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Chibani H, El Ouardani S, Rezzoug F, Arghal M, Jabi R, Nassira K, Al Jarroudi O, Brahmi SA, Bennani A, Bouziane M, Afqir S. A Rare Case of Retroperitoneal Immature Teratoma in a Young Adult Male: A Case Report From Eastern Morocco. Cureus 2024; 16:e66290. [PMID: 39238734 PMCID: PMC11376427 DOI: 10.7759/cureus.66290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2024] [Indexed: 09/07/2024] Open
Abstract
Teratomas are classified as germ-cell tumors. They occur more frequently in the gonads, but extragonadal localization can also occur. Retroperitoneal teratomas are rare and require multidisciplinary management. We report the case of a 20-year-old patient who presented with an immature retroperitoneal teratoma. The patient initially underwent a retroperitoneal mass resection, which resulted in positive resection margins and a residual mass observed in post-operative imaging, necessitating treatment with platinum-based chemotherapy. The purpose of this publication is to highlight the characteristics of retroperitoneal teratoma, along with diagnostic criteria and treatment approaches.
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Affiliation(s)
- Hind Chibani
- Medical Oncology, Mohammed VI University Hospital, Oujda, MAR
- Medical Oncology, Faculty of Medicine and Pharmacy of Oujda, Mohammed First University, Oujda, MAR
| | - Soufia El Ouardani
- Medical Oncology, Mohammed VI University Hospital, Oujda, MAR
- Medical Oncology, Faculty of Medicine and Pharmacy of Oujda, Mohammed First University, Oujda, MAR
| | - Fatima Rezzoug
- Medical Oncology, Mohammed VI University Hospital, Oujda, MAR
- Medical Oncology, Faculty of Medicine and Pharmacy of Oujda, Mohammed First University, Oujda, MAR
| | - Mohammed Arghal
- Radiology, Mohammed VI University Hospital, Oujda, MAR
- Radiology, Faculty of Medicine and Pharmacy of Oujda, Mohammed First University, Oujda, MAR
| | - Rachid Jabi
- Visceral Surgery, Mohammed VI University Hospital, Oujda, MAR
- Laboratory of Anatomy, Microsurgery and Surgery Experimental and Medical Simulation (LAMCESM), Faculty of Medicine and Pharmacy of Oujda, Mohammed First University, Oujda, MAR
| | - Karich Nassira
- Pathology, Mohammed VI University Hospital, Oujda, MAR
- Pathology, Faculty of Medicine and Pharmacy of Oujda, Mohammed First University, Oujda, MAR
| | - Ouissam Al Jarroudi
- Medical Oncology, Mohammed VI University Hospital, Oujda, MAR
- Medical Oncology, Faculty of Medicine and Pharmacy of Oujda, Mohammed First University, Oujda, MAR
| | - Sami Aziz Brahmi
- Medical Oncology, Mohammed VI University Hospital, Oujda, MAR
- Medical Oncology, Faculty of Medicine and Pharmacy of Oujda, Mohammed First University, Oujda, MAR
| | - Amal Bennani
- Pathology, Faculty of Medicine and Pharmacy of Oujda, Mohammed First University, Oujda, MAR
| | - Mohammed Bouziane
- Visceral Surgery, Mohammed VI University Hospital, Oujda, MAR
- Laboratory of Anatomy, Microsurgery and Surgery Experimental and Medical Simulation (LAMCESM), Faculty of Medicine and Pharmacy of Oujda, Mohammed First University, Oujda, MAR
| | - Said Afqir
- Medical Oncology, Mohammed VI University Hospital, Oujda, MAR
- Medical Oncology, Faculty of Medicine and Pharmacy of Oujda, Mohammed First University, Oujda, MAR
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Puljak L, Bojcic R, Cikes Botic M, Odak Z, Riva N, Gold VR, Tabone Y, Squizzato A, Calleja-Agius J. Trials of interventions for ovarian and testicular germ cell tumors registered in ClinicalTrials.gov: A cross-sectional study. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2024:108545. [PMID: 39068044 DOI: 10.1016/j.ejso.2024.108545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 07/11/2024] [Indexed: 07/30/2024]
Abstract
INTRODUCTION There is unmet need in the treatment of ovarian and testicular germ cell tumors (GCTs). This study analyzed registered trials of interventions for GCTs. MATERIALS AND METHODS We included trials of interventions for GCTs registered on ClinicalTrials.gov by July 29, 2022. We analyzed their interventions, outcome measures and study design. RESULTS We included 142 trials registrations; 42 (30 %) for ovarian GCTs, 50 (35 %) for testicular GCTs, and 50 (35 %) trials for both. The majority of the trials were completed (56 %) and did not have results available (75 %). Most trials were in Phase 2. Information about the study design were not reported for many analyzed trials. Most trials had a single-group assignment (44 %) and were open-label (68 %). The median planned number of enrolled participants was 43. Most registrations used medicine(s) (87 %), either as a single type of intervention or in combination. The most commonly used type of medicine was chemotherapy (54 %). Primary outcome was not reported in 23 % of registrations, and secondary outcomes were not reported in 35 % of registrations. Overall survival was used in 6 % of registrations as a primary outcome and in 31 % of registrations as a secondary outcome. CONCLUSIONS Few trials on GCTs were registered on ClinicalTrials.gov, and their number was declining in recent times. Most registrations did not report relevant information about the study design, or results if completed. More effort is needed to foster trials on GCTs, as well as to optimize the management of the registrations and foster the publication of research results.
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Affiliation(s)
- Livia Puljak
- Center for Evidence-Based Medicine and Health Care, Catholic University of Croatia, Zagreb, Croatia.
| | | | - Monika Cikes Botic
- Department of Gynecology and Obstetrics, University Hospital of Split, Split, Croatia.
| | - Zdravko Odak
- Department of Gynecology and Obstetrics, University Hospital of Split, Split, Croatia.
| | - Nicoletta Riva
- Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.
| | - Vienna R Gold
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.
| | - Ylenia Tabone
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.
| | | | - Jean Calleja-Agius
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.
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Collins K, Anderson WJ, Hirsch MS, Ulbright TM, Acosta AM. Giant bilateral prepubertal-type teratomas in a postpubertal patient: An illustrative case and review of the literature. Virchows Arch 2024; 485:143-151. [PMID: 38165518 DOI: 10.1007/s00428-023-03723-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/11/2023] [Accepted: 12/16/2023] [Indexed: 01/03/2024]
Abstract
Prepubertal-type teratomas are uncommon, especially in postpubertal male patients. We document a case of a 28-year-old man with a lifelong history of bilateral testicular masses who presented with scrotal fistulas and no clinical evidence of extratesticular disease. Bilateral radical orchiectomies demonstrated large bilateral solid and cystic masses that contained grossly visible hairs. Microscopically, both tumors consisted of pure teratomas comprising a mixture of mature tissues derived from the three embryonic layers. Germ cell neoplasia in situ was not identified, and fluorescence in situ hybridization studies demonstrated the absence of i(12p), supporting a diagnosis of prepubertal-type teratoma. The absence of metastases in this patient with longstanding tumors highlights the benign nature of prepubertal-type teratomas affecting postpubertal patients. Furthermore, this case illustrates that at least a subset of prepubertal-type teratomas seen in adult men represent a late diagnosis of a largely pediatric entity. Additionally, we performed a comprehensive review of the literature on this topic.
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Affiliation(s)
- Katrina Collins
- Department of Pathology, Indiana University School of Medicine, 305 W 11 Street, Room 4080, Indianapolis, IN, 46202, USA
| | - William J Anderson
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Michelle S Hirsch
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Thomas M Ulbright
- Department of Pathology, Indiana University School of Medicine, 305 W 11 Street, Room 4080, Indianapolis, IN, 46202, USA
| | - Andres M Acosta
- Department of Pathology, Indiana University School of Medicine, 305 W 11 Street, Room 4080, Indianapolis, IN, 46202, USA.
