapidly into general therapy. Quality management will ensure the introduction of results from study evaluation into general practice. It will also ensure continuous progress. Copyright 2001 S. Karger GmbH, Freiburg
UI - 21388453
AU - Tomomasa H; Shimizu H; Sato S; Adachi Y; Ashizawa Y; Kamiyama Y; Okano
TI - Y; Sato M; Yoshii T; Iizumi T; Umeda T; Yazaki T Clinical study of testicular germ cell tumors.
SO - Hinyokika Kiyo 2001 Jun;47(6):389-95
AD - Department of Urology, Teikyo University School of Medicine.
A clinical statistical analysis on 65 patients with 68 testicular germ cell tumors was performed. Thirty-six testes (53.7%) had seminomas and the remainder non-seminomatous germ cell testicular tumors (NSGCTTs). Of the seminomas, 31 (88.6%) were in stage I and the others showed distant metastases at presentation. Of the 32 NSGCTTs, 22 (68.8%) were in stage I. The average ages of the patients with seminomas and NSGCTTs were 40.4 and 29.9 years, respectively. Thirty-nine patients (60.0%) had tumors on the right side, 23 (35.4%) on the left and 3 (4.6%) in both testes. Five patients had a past history of cryptorchidism. Chief complaints in 49 patients (73.1%) were a painless scrotal mass. The interval from clinical onset to presentation was longer in seminoma patients than in NSGCTT patients (10.9 months on average versus 3.4 months). Immunosuppressive acidic protein (IAP) was a useful diagnostic tumor marker as well as alpha-feto protein (AFP), beta-human chorionic gonadotropin (beta-hCG) and lactic dehydrogenase (LDH). We adopted a surveillance policy in more than half of the stage I patients and obtained acceptable results. In the remaining cases, therapies including combination chemotherapy, radiation and salvage operation were performed after orchiectomy. The three-year survival rate was 98.0, 100.0 and 26.7%, for stage I, II and III patients respectively.
UI - 21388454
AU - Okamura K; Mizutani K; Hattori R; Gotoh M; Ono Y; Ohshima S
TI - [Peripheral blood stem cell harvest for patients with germ cell tumors]
SO - Hinyokika Kiyo 2001 Jun;47(6):397-403
AD - Department of Urology, Nagoya University School of Medicine. tumors underwent peripheral blood stem cell harvest during 15 courses of bleomycin, etoposide, cisplatin (BEP), 4 courses of etoposide, ifosfamide, cisplatin (VIP) and 3 courses of high-dose etoposide mobilization at Nagoya University Hospital. We performed 29 aphereses during BEP, eight during VIP, and six during high-dose etoposide. Although we were able to harvest 4.4 x 10(6)/kg of median CD34 positive cells per apheresis during BEP, the number of stem cells (more than 4 x 10(6)/kg of CD34 positive cells), which are needed for tandem high-dose chemotherapy, could not be obtained during four courses of BEP. For three patients in whom white blood cell counts at nadir were 2,000/microL or more, however, the required number of CD34 positive cells were harvested. VIP provided only 1.7 x 10(6)/kg of median CD34 positive cells per apheresis, while, 7.3 x 10(6)/kg of CD34 positive cells were harvested during high-dose etoposide mobilization. The dose of G-CSF was a significant factor for the number of CD34 positive cells harvested during BEP (p = 0.02); however, there might be some relationship between the harvest and the number of the peripheral white blood cells on the day of apheresis (p = 0.08), the day to start G-CSF (p = 0.13), or the day to initiate apheresis (p = 0.27). Based on our experience, it is recommended that 5 micrograms/kg of G-CSF should be started from the 14th or 15th day of BEP until the last apheresis and that aphereses should be performed between the 19th and 21st day, especially at the days when the peripheral white blood cell count increases beyond 10,000/microL.
UI - 21388462
AU - Uemura M; Nishimura K; Hirai T; Inoue H; Mizutani S; Miyoshi S;
TI - Tsujihata M [Undescended testicular tumor found by torsion of the testis: a case report]
SO - Hinyokika Kiyo 2001 Jun;47(6):437-9
AD - Department of Urology, Osaka Rosai Hospital.
A 37-year-old man was admitted with a painful mass in his left inguinal region. He had an undescended testis on the left side. Six months earlier, he had noted that his left inguinal testis was larger, and he had suddenly developed pain in the left inguinal region. The levels of AFP, hCG beta and LDH were normal. We diagnosed a left undescended testicular tumor and torsion of the left testis. Left inguinal high orchiectomy showed a torsion of the left testis and histopathological examination of the specimen revealed seminoma.
UI - 21377750
AU - Schrey A; Reiter WJ; Kratzik C
TI - [Value of ultrasound in microlithiasis of the testis in andrological patients]
SO - Ultraschall Med 2001 Jun;22(3):143-5
AD - Urologische Abteilung, Universitat Wien.
