Spermatocytic Seminoma:

Sarcomatoid Spermatocytic Tumour: Report of a Rare Case and Literature Review

Spermatocytic tumour (ST) accounts for 1% of testicular germ cell tumours. It is an indolent neoplasm with good prognosis. In approximately 6% of STs, sarcomatous dedifferentiation may occur, portending an aggressive behaviour and representing a significant diagnostic challenge that can lead to its misdiagnosis. Herein, we report the clinicopathological features of a patient with a sarcomatoid spermatocytic tumor, initially diagnosed as mixed germ cell tumour, who was referred to our institution with lung metastases mainly composed of rhabdomyosarcomatous elements. This case report illustrates the importance of recognizing this entity for adequate management of these patients.

Spermatocytic seminoma with sarcoma: an indication for adjuvant chemotherapy in localized disease

Spermatocytic seminoma (SCS) with sarcoma is an extremely rare testicular tumor with only 11 cases previously described in the literature. We present the 12th case of SCS with sarcoma in a 29-year-old male. SCS itself is an uncommon germ cell tumor with a relatively indolent clinical course that mostly affects males around the fifth decade of life. Sarcomatous differentiation of SCS occurs in 5% to 6% of cases and correlates with a higher possibility of metastatic disease and a poor prognosis. Clinically, this tumor manifests as a slow-growing testicular mass often with an accelerated period of secondary growth. After a concise review of the literature, we conclude that SCS with sarcoma should be treated by radical inguinal orchidectomy with strong consideration given to adjuvant chemotherapy.

Anaplastic variant of spermatocytic seminoma

We report a case of a 56-year-old male with an anaplastic variant of spermatocytic seminoma of the left testis. Grossly, the tumor measured 10 x 7.5 x 6.5 cm and consisted of soft grayish-white tissue, which varied from fleshy to gelatinous with formation of some pseudocysts. Histologically, the tumor was composed of the areas of typical spermatocytic seminoma; however, in some areas, the intermediate and large tumor cells showed prominent nucleoli. In another part of the tumor, we noted anaplastic areas composed of sheets of tumor cells with large vesicular nuclei and prominent nucleoli. Tunical and vascular invasion as well as growth into the epididymis were noted. Immunohistochemically, the tumor cells showed only weak positivity for CD117, the other markers examined were negative.