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4
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Salzillo C, Imparato A, Fortarezza F, Maniglio S, Lucà S, La Verde M, Serio G, Marzullo A. Gonadal Teratomas: A State-of-the-Art Review in Pathology. Cancers (Basel) 2024; 16:2412. [PMID: 39001474 PMCID: PMC11240729 DOI: 10.3390/cancers16132412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 06/24/2024] [Accepted: 06/28/2024] [Indexed: 07/16/2024] Open
Abstract
Teratomas are neoplasms arising from germ cells and encompass tissues derived from two or more embryonic germ layers, including ectoderm, mesoderm, and endoderm. These tumours typically localize along the midline or in paramedian positions and can manifest as gonadal (20%) or extragonadal (80%) entities. Although gonadal teratomas are uncommon, they represent the predominant type of gonadal tumour in the paediatric population. They comprise approximately 20-25% of all ovarian tumours in females and about 3-5% of all testicular tumours in males. Ovarian teratomas exhibit a higher incidence in early childhood and adolescence, whereas testicular teratomas are more prevalent during the first three months of life and between the ages of 15 and 19. While the majority of paediatric gonadal teratomas are benign, malignant or mixed variants may also arise, necessitating more aggressive therapeutic interventions.
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Affiliation(s)
- Cecilia Salzillo
- Department of Precision and Regenerative Medicine and Ionian Area, Pathology Unit, University of Bari "Aldo Moro", 70121 Bari, Italy
- Department of Experimental Medicine, PhD Course in Public Health, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Amalia Imparato
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Francesco Fortarezza
- Surgical Pathology and Cytopathology Unit, University Hospital of Padova, 35121 Padova, Italy
| | - Sonia Maniglio
- Department of Precision and Regenerative Medicine and Ionian Area, Pathology Unit, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Stefano Lucà
- Department of Experimental Medicine, PhD Course in Public Health, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
- Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Marco La Verde
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy
| | - Gabriella Serio
- Department of Precision and Regenerative Medicine and Ionian Area, Pathology Unit, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Andrea Marzullo
- Department of Precision and Regenerative Medicine and Ionian Area, Pathology Unit, University of Bari "Aldo Moro", 70121 Bari, Italy
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5
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Gagnon MH, Derenoncourt PR, Rayamahi S, Taylor S, Parikh AK, Ponisio MR, Khanna G. Unusual imaging findings associated with abdominal pediatric germ cell tumors. Pediatr Radiol 2024; 54:1093-1104. [PMID: 38462578 DOI: 10.1007/s00247-024-05894-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 02/19/2024] [Accepted: 02/20/2024] [Indexed: 03/12/2024]
Abstract
Germ cell tumors of childhood are tumors arising from germline cells in gonadal or extragonadal locations. Extragonadal germ cell tumors are characteristically located in the midline, arising intracranially or in the mediastinum, retroperitoneum, or pelvis. These tumors are generally easily diagnosed due to typical sites of origin, characteristic imaging findings, and laboratory markers. However, germ cell tumors can be associated with unusual clinical syndromes or imaging features that can perplex the radiologist. This review will illustrate atypical imaging/clinical manifestations and complications of abdominal germ cell tumors in childhood. These features include unusual primary tumors such as multifocal primaries; local complications such as ovarian torsion or ruptured dermoid; atypical presentations of metastatic disease associated with burned-out primary tumor, growing teratoma syndrome, and gliomatosis peritonei; endocrine manifestations such as precocious puberty and hyperthyroidism; and antibody mediated paraneoplastic syndrome such as anti-N-methyl-D-aspartate-receptor antibody-mediated encephalitis. This review aims to illustrate unusual imaging features associated with the primary tumor, metastatic disease, or distant complications of abdominal germ cell tumors of childhood.
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Affiliation(s)
- Marie-Helene Gagnon
- Department of Radiology & Imaging Sciences, Emory University and Children's Healthcare of Atlanta, 1405 Clifton Road NE, Atlanta, GA, 30322, USA.
| | - Paul-Robert Derenoncourt
- Mallinckrodt Institute of Radiology, Washington University in Saint Louis, 510 S Kingshighway Blvd, St. Louis, MO, 63110, USA
| | - Sampanna Rayamahi
- Mallinckrodt Institute of Radiology, Washington University in Saint Louis, 510 S Kingshighway Blvd, St. Louis, MO, 63110, USA
| | - Susan Taylor
- Department of Radiology & Imaging Sciences, Emory University and Children's Healthcare of Atlanta, 1405 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Ashishkumar K Parikh
- Department of Radiology & Imaging Sciences, Emory University and Children's Healthcare of Atlanta, 1405 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Maria R Ponisio
- Mallinckrodt Institute of Radiology, Washington University in Saint Louis, 510 S Kingshighway Blvd, St. Louis, MO, 63110, USA
| | - Geetika Khanna
- Department of Radiology & Imaging Sciences, Emory University and Children's Healthcare of Atlanta, 1405 Clifton Road NE, Atlanta, GA, 30322, USA
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Nagumo T, Yoshii R, Uzuka Y, Hoshino Y, Nakata K, Katayama M, Yamasaki M. Computed tomographic characteristics of testicular teratoma in a cat. Vet Radiol Ultrasound 2024. [PMID: 38706449 DOI: 10.1111/vru.13380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 04/06/2024] [Accepted: 04/22/2024] [Indexed: 05/07/2024] Open
Abstract
A 5-year-old intact male mixed-breed cat weighing 4.5 kg was referred to our hospital with a left testicular mass. CT revealed mild heterogeneous contrast enhancement and calcification in the testicular mass. A well-defined, contrast-enhancing, multiloculated mass with fluid-filled areas was extended from the testicular mass in the scrotum to the caudal aspect of the left kidney. The abdominal mass extended to the right crus of the diaphragm, and the gastrointestinal tract was compressed dorsally. Histopathology was consistent with teratoma. Characteristic CT findings in a feline testicular teratoma may include calcification and cystic areas.
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Affiliation(s)
- Takahiro Nagumo
- Division of Small Animal Surgery, Veterinary Teaching Hospital, Iwate University, Morioka, Japan
| | - Rika Yoshii
- Division of Small Animal Internal Medicine, Department of Veterinary Medicine, Faculty of Agriculture, Iwate University, Morioka, Japan
| | - Yuji Uzuka
- Division of Small Animal Surgery, Veterinary Teaching Hospital, Iwate University, Morioka, Japan
| | - Yuki Hoshino
- Division of Small Animal Surgery, Veterinary Teaching Hospital, Iwate University, Morioka, Japan
| | - Kohei Nakata
- Division of Small Animal Surgery, Veterinary Teaching Hospital, Iwate University, Morioka, Japan
| | - Masaaki Katayama
- Division of Small Animal Surgery, Veterinary Teaching Hospital, Iwate University, Morioka, Japan
| | - Masahiro Yamasaki
- Division of Small Animal Internal Medicine, Department of Veterinary Medicine, Faculty of Agriculture, Iwate University, Morioka, Japan
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Tsujioka H, Uemura KI, Osaka A, Iwahata T, Fujii A, Ban S, Okada H, Saito K. Two tumor types in a unilateral testis in a patient with severe oligozoospermia and a history of cryptorchidism surgery: A case report. Oncol Lett 2024; 27:130. [PMID: 38348386 PMCID: PMC10859824 DOI: 10.3892/ol.2024.14262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 12/27/2023] [Indexed: 02/15/2024] Open
Abstract
Testicular cancer, the most common cancer among young male adults, is associated with infertility. A 38-year-old male patient was admitted to Dokkyo Medical University Saitama Medical Center, Japan, with infertility associated with severe oligozoospermia. Scrotal ultrasonography revealed two distinct tumors in the left testis: A mass with abundant blood flow on the cranial side and a mass with poor blood flow on the caudal side. Additional analysis revealed mild elevation of intact human chorionic gonadotropin (hCG) levels (tumor marker level assessment), high testosterone and low luteinizing hormone and follicle-stimulating hormone levels (hormonal level assessment) and severe oligoasthenozoospermia (semen assessment). The preoperative diagnosis was left-sided testicular cancer and severe oligoasthenozoospermia and the patient underwent left high orchiectomy and oncological testicular sperm extraction. Based on the pathological assessment, the cranial tumor was diagnosed as a seminoma with syncytiotrophoblastic cells, whereas the caudal tumor had only scar tissue with germ cell neoplasia in situ in the adjacent parenchyma. Following surgery, intact hCG and hormone levels of the patient were normalized, and the semen parameters (semen volume, sperm density, and motility) improved dramatically. To the best of our knowledge, the present case is the first report of two types of testicular tumor in a unilateral testis in a patient with a history of cryptorchidism surgery. The present case demonstrated that scrotal ultrasonography should be performed in patients with abnormal semen results to rule out testicular tumors.