PURPOSE: The objective of this retrospective study is to show the importance of sonography in andrological patients with testicular microlithiasis (TM). PATIENTS AND METHODS: 1314 male patients were seen to our andrological clinic in the course of one year. The age range of these patients was 25 to 39 years (mean age 32 years). All patients underwent testicular sonography as well as a sperm-analysis. RESULTS: 284 patients showed normozoospermia without any evidence of TM. Of the remaining 1030 patients with a pathological spermiogram, 8 were shown to display more than 10 echogenic foci per transducer field in both tests. 1 patient suffering from an already palpable testicular tumor only showed, unilateral, unifocal calcification. Another patient who had suffered from a maldescensus testicle in his early childhood discharged only one unifocal calcification. Tumor markers including AFP and beta-HCG were normal in 9 patients, but elevated in 1 patient suffering from a testicular tumor (AFP: 73 kU/l; beta-HCG: 10.6 U/l). The hormonal status was normal in 6 patients and pathological 4 patients with the diagnosis of OAT-syndrome. CONCLUSION: TM is a rare condition even in andrological patients. Nevertheless, a thorough scrotal sonography is mandatory in order to rule out testicular malignancy.
UI - 21385661
AU - Skotheim RI; Kraggerud SM; Fossa SD; Stenwig AE; Gedde-Dahl T Jr;
TI - Danielsen HE; Jakobsen KS; Lothe RA Familial/bilateral and sporadic testicular germ cell tumors show frequent genetic changes at loci with suggestive linkage evidence.
SO - Neoplasia 2001 May-Jun;3(3):196-203
AD - Department of Genetics, Institute for Cancer Research, The Norwegian Radium Hospital, Montebello, Oslo N-0310, Norway.
Testicular germ cell tumor (TGCT) is the most common tumor type among adolescent and young adult males. Familial clustering and bilateral disease are suggestive of a genetic predisposition among a subgroup of these patients, but susceptibility genes for testicular cancer have not yet been identified. However, suggestive linkage between disease and genetic markers has been reported at loci on chromosome arms 3q, 5q, 12q, 18q, and Xq. We have analyzed primary familial/bilateral (n=20) and sporadic (n=27) TGCTs, including 28 seminomas and 19 nonseminomas, for allelic imbalance (AI) within the autosomal regions. DNA from all tumors were analyzed by fluorescent polymerase chain reaction of 22 polymorphic loci at 3q27-ter, 5q13-35.1, 12q21-ter, and 18q12--ter. All tumor genotypes were evaluated against their corresponding constitutional genotypes. The percentages of TGCTs with genetic changes at 3q, 5q, 12q, and 18q, were 79%, 36%, 53% and 43%, respectively. The frequencies at 3q and 12q in nonseminomas were significantly higher than in seminomas (P=.003 and P=.004). In order to evaluate changes at hemizygous Xq loci, five loci were analyzed by co-amplification with an autosomal reference marker known to reveal retained heterozygosity in the tumor DNA. Gain of Xq sequences was seen in more than 50% of the tumors. The degree of amplification varied among the loci in each of five tumors, and based on these breakpoints, a common region of overlapping gains was found at Xq28. No significant differences were found between the frequencies of genetic changes in familial/bilateral versus sporadic tumors, an observation speaking in disfavor of the existence of a single susceptibility gene for TGCT in any of the analyzed regions. Our data suggest that gain of genetic material at distal Xq and losses at 5q and 18q contribute to establishment of seminomas, whereas imbalances at 3q as well as gain at distal part of 12q are associated with further progression into nonseminomas.
UI - 21414852
AU - Suzuki K; Tokue A
TI - [Serum CA19-9 levels in testicular germ cell tumor patients]
SO - Hinyokika Kiyo 2001 Jul;47(7):467-72
AD - Department of Urology, Jichi Medical School.
This study was designed to examine whether measurement of serum CA19-9 was useful in testicular germ cell tumor patients. We analyzed the clinical courses of 55 testicular germ cell tumor cases diagnosed after high orchiectomy. The patients in this study consisted of 33 seminomas and 22 non-seminomatous germ cell tumors (NSGCT), and their mean age was 32.7 +/- 12.7 years (mean +/- SD). The mean follow-up period after the operation was 33.7 months. The positive rate of the pre-treatment serum CA19-9 level was 16.4% (3.0% in seminomas versus 36.4% in NSGCT, p = 0.0017). The pre-treatment serum CA19-9 levels in NSGCT patients were significantly higher than those in seminoma patients (46.6 +/- 50.0 U/ml versus 10.6 +/- 9.6 U/ml, p = 0.0008). We divided the patients into two groups according to the detailed histological types, and found that the serum CA19-9 levels in the patients with embryonal carcinoma (EC) were significantly higher than in those without EC (p = 0.0160), and the levels in those with yolk sac tumor (YS) were higher than in those without YS (p = 0.0099). Moreover, the levels in those with either EC or YS were significantly higher than in those with neither EC nor YS (p = 0.0004). In 9 patients with a high serum pre-treatment CA19-9 level, the serum CA19-9 level was useful as a monitoring marker through the treatment or tumor progression. On the other hand, the pre-treatment serum CA19-9 level did not correlate with the clinical stage or prognosis. In conclusion, the phenomenon that the serum levels of CA19-9 increase in testicular germ cell tumor patients is not extremely rare, and in NSGCT, especially in EC or YS, the serum CA19-9 can be a useful tumor marker.