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Affiliation(s)
- Hiroki Tsujioka
- Department of Urology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama 343-8555, Japan
| | - Kei-Ichiro Uemura
- Department of Urology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama 343-8555, Japan
- Department of Urology, School of Medicine, Kurume University, Kurume, Fukuoka 830-0011, Japan
| | - Akiyoshi Osaka
- Department of Urology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama 343-8555, Japan
| | - Toshiyuki Iwahata
- Department of Urology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama 343-8555, Japan
| | - Akiko Fujii
- Department of Pathology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama 343-8555, Japan
| | - Shinichi Ban
- Department of Pathology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama 343-8555, Japan
| | - Hiroshi Okada
- Department of Urology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama 343-8555, Japan
| | - Kazutaka Saito
- Department of Urology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama 343-8555, Japan
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Shahi M, Katsakhyan L, Hopkins M, Allen-Rhoades W, Cepress MK, Langstraat C, Ishitani MB, Vang R, Ronnett BM, Xing D. Ovarian non-gestational placental site trophoblastic tumor with lung metastasis: further evidence for a distinct category of trophoblastic neoplasm. Diagn Pathol 2024; 19:3. [PMID: 38172961 PMCID: PMC10765900 DOI: 10.1186/s13000-023-01436-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 12/23/2023] [Indexed: 01/05/2024] Open
Abstract
We previously described a series of cases which characterize a distinct group of primary ovarian placental site trophoblastic tumor (PSTT) and epithelioid trophoblastic tumor (ETT) as a non-gestational set consistent with germ cell type/origin. Here we report a new case of ovarian non-gestational PSTT. The patient was a 13 year-old young female admitted for a spontaneous pneumothorax of the left lung. The pathology of lung wedge excision specimen demonstrated metastatic PSTT and ovarian biopsy showed atypical intermediate trophoblastic proliferation which was found to be PSTT in the subsequent salpingo-oophorectomy specimen. In the ovary, the tumor was composed of singly dispersed or small clusters of predominantly mononuclear cells and rare multinucleated cells extensively infiltrating the ovarian parenchyma, tubal mucosa, and paraovarian/paratubal soft tissue. A minor component of mature cystic teratoma (less than 5% of total tumor volume) was present. Immunohistochemically, the neoplastic cells of main tumor were diffusely immunoreactive for hPL, Gata3 and AE1/AE3, and had only rare hCG-positive or p63-positive cells. The morphology and immunohistochemical results support a PSTT. Molecular genotyping revealed an identical genotype pattern between the normal lung tissue and the metastatic PSTT, indicating its non-gestational nature of germ cell type/origin. This case represents the first case of such tumor with distant (lung) metastasis. This case also provides further evidence to support our recommendation that primary ovarian non-gestational intermediate trophoblastic tumors of germ cell type/origin, including PSTT and ETT, should be formally recognized in classification systems.
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Affiliation(s)
- Maryam Shahi
- Department of Laboratory Medicine, Mayo Clinic, Rochester, MN, USA.
| | - Levon Katsakhyan
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Mark Hopkins
- Department of Laboratory Medicine, Mayo Clinic, Rochester, MN, USA
| | | | | | - Carrie Langstraat
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN, USA
| | | | - Russell Vang
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA
- Department of Gynecology and Obstetrics, The Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Brigitte M Ronnett
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA
- Department of Gynecology and Obstetrics, The Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Deyin Xing
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA
- Department of Gynecology and Obstetrics, The Johns Hopkins Medical Institutions, Baltimore, MD, USA
- Department of Oncology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA
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9
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Ghorbani H, Emadi Torghabeh A, Farzadnia M, Golshan A, Rabiei P. Renal vein thrombosis due to metastatic germ cell tumor, report of a case with a very rare clinical scenario. Cancer Rep (Hoboken) 2023; 6:e1910. [PMID: 37807242 PMCID: PMC10728514 DOI: 10.1002/cnr2.1910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 09/04/2023] [Accepted: 09/14/2023] [Indexed: 10/10/2023] Open
Abstract
BACKGROUND Renal metastasis is a rare manifestation of germ cell tumors. Extension of malignant lesions into the renal vein can complicate the scenario. CASE This report presents a 35-year-old man with primary stage IS NSGCT. Fourteen months after radical orchiectomy he presented with metastasis in the lung, kidney, and para-aortic lymph nodes. He received multiple lines of salvage treatments including chemotherapy and surgery. Intraoperative exploration during radical nephrectomy and retroperitoneal lymphadenectomy revealed intra-renal vein involvement with a prominent teratomatous component. CONCLUSION Defining the exact extent of malignant lesions, especially endovascular lesions, is very important to clarify how advanced the malignant lesions are. The surgeons must be aware of the risk factors that predict vascular involvement, and therefore, providing intraoperative access to vascular surgery procedures when needed.
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Affiliation(s)
- Hamidreza Ghorbani
- Kidney Transplantation Complications Research CenterMashhad University of Medical SciencesMashhadIran
| | | | - Mahdi Farzadnia
- Department of PathologyMashhad University of Medical SciencesMashhadIran
| | - Alireza Golshan
- Kidney Transplantation Complications Research CenterMashhad University of Medical SciencesMashhadIran
| | - Parisa Rabiei
- Cancer Research CenterMashhad University of Medical SciencesMashhadIran
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Pozza C, Tenuta M, Sesti F, Bertolotto M, Huang DY, Sidhu PS, Maggi M, Isidori AM, Lotti F. Multiparametric Ultrasound for Diagnosing Testicular Lesions: Everything You Need to Know in Daily Clinical Practice. Cancers (Basel) 2023; 15:5332. [PMID: 38001591 PMCID: PMC10670367 DOI: 10.3390/cancers15225332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/20/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Ultrasonography (US) represents the gold standard imaging method for the assessment of testicular lesions (TL). The gray-scale (GSUS) and color-Doppler (CDUS) ultrasound examination allow sonographers to investigate the size, margins, echotexture, and vascular features of TLs with the aim to differentiate benign from malignant lesions. Recently, the use of contrast-enhanced US (CEUS) and sonoelastography (SE) has led to further improvements in the differential diagnosis of TL. Although GSUS and CDUS are often sufficient to suggest the benign or malignant nature of the TL, CEUS can be decisive in the differential diagnosis of unclear findings, while SE can help to strengthen the diagnosis. The contemporary combination of GSUS, CDUS, CEUS, and SE has led to a new diagnostic paradigm named multiparametric US (mp-US), which is able to provide a more detailed characterization of TLs than single techniques alone. This narrative and pictorial review aimed to describe the mp-US appearance of several TLs. METHODS An extensive Medline search was performed to identify studies in the English language focusing on the mp-US evaluation of TLs. RESULTS A practical mp-US "identity card" and iconographic characterization of several benign and malignant TLs is provided herein. CONCLUSIONS The mp-US characterization of TL reported herein can be useful in daily clinical practice.
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Affiliation(s)
- Carlotta Pozza
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy; (C.P.); (M.T.); (F.S.); (A.M.I.)
| | - Marta Tenuta
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy; (C.P.); (M.T.); (F.S.); (A.M.I.)
| | - Franz Sesti
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy; (C.P.); (M.T.); (F.S.); (A.M.I.)
| | - Michele Bertolotto
- Department of Radiology, Ospedale Di Cattinara, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy;
| | - Dean Y. Huang
- Department of Imaging Sciences, Faculty of Life Sciences and Medicine, School of Biomedical Engineering and Imaging Sciences, King’s College London, London WC2R 2LS, UK; (D.Y.H.); (P.S.S.)
| | - Paul S. Sidhu
- Department of Imaging Sciences, Faculty of Life Sciences and Medicine, School of Biomedical Engineering and Imaging Sciences, King’s College London, London WC2R 2LS, UK; (D.Y.H.); (P.S.S.)
| | - Mario Maggi
- Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50139 Florence, Italy;
| | - Andrea M. Isidori
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy; (C.P.); (M.T.); (F.S.); (A.M.I.)
| | - Francesco Lotti
- Andrology, Female Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy
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Alkhayal AM, Aljarallah MF, Alqirnas MQ, Aldusari RS, Alyami F, Jamalalail Y, Hadhoud H, Alrabeeah K, Alsaikhan BH, Ghazwani Y, Noureldin YA. Malignant testicular tumors in children: overview on 10 years of Saudi Cancer Registry. Int Urol Nephrol 2023; 55:2677-2683. [PMID: 37477777 DOI: 10.1007/s11255-023-03701-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 06/29/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND/OBJECTIVE The aim of this study was to identify epidemiological and histopathological patterns of pediatric testicular tumor (TT) in Saudi population over 10 years. METHODS Retrospective data extracted from the Saudi Cancer Registry for Saudi children diagnosed with TT from 2008 to 2017. The data collected included patient's factors as age, year of diagnosis, survival status, and tumor factors as basis of diagnosis, origin of the tumor, histopathological group and subtype, and tumor behavior, stage, and laterality. RESULTS A total of 115 patients with a median age of 14 (IQR 1.5-17) were included. The primary tumor site was a normal descended testis in 98.3% (115). Yolk sac tumor was the most common 28.2% (33), followed by embryonal carcinoma in 27.4% (32) and mixed germ-cell tumors in 23.1% (27). Kaplan-Meier analysis revealed significant association between survival and the stage of the tumor (p = 0.002). However, there was a lack of significant association between survival and age groups, histopathological groups, and histopathological subtypes (p = 0.541, p = 0.609, and p = 0.733, respectively). The overall mortality rate of TT 5.2% with all deaths caused by non-seminomatous germ-cell tumor diagnosed with stage 3. CONCLUSIONS The median age of the patients was 14 years. Yolk sac tumors were the most common while testicular choriocarcinomas were the least in incidence. No increase in the incidence of TT was seen and the mortality rate over the 10-year period was 5.2%. Shorter survival was associated with higher tumor stage.
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Affiliation(s)
- Abdullah Mohammed Alkhayal
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
- Division of Urology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Meshal Fahad Aljarallah
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Muhannad Q Alqirnas
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Rakan S Aldusari
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Fahad Alyami
- College of Medicine, King Saud University Riyadh, Riyadh, Saudi Arabia
- Department of Urology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Yasser Jamalalail
- Pediatric Urology Division, King Abdulaziz Medical City, King Abdullah Specialized Children Hospital, National Guard-Health Affiars, Riyadh, Saudi Arabia
| | - Hala Hadhoud
- Department of Pediatrics, Faculty of Medicine, Benha University, Benha, Egypt
| | - Khaled Alrabeeah
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
- Division of Urology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Bader H Alsaikhan
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
- Division of Urology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Yahya Ghazwani
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
- Division of Urology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Yasser A Noureldin
- Division of Urology, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
- Department of Urology, Faculty of Medicine, Benha University, Benha, Egypt.
- Division of Clinical Sciences, Northern Ontario School of Medicine, Thunder Bay, ON, Canada.
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12
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Kitamura J, Tambo M, Nishijima A, Masuda K, Miyakawa J, Nakamura Y, Fujiwara M, Kishida T, Ito H, Fukuhara H. Surgical resection in patient with teratoma with somatic-type malignancy transformed into rhabdomyosarcoma resulted in long-term survival. IJU Case Rep 2023; 6:302-305. [PMID: 37667763 PMCID: PMC10475337 DOI: 10.1002/iju5.12610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 07/11/2023] [Indexed: 09/06/2023] Open
Abstract
Introduction Testicular germ cell tumors with somatic-type malignancy, wherein teratomas transform into sarcomas, is drug resistant and has a poor prognosis. Case presentation A 43-year-old man presented with a left testicular tumor, multiple pulmonary metastases, and mediastinal and para-aortic lymph node metastases. The testicular tumors were diagnosed as germ cell tumors. After bleomycin, etoposide, and cisplatin chemotherapy; right upper lobectomy for the pulmonary metastasis; and paclitaxel, ifosfamide, and cisplatin chemotherapy, rapidly progressing mediastinal lymph node metastasis was observed. It was resected at another specialized center owing to the challenging surgical approach. The histopathological diagnosis of the resected tumor was a teratoma with somatic-type malignancy (rhabdomyosarcoma). Subsequently, left hilar lymph node metastasectomy and left upper lobectomy were performed for the pulmonary metastases. The patient survived for more than 8 years after initial treatment. Conclusion Surgery, although challenging, may yield long-term survival for patients with testicular germ cell tumors with sarcomatous transformation.
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Affiliation(s)
- Junji Kitamura
- Department of UrologyKyorin University School of MedicineMitakaTokyoJapan
| | - Mitsuhiro Tambo
- Department of UrologyKyorin University School of MedicineMitakaTokyoJapan
| | - Ayano Nishijima
- Department of UrologyKyorin University School of MedicineMitakaTokyoJapan
| | - Kazuki Masuda
- Department of UrologyKyorin University School of MedicineMitakaTokyoJapan
| | - Jimpei Miyakawa
- Department of UrologyKyorin University School of MedicineMitakaTokyoJapan
| | - Yu Nakamura
- Department of UrologyKyorin University School of MedicineMitakaTokyoJapan
| | - Masachika Fujiwara
- Department of PathologyKyorin University School of MedicineMitakaTokyoJapan
| | - Takeshi Kishida
- Department of UrologyKanagawa Cancer CenterYokohamaKanagawaJapan
| | - Hiroyuki Ito
- Department of Thoracic SurgeryKanagawa Cancer CenterYokohamaKanagawaJapan
| | - Hiroshi Fukuhara
- Department of UrologyKyorin University School of MedicineMitakaTokyoJapan
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13
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Bapir R, Aghaways I, Ali RM, Fakhralddin SS, Ali RM, Rashid RJ, Abdullah AM, Ali MBA, Mohammed KK, Abdullah HO, Kakamad FH. Spermatocytic tumor of the testis: A case report and mini‑review of the literature. MEDICINE INTERNATIONAL 2023; 3:51. [PMID: 37810904 PMCID: PMC10557091 DOI: 10.3892/mi.2023.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/08/2023] [Indexed: 10/10/2023]
Abstract
Spermatocytic tumors are a rare type of testicular cancer, comprising <1% of all testicular malignancies. This type of cancer typically affects males in their 60s and 70s and rarely metastasizes; however, it poses a threat to the health of affected individuals if left untreated. The present study describes the case of a 68-year-old male patient with this type of tumor, including a presentation of his initial symptoms, treatment and subsequent monitoring. A male patient, aged 68 years, visited the authors' clinic with an asymptomatic mass in the right testicle. The mass had been progressively increasing in size for a duration of 5 years following a history of blunt injury. During the examination, a noticeable, painless enlargement was detected in the right testis, whereas the left testis appeared to be in a normal state. Tumor markers were within normal limits. Imaging revealed a complex mass (11x8x7 cm) almost replacing the right testis, with no detectable lymph nodes. A right radical orchidectomy was performed under spinal anesthesia. A histopathological examination revealed a spermatocytic tumor. The post-operative period was uneventful, with no metastasis detected in the CT scans. The patient was discharged with instructions for regular follow-up appointments. The case presented herein highlights a rare spermatocytic tumor in a 68-year-old male. The early detection and treatment of testicular tumors, regardless of age, are crucial for a good prognosis.