UI - 21439128
AU - Moroni M; Veronese S; Schiavo R; Carminati O; Sorensen BS; Gambacorta M;
TI - Siena S Epidermal growth factor receptor expression and activation in nonseminomatous germ cell tumors.
SO - Clin Cancer Res 2001 Sep;7(9):2770-5
AD - The Falck Division of Medical Oncology, Department of Oncology and Hematology, Ospedale Niguarda Ca' Granda, I-20162 Milan, Italy. email@example.com
PURPOSE: The goal of this work was to study the expression of epidermal growth factor receptor (by use of monoclonal antibody EGFR 1) and HER-2/neu (by use of monoclonal antibody EGFR 2), as well as EGFR activation [phosphorylated EGFR (P-EGFR)] and autocrine stimulation [ligand transforming growth factor-alpha (TGF-alpha)] markers in a series of 24 testicular tumors [18 nonseminomatous germ cell tumors (GCTs), 1 Leydig cell tumor, and 5 seminomatous GCTs]. EXPERIMENTAL DESIGN: Paraffin-embedded sections of tumors were studied immunohistochemically for beta-human chorionic gonadotropin (beta-HCG), EGFR 1, HER-2/neu, TGF-alpha, and P-EGFR expression. In one case of pure choriocarcinoma, fresh-frozen tumor sections were also evaluated. The presence of EGFR mRNA was studied in the Jar choriocarcinoma cell line using reverse transcription-PCR. RESULTS: Staining for cell membrane EGFR was detected immunohistochemically in the 16 beta-HCG-positive components of 18 nonseminomatous GCTs as well as in the control Jar choriocarcinoma cell line and normal placenta. In contrast, 1 Leydig cell tumor, 5 seminomatous GCTs, and beta-HCG-negative components of 18 GCTs, as well as control B and T lymphoma cell lines, did not express EGFR. Expression of HER-2/neu, TGF-alpha, and P-EGFR was detected in 25, 36, and 27% of EGFR-positive, nonseminomatous GCTs, respectively. EGFR mRNA was detected in the Jar choriocarcinoma cells. CONCLUSIONS: We report data, for the first time, that document EGFR and HER-2/neu expression and indicate EGFR activation and autocrine stimulation in beta-HCG-positive, nonseminomatous GCTs. These findings may be clinically relevant in relation to the recent availability of active EGFR- and HER-2/neu-targeted pharmaceutical agents and to the extensively described negative prognostic significance of beta-HCG expression in mixed GCTs.
UI - 21268707
AU - Kollmannsberger C; Mayer F; Kuczyk M; Kanz L; Bokemeyer C
TI - Treatment of patients with metastatic germ cell tumors relapsing after high-dose chemotherapy.
SO - World J Urol 2001 Apr;19(2):120-5
AD - Department of Medicine II, University of Tuebingen, Otfried-Mueller-Str. 10, 72076 Tuebingen, Germany.
With the use of cisplatin-based combination chemotherapy, metastatic testicular germ cell tumors can be cured in 70-80% of patients. Patients refractory to cisplatin-based chemotherapy have a very poor prognosis. Several mechanisms have been discussed for the development of platinum resistance such as a decreased intracellular concentration of the drug, increased repair of the drug induced damage, or an altered apoptotic response to this damage. Various chemotherapeutic agents have been evaluated in intensively pretreated or cisplatin-refractory patients. Neither the antracyclines nor vinorelbine, bendamustine, topotecan, nor biological agents such as suramin and retinoic acid have demonstrated clinical activity. Paclitaxel has been evaluated at different doses and schedules and yielded a response rate of 21% (range 11-30%) with individual patients achieving complete remissions. This has led to the inclusion of paclitaxel in salvage regimens in combination with cisplatin and/or ifosfamide. Two recent studies have evaluated gemcitabine in refractory germ cell tumors, demonstrating a response rate of 17% (95% CI: 7-28%) in 52 intensively pretreated patients, two-thirds of whom had relapsed after previous high-dose chemotherapy plus autologous stem cell transplantation. The nonhematologic toxicity of weekly gemcitabine at doses of 1000-1250 mg/m2 was tolerable and hematologic side effects included thrombocytopenia in approximately 20% of patients. Ongoing studies in refractory germ cell tumors performed by the German Testicular Cancer Study Group (GTCSG) are evaluating oxaliplatin, a platinum derivative with incomplete cross-resistance to cisplatin. Future trials combining new active agents may make it possible to test the use of alternating treatment strategies in patients with "poor prognostic" disease or as salvage treatment. It is hoped that the increase in knowledge of the molecular mechanism of testicular cancer may lead to the development of new therapeutic options.