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Affiliation(s)
- Rawa Bapir
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
- Department of Urology, Sulaimani Teaching Hospital, Sulaimani, Kurdistan 46001, Iraq
- Kscien Organization for Scientific Research, Sulaimani, Kurdistan 46001, Iraq
| | - Ismaeel Aghaways
- College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46001, Iraq
| | - Rawa M. Ali
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
| | - Saman S. Fakhralddin
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
- Department of Urology, Sulaimani Teaching Hospital, Sulaimani, Kurdistan 46001, Iraq
- College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46001, Iraq
| | - Rebaz M. Ali
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
- Department of Oncology, Hiwa Hospital, Sulaimani, Kurdistan 46001, Iraq
| | - Rezheen J. Rashid
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
- Department of Radiology, Hiwa Hospital, Sulaimani, Kurdistan 46001, Iraq
| | - Ari M. Abdullah
- Department of Urology, Sulaimani Teaching Hospital, Sulaimani, Kurdistan 46001, Iraq
- Department of Pathology, Sulaimani Teaching Hospital, Sulaimani, Kurdistan 46001, Iraq
| | | | - Karukh K. Mohammed
- Kscien Organization for Scientific Research, Sulaimani, Kurdistan 46001, Iraq
- Smart Health Tower (Raparin branch), Sulaimani, Kurdistan 46001, Iraq
| | - Hiwa O. Abdullah
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
- Kscien Organization for Scientific Research, Sulaimani, Kurdistan 46001, Iraq
| | - Fahmi H. Kakamad
- Department of Scientific Affairs, Smart Health Tower, Sulaimani, Kurdistan 46001, Iraq
- Kscien Organization for Scientific Research, Sulaimani, Kurdistan 46001, Iraq
- College of Medicine, University of Sulaimani, Sulaimani, Kurdistan 46001, Iraq
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14
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Franco APDS, Lima Figueiredo ER, Melo GS, Souza JDSE, Gonçalves NV, Gomes FDC, Neto JSDM. Predictors of Testicular Cancer Mortality in Brazil: A 20-Year Ecological Study. Cancers (Basel) 2023; 15:4149. [PMID: 37627177 PMCID: PMC10453307 DOI: 10.3390/cancers15164149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 07/28/2023] [Accepted: 08/02/2023] [Indexed: 08/27/2023] Open
Abstract
Testicular cancer is common in young men, and early detection and multimodality treatment can lead to successful outcomes. This study aims to identify sociodemographic and risk factors associated with higher testicular cancer mortality and poorer survival rates, while examining the impact of diagnostic and treatment procedures on reducing mortality. The retrospective ecological study analyzed mortality data from testicular cancer in Brazil from 2001 to 2020. Sociodemographic variables such as marital status, age, birth period, year of death (cohort), race, and geographic region were assessed. Risk factors included cryptorchidism and pesticide exposure. Data were subjected to statistical analysis, which revealed an increasing trend in mortality after 2011 among persons born after 1976 in the 15-40 age group. Individuals in the South Region, whites, and singles had higher age-standardized mortality rates (ASMRs), while singles had lower survival rates. The Northeast region had a higher survival rate. Fungicides and insecticides increase ASMR in Brazil. Herbicides increase ASMR in the Northeast and Midwest regions and insecticides increase ASMR in the Northeast, Southeast, and Midwest regions. High rates of implementation of diagnostic procedures in the Midwest were not sufficient to reduce ASMR. No treatment procedure was associated with mortality at the national or regional level.
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Affiliation(s)
- Ana Paula de Souza Franco
- Urogenital System Clinical and Experimental Research Unit, Institute of Health Sciences, Federal University of Pará (UFPA), Belém 66075-110, PA, Brazil; (A.P.d.S.F.); (E.R.L.F.); (G.S.M.); (J.d.S.e.S.)
| | - Eric Renato Lima Figueiredo
- Urogenital System Clinical and Experimental Research Unit, Institute of Health Sciences, Federal University of Pará (UFPA), Belém 66075-110, PA, Brazil; (A.P.d.S.F.); (E.R.L.F.); (G.S.M.); (J.d.S.e.S.)
| | - Giovana Salomão Melo
- Urogenital System Clinical and Experimental Research Unit, Institute of Health Sciences, Federal University of Pará (UFPA), Belém 66075-110, PA, Brazil; (A.P.d.S.F.); (E.R.L.F.); (G.S.M.); (J.d.S.e.S.)
| | - Josiel de Souza e Souza
- Urogenital System Clinical and Experimental Research Unit, Institute of Health Sciences, Federal University of Pará (UFPA), Belém 66075-110, PA, Brazil; (A.P.d.S.F.); (E.R.L.F.); (G.S.M.); (J.d.S.e.S.)
| | - Nelson Veiga Gonçalves
- Laboratory of Epidemiology and Geoprocessing of Amazon, State University of Pará (UEPA), Belém 66113-010, PA, Brazil;
| | | | - João Simão de Melo Neto
- Urogenital System Clinical and Experimental Research Unit, Institute of Health Sciences, Federal University of Pará (UFPA), Belém 66075-110, PA, Brazil; (A.P.d.S.F.); (E.R.L.F.); (G.S.M.); (J.d.S.e.S.)
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15
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Guth M, Coste A, Lefevre M, Deygas F, Danjou A, Ahmadi S, Dananché B, Pérol O, Boyle H, Schüz J, Bujan L, Metzler-Guillemain C, Giscard d'Estaing S, Teletin M, Ducrocq B, Frapsauce C, Olsson A, Charbotel B, Fervers B. Testicular germ cell tumour risk by occupation and industry: a French case-control study - TESTIS. Occup Environ Med 2023; 80:407-417. [PMID: 37230752 PMCID: PMC10314033 DOI: 10.1136/oemed-2022-108601] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 05/04/2023] [Indexed: 05/27/2023]
Abstract
OBJECTIVE Testicular germ cell tumours (TGCT) are the most common cancer in men of working age and its incidence has increased notably over the past 40 years. Several occupations have been identified as potentially associated with TGCT risk. The aim of this study was to further explore the relationship between occupations, industries and TGCT risk in men aged 18-45 years. METHODS The TESTIS study is a multicenter case-control study conducted between January 2015 and April 2018 in 20 of 23 university hospital centers in metropolitan France. A total of 454 TGCT cases and 670 controls were included. Full job histories were collected. Occupations were coded according to the International Standard Classification of Occupation 1968 version (ISCO-1968) and industry according to the 1999 version of Nomenclature d'Activités Française (NAF-1999). For each job held, ORs and 95% CIs were estimated using conditional logistic regression. RESULTS A positive association was observed between TGCT and occupation as agricultural, animal husbandry worker (ISCO: 6-2; OR 1.71; 95% CI (1.02 to 2.82)), as well as salesman (ISCO: 4-51; OR 1.84; 95% CI (1.20 to 2.82)). An increased risk was further observed among electrical fitters and related, electrical and electronics workers employed for 2 years or more (ISCO: 8-5; OR≥2 years 1.83; 95% CI (1.01 to 3.32)). Analyses by industry supported these findings. CONCLUSIONS Our findings suggest that agricultural, electrical and electronics workers, and salesmen workers experience an increased risk of TGCT. Further research is needed to identify the agents or chemicals in these high-risk occupations which are relevant in the TGCT development. TRIAL REGISTRATION NUMBER NCT02109926.
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Affiliation(s)
- Margot Guth
- UMRESTTE, Université Claude Bernard Lyon 1, Lyon, France
| | - Astrid Coste
- Radiation: Defense, Health, Environment, INSERM UMR1296, Lyon, France
- Prevention Cancer Environnement Departement, Centre Léon Bérard, Lyon, France
| | - Marie Lefevre
- UMRESTTE, Université Claude Bernard Lyon 1, Lyon, France
| | | | - Aurélie Danjou
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer/World Health Organization (IARC/WHO), Lyon, France
| | - Shukrullah Ahmadi
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer/World Health Organization (IARC/WHO), Lyon, France
| | - Brigitte Dananché
- Prevention Cancer Environnement Departement, Centre Léon Bérard, Lyon, France
| | - Olivia Pérol
- Prevention Cancer Environnement Departement, Centre Léon Bérard, Lyon, France
| | - Helen Boyle
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | - Joachim Schüz
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer/World Health Organization (IARC/WHO), Lyon, France
| | - Louis Bujan
- DEFE (Développement Embryonnaire, Fertilité, Environnement) INSERM 1202 Universités Montpellier et Toulouse 3, CECOS Hôpital Paule de Viguier, CHU de Toulouse, Toulouse, France
- Fédération Française des CECOS, Paris, France
| | - Catherine Metzler-Guillemain
- Fédération Française des CECOS, Paris, France
- Centre Clinico-Biologique d'AMP-CECOS, AP-HM La Conception University Hospital, Marseille, France
| | - Sandrine Giscard d'Estaing
- Fédération Française des CECOS, Paris, France
- CECOS de Lyon, Service de Médecine de la Reproduction, Hôpital Femme Mère Enfant, Bron, France
| | - Marius Teletin
- Fédération Française des CECOS, Paris, France
- Department of Functional Genomics and Cancer, Institut de Génétique et de Biologie Moléculaire et Cellulaire, Illkirch-Grafenstaden, France
| | - Berengere Ducrocq
- Fédération Française des CECOS, Paris, France
- CECOS Nord Lille, Hôpital Albert Calmette, Lille, France
| | - Cynthia Frapsauce
- Fédération Française des CECOS, Paris, France
- Médecine et Biologie de la Reproduction-CECOS, CHU Bretonneau, Tours, France
| | - Ann Olsson
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer/World Health Organization (IARC/WHO), Lyon, France
| | - Barbara Charbotel
- UMRESTTE, Université Claude Bernard Lyon 1, Lyon, France
- Service des Maladies Professionnelles, Hospices Civils de Lyon, Pierre Bénite, France
| | - Béatrice Fervers
- Radiation: Defense, Health, Environment, INSERM UMR1296, Lyon, France
- Prevention Cancer Environnement Departement, Centre Léon Bérard, Lyon, France
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16
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Yamashita M, Sakai T, Yamashita S, Fujishima F, Goto T, Sato T, Kawasaki Y, Kawamorita N, Tanaka T, Ito A. A case of testicular cancer with retroperitoneal lymph node metastasis of teratoma with somatic-type malignancy 18 years after initial treatment. IJU Case Rep 2023; 6:226-229. [PMID: 37405035 PMCID: PMC10315248 DOI: 10.1002/iju5.12593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 04/11/2023] [Indexed: 07/06/2023] Open
Abstract
Introduction In testicular cancer, late relapse of teratoma with somatic-type malignancy is rare and associated with a poor survival. A case of retroperitoneal lymph node metastasis of teratoma with somatic-type malignancy 18 years after initial treatment for testicular cancer is reported. Case presentation A 46-year-old man had a 15-mm-sized mass in the para-aortic region 18 years after initial treatment for testicular cancer, without elevated serum alfa-fetoprotein or human chorionic gonadotropin levels. Laparoscopic retroperitoneal lymph node dissection was performed. The pathological findings showed teratoma with somatic-type malignancy, and the findings of primary testicular cancer reported a yolk sac tumor, not teratoma. Conclusion Late relapse of teratoma with somatic-type malignancy was resected by laparoscopic retroperitoneal lymph node dissection. Therefore, long-term follow-up should be considered if patients with small retroperitoneal masses did not undergo retroperitoneal lymph node dissection, and early detection and surgical resection for relapse might be effective.
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Affiliation(s)
- Maiko Yamashita
- Department of UrologyTohoku University Graduate School of MedicineSendaiMiyagiJapan
| | - Takanari Sakai
- Department of UrologyTohoku University Graduate School of MedicineSendaiMiyagiJapan
- Department of UrologyHachinohe City HospitalHachinoheAomoriJapan
| | - Shinichi Yamashita
- Department of UrologyTohoku University Graduate School of MedicineSendaiMiyagiJapan
| | | | - Takuro Goto
- Department of UrologyTohoku University Graduate School of MedicineSendaiMiyagiJapan
| | - Takuma Sato
- Department of UrologyTohoku University Graduate School of MedicineSendaiMiyagiJapan
| | - Yoshihide Kawasaki
- Department of UrologyTohoku University Graduate School of MedicineSendaiMiyagiJapan
| | - Naoki Kawamorita
- Department of UrologyTohoku University Graduate School of MedicineSendaiMiyagiJapan
| | - Takaki Tanaka
- Department of UrologyTohoku University Graduate School of MedicineSendaiMiyagiJapan
- Department of UrologyHachinohe City HospitalHachinoheAomoriJapan
| | - Akihiro Ito
- Department of UrologyTohoku University Graduate School of MedicineSendaiMiyagiJapan
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Yi X, Zhang Y, Cai J, Hu Y, Wen K, Xie P, Yin N, Zhou X, Luo H. Development and External Validation of Machine Learning-Based Models for Predicting Lung Metastasis in Kidney Cancer: A Large Population-Based Study. Int J Clin Pract 2023; 2023:8001899. [PMID: 37383704 PMCID: PMC10299882 DOI: 10.1155/2023/8001899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 05/24/2023] [Accepted: 06/06/2023] [Indexed: 06/30/2023] Open
Abstract
The accuracy of indices widely used to evaluate lung metastasis (LM) in patients with kidney cancer (KC) is insufficient. Therefore, we aimed at developing a model to estimate the risk of developing LM in KC based on a large population size and machine learning algorithms. Demographic and clinicopathologic variables of patients with KC diagnosed between 2004 and 2017 were retrospectively analyzed. We performed a univariate logistic regression analysis to identify risk factors for LM in patients with KC. Six machine learning (ML) classifiers were established and tuned using the ten-fold cross-validation method. External validation was performed using clinicopathologic information from 492 patients from the Southwest Hospital, Chongqing, China. Algorithm performance was estimated by analyzing the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, specificity, precision, recall, F1 score, clinical decision analysis (DCA), and clinical utility curve (CUC). A total of 52,714 eligible patients diagnosed with KC were enrolled, of whom 2,618 developed LM. Variables of age, sex, race, T stage, N stage, tumor size, histology, and grade were identified as important for the prediction of LM. The extreme gradient boosting (XGB) algorithm performed better than other models in both the internal validation (AUC: 0.913, sensitivity: 0.873, specificity: 0.809, and F1 score: 0.325) and the external validation (AUC: 0.904, sensitivity: 0.750, specificity: 0.878, and F1 score: 0.364). This study established a predictive model for LM in KC patients based on ML algorithms which showed high accuracy and applicative value. A web-based predictor was built using the XGB model to help clinicians make more rational and personalized decisions.
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Affiliation(s)
- Xinglin Yi
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of the Army Medical University, Chongqing, China
| | - Yuhan Zhang
- Department of Renal Dialysis Center, The First Affiliated Hospital of the Army Medical University, Chongqing, China
| | - Juan Cai
- Department of Renal Dialysis Center, The First Affiliated Hospital of the Army Medical University, Chongqing, China
| | - Yu Hu
- Department of Renal Dialysis Center, The First Affiliated Hospital of the Army Medical University, Chongqing, China
| | - Kai Wen
- Department of Renal Dialysis Center, The First Affiliated Hospital of the Army Medical University, Chongqing, China
| | - Pan Xie
- Department of Renal Dialysis Center, The First Affiliated Hospital of the Army Medical University, Chongqing, China
| | - Na Yin
- Department of Renal Dialysis Center, The First Affiliated Hospital of the Army Medical University, Chongqing, China
| | - Xiangdong Zhou
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of the Army Medical University, Chongqing, China
| | - Hu Luo
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of the Army Medical University, Chongqing, China
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18
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Yazici S, Del Biondo D, Napodano G, Grillo M, Calace FP, Prezioso D, Crocetto F, Barone B. Risk Factors for Testicular Cancer: Environment, Genes and Infections-Is It All? MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59040724. [PMID: 37109682 PMCID: PMC10145700 DOI: 10.3390/medicina59040724] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/11/2023] [Accepted: 03/29/2023] [Indexed: 04/29/2023]
Abstract
The incidence of testicular cancer is steadily increasing over the past several decades in different developed countries. If on one side better diagnosis and treatment have shone a light on this disease, on the other side, differently from other malignant diseases, few risk factors have been identified. The reasons for the increase in testicular cancer are however unknown while risk factors are still poorly understood. Several studies have suggested that exposure to various factors in adolescence as well as in adulthood could be linked to the development of testicular cancer. Nevertheless, the role of environment, infections, and occupational exposure are undoubtedly associated with an increase or a decrease in this risk. The aim of this narrative review is to summarize the most recent evidence regarding the risk factors associated with testicular cancer, starting from the most commonly evaluated (cryptorchidism, family history, infections) to the newer identified and hypothesized risk factors.