UI - 21268701
AU - Albers P; Perabo FG; Melchior D; Siener R
TI - Adjuvant chemotherapy in stage I and stage II testicular cancer.
SO - World J Urol 2001 Apr;19(2):76-81
AD - Department of Urology, Bonn University, 53105 Bonn, Germany. firstname.lastname@example.org
Adjuvant chemotherapy in low-stage testis cancer is an accepted treatment option for two clinical situations: (1) chemotherapy after complete removal of the primary tumor by orchidectomy without clinical evidence of metastasis (clinical stage I), and (2) chemotherapy after complete surgical removal of non-seminomatous retroperitoneal metastases up to 5 cm in greatest transverse diameter by retroperitoneal lymph node dissection in clinical stage II. Aim of treatment is the prevention of tumor recurrences. The risk of recurrence depends on the type and stage of disease and ranges from 16% (clinical stage I seminoma) to 50% (pathological stage II B non-seminoma). Thus, 50-84% of patients receive adjuvant treatment unnecessarily. Prognostic factors have been developed in each tumor entity to tailor treatment to patients with high risk of recurrence.
UI - 21268702
AU - Nichols CR
TI - Chemotherapy of disseminated germ cell tumors.
SO - World J Urol 2001 Apr;19(2):82-9
AD - Oregon Health Sciences University, 3181 SW Sam Jackson Park Road, OP-28, Portland, Oregon, USA, 97201.
The fact that germ cell tumors can be successfully managed puts an extraordinary burden on the physician and health care system to ensure that the promise of cure is achieved in all patients except the small proportion that present with advanced refractory disease. Good risk disseminated disease should be treated with three cycles of bleomycin, etoposide and cisplatin (BEP) whereas those with more advanced disease should receive four cycles. Postchemotherapy resection of residual disease is commonly required. In patients in whom disease recurs after primary chemotherapy, salvage treatments can result in cure in 30-40% of patients. Physicians managing these patients should be aware of some of the pitfalls encountered when determining relapse and should be versed in the indications for salvage conventional dose chemotherapy, high dose chemotherapy, and the role of aggressive desperation surgery.
UI - 21268703
AU - Beyer J; Rick O; Siegert W; Bokemeyer C
TI - Salvage chemotherapy in relapsed germ cell tumors.
SO - World J Urol 2001 Apr;19(2):90-3
AD - Department of Hematology and Oncology, Philipps Universitat Marburg, Baldinger Strasse, 35033 Marburg, Germany. email@example.com
Issues concerning the optimal salvage treatment in patients with germ cell tumors are for the most part controversial. As the majority of patients will suffer systemic relapses, chemotherapy will remain the mainstay of any salvage treatment. However, the question of whether to use conventional-dose or high-dose chemotherapy (HDCT) immediately arises. Prognostic factors have recently been recognized as an aid in this decision. However, as reliable data are lacking for many clinical scenarios, the salvage treatment of germ-cell tumors continues to be a therapeutic challenge.
UI - 21268020
AU - Slowikowska-Hilczer J; Walczak-Jedrzejowska R; Kula K
TI - Immunohistochemical diagnosis of preinvasive germ cell cancer of the testis.
SO - Folia Histochem Cytobiol 2001;39(2):67-72
AD - Department of Andrology and Reproductive Endocrinology, Institute of Endocrinology, Medical University, Lodz, Poland.
The aim of the study was to identify testicular carcinoma in situ (CIS), a precursor of germ cell tumours (GCT), in patients from the high risk groups, using classic and alternative immunohistochemical methods. 70 patients with 46,XY karyotype were examined. Whole gonads or biopsy specimens were fixed in Bouin's fluid. In cases with dysgenetic male pseudohermaphroditism (DMP), gross histopathology revealed sex cord tumour gonadoblastoma in 4 and malignant dysgerminoma in 1 out of 23 patients. In all patients, paraffin sections were treated with antibodies against placental-like alkaline phosphatase (PLAP), a classic immunohistochemical marker of GCT and CIS. CIS was detected immunohistochemically in 10 out of 23 cases with DMP (43.5%), in 1 out of 10 cases with androgen insensitivity syndrome (10%), in 3 out of 18 cases operated previously because of already developed GCT in contralateral testis (16.6%) and in 1 out of 3 patients with cryptorchidism in anamnesis (33.3%). CIS was not found in 16 examined adult infertile men with azoospermia. In addition to PLAP investigation, 12 cases with DMP and 6 cases with GCT were examined using M2A and TRA-1-60 antibodies, the alternative immunohistochemical markers of CIS. While in DMP positive reactions for M2A and TRA-1-60 accompanied PLAP reaction in 1/3 of cases, M2A accompanied PLAP in all cases with GCT. The positive reaction for TRA-1-60 accompanied PLAP and M2A in 1 case with GCT. The results indicate that among different risk groups the highest incidence of CIS occurs in DMP. Screening for CIS is of importance also in cryptorchidism, androgen insensitivity syndrome and in men who underwent gonadectomy because of unilateral GCT. The immunostaining for PLAP seems to be more discriminative procedure. The positive staining of CIS cells with M2A and TRA-1-60 antibodies may be indicative for more advanced neoplastic transformation.
UI - 21384903
AU - Witjes JA; Spermon JR
TI - Prognostic factors in clinical stage 1 non-seminomatous testicular tumours.
SO - Curr Opin Urol 2001 Sep;11(5):531-4
AD - Department of Urology, University Medical Center St Radboud, Nijmegen, The Netherlands. firstname.lastname@example.org
For patients with a clinical stage 1 non-seminomatous germ cell tumour of the testis cure rates should be close to 100%, whether surveillance, primary surgery, primary chemotherapy or a combination is chosen. The identification of patients with microscopic metastases is difficult. Even with the best predictive factors currently available (vascular invasion and percentage embryonal cell carcinoma in the primary tumour), the identification of micro-metastases is no better than the flip of a coin. Several additional prognostic factors have been studied, but none is yet applicable in daily practice.
UI - 21455681
AU - Ono Y; De-Meyts ER; Guellaen G; Bulle F
TI - Sporadic testicular germ cell cancers do not exhibit specific alteration in CAG/CTG repeats containing genes expressed in human testis.
SO - Oncogene 2001 Sep 6;20(39):5548-53
AD - Unite 99 INSERM, Hopital Henri Mondor, 94010 Creteil, France.
CAG/CTG repeat expansions in genomic DNA of testicular tumour cell lines, and germline DNA from members of families predisposed to this malignancy, have been previously described. In order to identify genes possibly concerned by this alteration, we attempted to clone all possible human testis cDNA containing at least five CAG/CTG repeats. Thirty-four different transcripts were identified. By using PCR and non denaturing gel electrophoresis, we determined the size of their repeats, as well as their polymorphisms in a collection of human testicular germ cell tumours and the normal surrounding tissues. For all tested genes, we detected the presence of several species of the same mRNA for each person. Nine genes exhibited specific patterns of expression among different groups of individuals, indicative of polymorphism. None of these polymorphisms was related to human testicular tumours.
UI - 20253605
AU - Tekin A; Aygun YC; Aki FT; Ozen H
TI - Bilateral germ cell cancer of the testis: a report of 11 patients with a long-term follow-up.
SO - BJU Int 2000 May;85(7):864-8
AD - Department of Urology, School of Medicine, Hacettepe University, Ankara, Turkey.
OBJECTIVE: To describe the incidence, clinical characteristics, treatment methods and long-term follow-up of bilateral germ cell tumours of the testis (GCTT) in patients treated at one institution. PATIENTS AND METHODS: Of 552 patients with GCTT, 11 (2%, mean age 26. 9 years) developed bilateral disease; all 11 underwent radical orchidectomy. Additional treatment was planned according to the histological type and clinical stage of the tumour, and previous treatments. Intramuscular testosterone was administered periodically after total castration. The data on survival, sexual status and treatment complications were reviewed. RESULTS: Of the 11 patients, seven developed a second tumour metachronously (median interval 87 months) and four had synchronous bilateral GCTT. Cryptorchidism, infertility or atrophic testis was associated with the development of bilateral GCTT in seven of the 11 patients. All synchronous tumours and most of the sequential tumours had identical histology on both sides. Although all sequential tumours presented at an early clinical stage, three of four synchronous bilateral GCTTs presented at an advanced stage. Five patients received platinum-based chemotherapy; three patients underwent post- chemotherapy resection of the retroperitoneal residual mass. Sexual libido and potency were conserved in all patients. No significant morbidity was recorded as being caused by any of these treatments. At a median follow-up of 11. 6 years, all patients were alive with no evidence of cancer. CONCLUSIONS: All patients with unilateral GCTT have an increased risk of developing a contralateral testicular tumour, even decades after diagnosis. Management should be adapted to each patient. As all patients in this series survived in the long-term, developing a second germ cell cancer does not necessarily predict a poor prognosis.
UI - 21119554
AU - Heidenreich A; Weissbach L; German Testicular Cancer Intergroup
TI - Bilateral germ cell cancer of the testis: a report of 11 patients with a long-term follow-up.
SO - BJU Int 2001 Feb;87(3):278-80
UI - 21287672
AU - Janetschek G; Peschel R; Hobisch A; Bartsch G
TI - Laparoscopic retroperitoneal lymph node dissection.
SO - J Endourol 2001 May;15(4):449-53; discussion 453-5
AD - Department of Urology, University of Innsbruck, Austria.