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Affiliation(s)
- Sertac Yazici
- Department of Urology, Hacettepe University School of Medicine, 06230 Ankara, Turkey
| | - Dario Del Biondo
- Department of Urology, ASL NA1 Centro Ospedale del Mare, 80147 Naples, Italy
| | - Giorgio Napodano
- Department of Urology, ASL NA1 Centro Ospedale del Mare, 80147 Naples, Italy
| | - Marco Grillo
- Department of Urology, ASL NA1 Centro Ospedale del Mare, 80147 Naples, Italy
- University of Rome Tor Vergata, 00133 Rome, Italy
| | - Francesco Paolo Calace
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80131 Naples, Italy
| | - Domenico Prezioso
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80131 Naples, Italy
| | - Felice Crocetto
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80131 Naples, Italy
| | - Biagio Barone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80131 Naples, Italy
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19
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Schnell-Inderst P, Laschkolnig A, Marckmann G, Antony D, Siebert U, Mühlberger N. [Testicular Cancer Screening in Men Aged 16 Years and Older: IQWiG ThemenCheck Health Technology Assessment Report on Medical, Economic, Social, Ethical, Legal and Organisational Aspects]. DAS GESUNDHEITSWESEN 2023; 85:234-241. [PMID: 34872119 PMCID: PMC11248508 DOI: 10.1055/a-1658-0057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Testicular cancer occurs mainly in young men between 25 and 45 years and is the most common cancer at this age. Possible testicular cancer early detection measures, clinical palpation and scrotal ultrasound (CUS) or testicular self-examination (TSE) in asymptomatic men aged 16 years and older, could perhaps avoid deaths and aggressive late therapies. Therefore, we investigated whether these measures have an additional benefit compared to the current situation. Ethical, legal, social and organisational aspects were considered as well. METHODS The methodology of this review follows IQWiG's "Allgemeine[n] Methoden Version 5.0". In addition, to estimate the theoretically possible benefits and potential harms of screening, a supplementary presentation was used for the benefit assessment based on published data from tumour registries and data on predictive values from diagnostic studies. RESULTS No intervention studies were identified, therefore evidence-based statements on additional benefit or harm of the studied interventions could not be made. The epidemiological data showed that per 100,000 men participating in screening annually, a maximum of 1.2 advanced tumours and 0.4 deaths would have been preventable. Harm calculations suggest that with CUS of 100,000 men, 1 to 22 unnecessary testicular exposures or removals might be expected, with TSE it would be 2 cases. However, these data on the possible harm of screening are subject to great uncertainty. CONCLUSIONS There are no intervention studies demonstrating that the benefit of testicular cancer screening in men aged 16 years and older outweighs the harm. The maximum possible additional benefit is low and chances of detection and cure are good even without screening. At present, testicular cancer screening cannot be recommended.
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Affiliation(s)
- Petra Schnell-Inderst
- Dept. of Public Health, Health Services Research and Health Technology
Assessment, UMIT – University for Health Sciences, Medical Informatics
and Technology, Hall i.T, Österreich
| | | | - Georg Marckmann
- Institut für Ethik, Geschichte und Theorie der Medizin,
Ludwig-Maximilians-Universität München, München,
Deutschland
| | | | - Uwe Siebert
- Dept. of Public Health, Health Services Research and Health Technology
Assessment, UMIT – University for Health Sciences, Medical Informatics
and Technology, Hall i.T, Österreich
- Center for Health Decision Science, Department of Health Policy and
Management, Harvard T.H. Chan School of Public Health, Boston, MA,
USA
- Institute for Technology Assessment and Department of Radiology,
Massachusetts General Hospital, Harvard Medical School, Boston, MA,
USA
| | - Nikolai Mühlberger
- Dept. of Public Health, Health Services Research and Health Technology
Assessment, UMIT – University for Health Sciences, Medical Informatics
and Technology, Hall i.T, Österreich
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20
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Kumar M, Sahoo SS, Jamaluddin MFB, Tanwar PS. Loss of liver kinase B1 in human seminoma. Front Oncol 2023; 13:1081110. [PMID: 36969070 PMCID: PMC10036840 DOI: 10.3389/fonc.2023.1081110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 02/27/2023] [Indexed: 03/12/2023] Open
Abstract
Testicular cancer is a common malignancy of young males and is believed to be originated from defective embryonic or adult germ cells. Liver kinase B1 (LKB1) is a serine/threonine kinase and a tumor suppressor gene. LKB1 is a negative regulator of the mammalian target of rapamycin (mTOR) pathway, often inactivated in many human cancer types. In this study, we investigated the involvement of LKB1 in the pathogenesis of testicular germ cell cancer. We performed immunodetection of LKB1 protein in human seminoma samples. A 3D culture model of human seminoma was developed from TCam-2 cells, and two mTOR inhibitors were tested for their efficacy against these cancer cells. Western blot and mTOR protein arrays were used to show that these inhibitors specifically target the mTOR pathway. Examination of LKB1 showed reduced expression in germ cell neoplasia in situ lesions and seminoma compared to adjacent normal-appearing seminiferous tubules where the expression of this protein was present in the majority of germ cell types. We developed a 3D culture model of seminoma using TCam-2 cells, which also showed reduced levels of LKB1 protein. Treatment of TCam-2 cells in 3D with two well-known mTOR inhibitors resulted in reduced proliferation and survival of TCam-2 cells. Overall, our results support that downregulation or loss of LKB1 marks the early stages of the pathogenesis of seminoma, and the suppression of downstream signaling to LKB1 might be an effective therapeutic strategy against this cancer type.
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21
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Brönimann S, Mun DH, Hackl M, Yang L, Shariat SF, Waldhoer T. Increase and Plateauing of Testicular Cancer Incidence in Austria-A Time Trend Analysis of the Past Four Decades. EUR UROL SUPPL 2023; 49:104-109. [PMID: 36874603 PMCID: PMC9974997 DOI: 10.1016/j.euros.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2023] [Indexed: 02/09/2023] Open
Abstract
Background Testicular germ cell tumors (TGCTs) are the most common malignant tumors in young men. Despite considerable geographic, ethnic, and temporal variations in the incidence of TGCTs, without convincing explanation, incidence rates of TGCTs have been increasing in many countries since, at least, the mid-20th century. Objective To investigate the incidence rates of TGCTs in Austria by analyzing data from the Austrian Cancer Registry. Design setting and participants Available data between 1983 and 2018 were provided by the Austrian National Cancer Registry and analyzed retrospectively. Outcome measurements and statistical analysis Germ cell tumors derived from germ cell neoplasia in situ were classified into seminomas and nonseminomas. Age-specific incidence rates and age-standardized rates were calculated. Annual percent changes (APCs) and average annual percent changes in incidence rates were determined to describe trends from 1983 to 2018. All statistical analyses were performed using SAS version 9.4 and joinpoint. Results and limitations The study population consists of 11 705 patients diagnosed with TGCTs. The median age at diagnosis was 37.7 yr. The standardized incidence rate of TGCTs increased significantly (p < 0.0001) from 4.1 (3.4, 4.8) per 100 000 in 1983 to 8.7 (7.9, 9.6) per 100 000 in 2018 by an average APC of 1.74 (1.20, 2.29). The joinpoint regression revealed a change point in time trend in 1995 with an APC of 4.24 (2.77, 5.72) before 1995 and an APC of 0.47 (0.06, 0.89) thereafter. Incidence rates were about twice as high for seminomas as for nonseminomas. A trend analysis by age group showed that the highest TGCT incidence rate was observed among men aged 30-40 yr, with a steep increase before 1995. Conclusions The incidence rate of TGCTs increased in Austria over the past decades and appears to have reached a plateau at a high level. A time trend analysis by age group for the overall incidence was highest in men aged 30-40 yr, with a steep increase before 1995. These data should lead to awareness campaigns and research to further investigate the causes of this development. Patient summary We reviewed the data between 1983 and 2018 provided by the Austrian National Cancer Registry to analyze the incidence and incidence trend in testicular cancer. Testicular cancer shows an increasing incidence in Austria. The overall incidence was highest in men aged 30-40 yr, with a steep increase before 1995. The incidence appears to have reached a plateau at a high level in recent years.