PURPOSE: Retroperitoneal lymph node dissection is the most sensitive and specific diagnostic modality for detecting occult lymph node metastases in clinical stage I testicular tumor. In stage II disease, residual tumors after chemotherapy have to be removed surgically. To reduce the morbidity of these procedures we have replaced open surgery by 125 patients underwent laparoscopic RPLND (stage I: 76 pts., stage II: 49 pts.) RESULTS: Laparoscopic RPLND could be completed as planned in all but two patients in whom bleeding required conversion to open surgery. Once the learning curve had been overcome, mean operative time decreased significantly from 476 to 219 min for stage I and averaged 226 min in stage IIB disease. Only minor postoperative complications occurred such as asymptomatic lymphoceles (7 pts.) and chylous ascites (6 pts.). Mean post-op hospital stay was 3.3 and 3.5 days, respectively (stages I and II). Mean followup is currently 46 months for stage I and 35 months for stage II tumors. Over this period a single retroperitoneal recurrence was observed (stage I), which, however, was not due to surgical failure, but to false negative histologic findings. All other patients have remained free of relapse. CONCLUSIONS: Laparoscopic RPLND is a demanding procedure with a long and steep learning curve. It has proved feasible also after chemotherapy. The diagnostic accuracy of laparoscopic RPLND was as good as that of the open procedure, while the morbidity is significantly lower. Tumor control was not compromised by the laparoscopic approach.
UI - 21318320
AU - Incarbone GP; Poletti F; Salsi P; Sebastio N; Cortellini P; Gabrielli M;
TI - Crafa P [Report of 2 cases extragonadal germ cell neoplasia with primary burnt out tumor of the testis]
SO - Acta Biomed Ateneo Parmense 2000;71(1-2):53-7
AD - Divisione di Urologia, Azienda Ospedaliera di Parma.
If the histogenesis of the extragonadal germ cell tumor is a still debatable subject, its clinical diagnosis remains a question of no immediate solution. In fact, only the keen histologic evaluation of microfocuses and/or scar tissue in the testis, possibly on the guide of US finding, could give the answer about the primitiveness or not of the extragonadal neoplasia. Which implies, of course, some problems of compliance on the part of young locally symptomless men, especially on the ground of possibly bilateral involvement.
UI - 21456675
AU - Wittekind C; Loy V
TI - [Pathology and pathomorphologic diagnosis of germ cell tumors of the testis]
SO - Pathologe 2001 Sep;22(5):316-25
AD - Institut fur Pathologie, Universitatsklinikum Leipzig, Liebigstrasse 26, 04103 Leipzig. email@example.com
Testicular germ cell tumors are rare and comprise about 90% of all testis tumors. Genetic factors may play a role in the pathogenesis as can be deduced by a higher family-linked incidence and the p53 gene seems to be important in the development of these tumors which derive from a malignant transformed germ cell. Testicular intraepithelial neoplasia (TIN) may differentiate in two directions, namely into seminomas which comprise nearly 50% of all testicular germ cell tumors and non-seminomas. Since the term "differentiated teratoma" may be misleading, we propose the use of the term "teratoma" only. A preoperative diagnosis by biopsy is not indicated. An exact postoperative diagnosis including all necessary classifications, particularly the WHO and the TNM classifications, requires a very careful preparation of the resected specimen. The histological diagnosis should list all the different types of the WHO classification and the percentage of the tumor should be indicated, at least for embryonal carcinomas. For T categorisation in the TNM classification, the presence of invasion of veins or lymph vessels is important. Documentation, preferably in the form of a standard checklist, is strongly recommended.
UI - 21467940
AU - Danikas D; Sachs R; Dressner RM; Arvanitis ML
TI - Testicular metastasis from ileal carcinoid: report of a case.
SO - Dis Colon Rectum 2001 Sep;44(9):1365-6
AD - Department of Surgery, Monmouth Medical Center, Long Branch, New Jersey, USA.
PURPOSE: This report presents a patient with testicular metastasis from an ileal carcinoid. METHODS: This was a retrospective case review with literature review. RESULTS: The patient underwent right orchiectomy for a solid mass. Pathology revealed carcinoid tumor. Octreotide scan showed increased concentration in the right lower quadrant of the abdomen. Computerized tomography results were negative. Colonoscopy with biopsy revealed carcinoid of the terminal ileum. The patient underwent an elective resection of the terminal ileum and the right colon. Pathology revealed carcinoid tumor with vascular and lymphatic invasion present, and eight lymph nodes were positive. The patient had adjuvant treatment with octreotide. CONCLUSION: Carcinoid tumors have been reported to metastasize to numerous areas. This is the first report of testicular metastasis from ileal carcinoid. Primary carcinoids of the testicle have been reported also. The clinician should be aware of this rare metastatic event. When pathology reveals carcinoid of the testicle, metastatic disease should be excluded before the tumor is identified as primary.
UI - 21473607
AU - Molto Marhuenda J; Mora Rufete A; Gonzalvez Gasch A; Sanchez Sevillano
TI - A; Lopez Menendez V; Martin Hidalgo A [Leydig cell tumor, gynecomastia, and inferior vena cava thrombosis]
SO - An Med Interna 2001 Aug;18(8):432-4
AD - Servicios de Medicina Interna, Hospital General Universitario de Elche, Alicante.
Leydig cell tumor is a testicular tumor with a low incidence characterized by a high estrogens secretion from the tumoral cells. Its more frequent clinical presentation is a testicular nodule with or without other endocrine manifestations due to estrogenic hypersecretion. We're reporting a case of a Leydig cell tumor with high plasmatic levels of estradiol, gynecomastia and inferior cava vein thrombosis, which hasn't been described among its clinical features up to now. Vascular thrombotic phenomenons have already been reported in other clinical situations with hiperestrogesism and they could also be associated with these tumors. Patients with Leydig cell tumors could be at a higher risk of developing thromboembolic phenomenons because of tumoral hyperestrogenism and could present thrombotic complications among the clinical findings.
UI - 21426708
AU - Jain M; Aiyer HM; Bajaj P; Dhar S
TI - Intracytoplasmic and intranuclear Reinke's crystals in a testicular Leydig-cell tumor diagnosed by fine-needle aspiration cytology: a case report with review of the literature.
SO - Diagn Cytopathol 2001 Sep;25(3):162-4
AD - Department of Pathology, Lady Hardinge Medical College and S.K. Hospital, New Delhi, India.
We report on the cytopathologic findings of a Leydig-cell tumor of the testis in a young adult male with no evidence of endocrine dysfunction. The preoperative diagnosis was based on fine-needle aspiration cytology (FNAC) alone, which was subsequently confirmed on histopathology. The present case was of interest on account of the paucity of literature regarding the cytodiagnosis of this lesion. In addition, the finding of intracytoplasmic lipofuscin pigment and several intracytoplasmic as well as intranuclear Reinke's crystals served to clinch the diagnosis on FNA. Therefore, the use of FNAC, especially in the presence of diagnostic Reinke's crystals, may vitiate the need for more invasive biopsy procedures in the preoperative diagnosis of testicular Leydig-cell tumors. Copyright 2001 Wiley-Liss, Inc.
UI - 99398922
AU - Lane TM; Wilde M; Schofield J; Trotter GA
TI - Benign cystic mesothelioma of the tunica vaginalis.
SO - BJU Int 1999 Sep;84(4):533-4
AD - Departments of Surgery and Cellular Pathology, The Maidstone Hospital, Kent, UK.
UI - 97054309
AU - Foley SJ; De Winter P; McFarlane JP; Shah PJ; Bahadur G
TI - Storage of sperm and embryos. Cryopreservation of sperm should be offered to men with testicular cancer.
SO - BMJ 1996 Oct 26;313(7064):1078
UI - 21269963
AU - Bajdik CD; Phillips N; Huchcroft S; Hill GB; Gallagher RP
TI - Cancer in the mothers and siblings of testicular cancer patients.
SO - Can J Urol 2001 Apr;8(2):1229-33
AD - Cancer Control Research, British Columbia Cancer Agency, Vancouver, BC, Canada.
Some families seem to have an increased risk of several different cancers and a reduced risk of others. Either genetic predisposition or a shared environment may explain this familial clustering, and the type of cause can affect how family members should be advised. We used data from a case-control study to examine the risk of cancer in the mother, sisters and brothers of men with testicular cancer. Our results show a significant relative risk (RR=1.7; 95% confidence interval (CI): 1.05-2.6) of cancer for sisters of testicular cancer patients in comparison with the sisters of controls. When data were combined for brothers and sisters, the RR for all cancers was 1.53 (CI: 1.1-2.3). Despite the limitations of our data, there is evidence for cancer clustering in the families of testicular cancer patients. Unfortunately, the evidence is consistent with either a genetic or environmental etiology.
UI - 21269964
AU - Lo KC; Wong C; Emond J; Aprikian AG
TI - Scrotal orchiectomy for a large testicular seminoma.
SO - Can J Urol 2001 Apr;8(2):1234-6
AD - Department of Urology, Montreal General Hospital, McGill University Health Centre, Montreal, Quebec, Canada.
Our patient had neglected a growing left testicular mass over a 5-year period. Due to the large size of the tumor a scrotal delivery was necessary. Pathology showed a 1.6 kg pure classic seminoma. Metastatic work up revealed stage IIC disease and he was treated with primary cisplatin-based chemotherapy and remains free of recurrence after 24 months. The potential risk of scrotal violation is discussed.
UI - 21279588
AU - Augustin H; Schips L; Vilits P; Zigeuner R; Petritsch HP; Uggowitzer M;
TI - Hubmer G Handicap of walking by a huge paratesticular liposarcoma.
SO - Urol Int 2001;66(4):229-30
AD - Department of Urology, Karl Franzens University, Graz, Austria. firstname.lastname@example.org
We describe the case of a 71-year-old male with a huge left-sided paratesticular tumour, whose walking was increasingly handicapped by this vast mass. Two palliative excisions of tumour tissue were performed. Histology revealed a poorly differentiated paratesticular liposarcoma. The patient achieved satisfying mobility for several months before he died of cachexia. Copyright 2001 S. Karger AG, Basel
UI - 21291612
AU - Arranz Arija JA; Garcia del Muro X; Guma J; Aparicio J; Salazar R; Saenz
TI - A; Carles J; Sanchez M; Germa-Lluch JR E400P in advanced seminoma of good prognosis according to the international germ cell cancer collaborative group (IGCCCG) classification: the Spanish Germ Cell Cancer Group experience.
SO - Ann Oncol 2001 Apr;12(4):487-91
AD - Hospital Gregorio Maranon, Madrid, Spain.
PURPOSE: To evaluate the efficacy and toxicity of primary chemotherapy with the schedule E400P in the treatment of patients with early stage II (IIa and IIb) and advanced seminoma of good prognosis according to the international classification (IGCCCG). PATIENTS AND METHODS: Sixty-four patients were included. E400P consisted of cisplatin 25 mg/m2/day and etoposide 100 mg/m2/day for four days, every three weeks. Royal Marsden stages were IIab: 53% and IIc-IV: 47%. Twenty-three percent had high BHCG levels, twenty-seven percent had LDH > 2 x N. Sixty-two patients were of good prognosis according to the Medical Research Council classification. RESULTS: Response rate was 98% (69% complete remission, 29% residual disease). After a median follow-up of 34 months, treatment failure was seen in 7 patients (11%). Neutropenia (32%) was the most relevant grade 3-4 toxicity. Other important grade 3-4 side effects were found in less than 5%. Three-year time to treatment failure (TTF) was 89% (95% confidence intervals (CI): 80%-97%) for all patients, 91% (95% CI: 80%-99%) for stages IIa-b, and 87% (95% CI: 74%-99%) for stages IIc-IV. Three-year overall survival (OS) was 97% (95% CI: 93%-99%) for all patients and 95% (95% CI: 85%-99%) for stages IIa-b. CONCLUSIONS: E400P was a very active and safe regimen in good-prognosis advanced seminoma, with low toxicity rates. Definitive comparisons of this regimen with radiotherapy in stages IIa-b or with the more standard E500P or BEP, could be of interest.
UI - 21481156
AU - Bates MN; Fawcett J; Garrett N; Arnold R; Pearce N; Woodward A
TI - Is testicular cancer an occupational disease of fire fighters?
SO - Am J Ind Med 2001 Sep;40(3):263-70
AD - Institute of Environmental Science and Research Ltd., Kenepuru Science Centre, PO Box 50-348, Porirua, New Zealand. email@example.com
BACKGROUND: A previous investigation showed an increased risk of testicular cancer among fire fighters in Wellington City, New Zealand, during the 1980s. Other studies of fire fighters had not identified testicular cancer as an occupational disease. METHODS: This was an historical cohort study of mortality and cancer incidence in all paid New Zealand fire fighters, from 1977 to 1995. RESULTS: The only cancer for which this study provided evidence of an increased risk was testicular cancer, even after excluding cases from the previous investigation. The standardized incidence ratio for 1990-96 was 3.0 (95% confidence interval: 1.3-5.90). There was no evidence that fire fighters were at increased risk from any particular cause of death. CONCLUSIONS: This study confirmed that New Zealand fire fighters are at increased risk of testicular cancer, although the reason is unknown. Other incidence studies of cancer in fire fighters are needed to confirm this finding. Copyright 2001 Wiley-Liss, Inc.
UI - 21477282
AU - Bartkova J; Falck J; Rajpert-De Meyts E; Skakkebaek NE; Lukas J; Bartek
TI - J Chk2 tumour suppressor protein in human spermatogenesis and testicular germ-cell tumours.
SO - Oncogene 2001 Sep 13;20(41):5897-902
AD - Danish Cancer Society, Institute of Cancer Biology, Strandboulevarden 49, DK-2100 Copenhagen O, Denmark.
Chk2 is a transducer of DNA damage signals and a tumour suppressor whose germ-line mutations predispose to diverse tumour types. Unlike its downstream targets such as the p53 tumour suppressor, the expression patterns of Chk2 in tissues and tumours remain unknown. As DNA breaks occur commonly during gametogenesis, and p53 is wild-type and overexpressed in testicular cancer, we examined abundance and localisation of the Chk2 protein during normal development of human testes, and at various stages of germ-cell tumour (GCT) pathogenesis. Our results show that Chk2 is abundant in foetal germ cells and adult spermatogonia, yet only weakly expressed or lacking during the meiotic and later stages of spermatogenesis. High levels of Chk2 are detected in the majority of GCTs including all pre-invasive carcinoma-in-situ lesions, contrary to variable e