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Affiliation(s)
- Stephan Brönimann
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Dong-Ho Mun
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Monika Hackl
- Austrian National Cancer Registry, Statistics Austria, Vienna, Austria
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, AB, Canada.,Preventive Oncology & Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,Department of Urology, Weill Cornell Medical College, New York, NY, USA.,Department of Urology, University of Texas Southwestern, Dallas, TX, USA.,Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic.,Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan.,Karl Landsteiner Institute, Vienna, Austria
| | - Thomas Waldhoer
- Centre for Public Health, Department of Epidemiology, Medical University of Vienna, Vienna, Austria
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22
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Enzlin R, Vervoort SCJM, Suelmann BBM, Meijer RP, Teunissen SCCM, Zweers D. The prevalence and intensity of late effects in patients with testicular germ cell tumors: A first step of instrument development using a stepwise approach. Eur J Oncol Nurs 2023; 64:102303. [PMID: 36931098 DOI: 10.1016/j.ejon.2023.102303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 02/13/2023] [Accepted: 02/19/2023] [Indexed: 03/05/2023]
Abstract
PURPOSE Patients with Testicular Germ Cell Tumors (TGCT) may suffer from several late effects due to their diagnosis or treatment. Follow-up care aims to identify the recurrence of cancer and support patients with TGCT in their experienced late effects. In the Netherlands, the validated Dutch version of the Edmonton Symptom Assessment System, Utrecht Symptom Diary (USD) is used to assess and monitor patient reported symptoms. As a first step to develop a specific USD module for TGCT-patients, it was necessary to identify the prevalence and intensity of late effects in patients with TGCT, covering the physical, social, psychical and existential domains of care. METHODS A cross-sectional study was conducted. First, literature was systematically assessed to create a comprehensive list of symptoms. This generated list was reviewed by expert healthcare professionals and the research group. Lastly, a survey was distributed amongst patients with TGCT in follow-up care in the University Medical Center Utrecht (UMCU) outpatient clinic. RESULTS In total, 65 TGCT-patients completed the survey. All described late effects were recognized by TGCT-patients, with 'fatigue', 'disturbed overall well-being', 'concentration problems' and 'neuropathy', indicated as most prevalent and scored with highest intensity. When prioritizing these late effects, patients assigned 'neuropathy' as most important. CONCLUSIONS This study provided insight into prevalence and intensity of late effects, as indicated by TGCT-patients. In clinical practice, follow-up care can improve by empowering patients to discuss important items in daily life with their health-care professionals.
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Affiliation(s)
- Roos Enzlin
- Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066CX, Amsterdam, the Netherlands; University Medical Center Utrecht, Department Medical Oncology, Heidelberglaan 100, 3584CX, Utrecht, the Netherlands.
| | - Sigrid C J M Vervoort
- University Medical Center Utrecht, Department of Nursing Science, Julius Center for Health Sciences and Primary Care, Heidelberglaan 100 3584CX, Utrecht, the Netherlands.
| | - Britt B M Suelmann
- University Medical Center Utrecht, Department Medical Oncology, Heidelberglaan 100, 3584CX, Utrecht, the Netherlands.
| | - Richard P Meijer
- University Medical Center Utrecht, Department of Oncological Urology, Heidelberglaan 100, 3584CX, Utrecht, the Netherlands.
| | - Saskia C C M Teunissen
- University Medical Center Utrecht, Department of Primary Care, Heidelberglaan 100, 3584CX, Utrecht, the Netherlands.
| | - Danielle Zweers
- University Medical Center Utrecht, Department Medical Oncology, Heidelberglaan 100, 3584CX, Utrecht, the Netherlands.
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23
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Zhou G, Sun F, Yu X, Huang R, Liu X, Ouyang Y, Yang Z, Li S. Clinical characteristics and long-term management of prepubertal testicular teratomas: a retrospective, multicenter study. Eur J Pediatr 2023; 182:1823-1828. [PMID: 36795187 PMCID: PMC10167136 DOI: 10.1007/s00431-023-04859-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 02/17/2023]
Abstract
Prepubertal testicular teratomas are rare tumors with limited practical guidance for their management. This study aimed to analyze a large multicenter database to establish the optimal management of testicular teratomas. We retrospectively collected data on testicular teratomas in children younger than 12 years who underwent surgery without postoperative chemotherapy in three large professional children's institutions in China between 2007 and 2021. The biological behavior and long-term outcomes of testicular teratomas were analyzed. In total, 487 children (with 393 mature teratomas and 94 immature teratomas) were included. Among mature teratomas, 375 cases were testis-sparing, 18 were orchiectomies, 346 were operated through the scrotal approach, and 47 underwent the inguinal approach. The median follow-up period was 70 months, and no recurrence or testicular atrophy was observed. Among the children with immature teratomas, 54 underwent testis-sparing surgery, 40 underwent orchiectomy, 43 were operated through the scrotal approach, and 51 were operated through the inguinal approach. Two cases of immature teratomas with cryptorchidism had local recurrence or metastasis within 1 year of the operation. The median follow-up duration was 76 months. No other patients had recurrence, metastasis, or testicular atrophy. Conclusion: Testicular-sparing surgery is the first treatment choice for prepubertal testicular teratomas, with the scrotal approach being a safe and well-tolerated strategy for these diseases. Additionally, patients with immature teratomas and cryptorchidism may have tumor recurrence or metastasis after surgery. Therefore, these patients should be closely followed up in the first year after surgery. What is Known: • There is a fundamental difference between testicular tumours in childhood and those in adulthood - not only in terms of the difference and incidence but also in terms of histology. • For surgical techniques, the inguinal approach is recommended for the treatment of testicular teratomas in children. What is New: • The scrotal approach being a safe and well-tolerated strategy for testicular teratomas in children. • Patients with immature teratomas and cryptorchidism may have tumor recurrence or metastasis after surgery. These patients should be closely followed up in the first year after surgery.
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Affiliation(s)
- Guanglun Zhou
- Department of Urology and Laboratory of Pelvic Floor Muscle Function, Shenzhen Children's Hospital, Futian District, Shenzhen, 518000, Guangdong, China
| | - Fenglan Sun
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, 434020, China
| | - Xin Yu
- Department of Urology, Anhui Provincial Children's Hospital, Hefei, China
| | - Ruifeng Huang
- Department of Gastroenterology and Zhengzhou Key Laboratory of Children's Digestive Diseases, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, Henan, China
| | - Xiaodong Liu
- Department of Urology and Laboratory of Pelvic Floor Muscle Function, Shenzhen Children's Hospital, Futian District, Shenzhen, 518000, Guangdong, China
| | - Yaoling Ouyang
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, 434020, China
| | - Zhilin Yang
- Department of Urology and Laboratory of Pelvic Floor Muscle Function, Shenzhen Children's Hospital, Futian District, Shenzhen, 518000, Guangdong, China
| | - Shoulin Li
- Department of Urology and Laboratory of Pelvic Floor Muscle Function, Shenzhen Children's Hospital, Futian District, Shenzhen, 518000, Guangdong, China.
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24
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Integrated Microarray-Based Data Analysis of miRNA Expression Profiles: Identification of Novel Biomarkers of Cisplatin-Resistance in Testicular Germ Cell Tumours. Int J Mol Sci 2023; 24:ijms24032495. [PMID: 36768818 PMCID: PMC9916636 DOI: 10.3390/ijms24032495] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/13/2023] [Accepted: 01/25/2023] [Indexed: 01/31/2023] Open
Abstract
Testicular germ cell tumours (TGCTs) are the most common solid malignancy among young men, and their incidence is still increasing. Despite good curability with cisplatin (CDDP)-based chemotherapy, about 10% of TGCTs are non-responsive and show a chemoresistant phenotype. To further increase TGCT curability, better prediction of risk of relapse and early detection of refractory cases is needed. Therefore, to diagnose this malignancy more precisely, stratify patients more accurately and improve decision-making on treatment modality, new biomarkers are still required. Numerous studies showed association of differential expressions of microRNAs (miRNAs) with cancer. Using microarray analysis followed by RT-qPCR validation, we identified specific miRNA expression patterns that discriminate chemoresistant phenotypes in TGCTs. Comparing CDDP-resistant vs. -sensitive TGCT cell lines, we identified miR-218-5p, miR-31-5p, miR-125b-5p, miR-27b-3p, miR-199a-5p, miR-214-3p, let-7a and miR-517a-3p as significantly up-regulated and miR-374b-5p, miR-378a-3p, miR-20b-5p and miR-30e-3p as significantly down-regulated. In patient tumour samples, we observed the highest median values of relative expression of miR-218-5p, miR-31-5p, miR-375-5p and miR-517a-3p, but also miR-20b-5p and miR-378a-3p, in metastatic tumour samples when compared with primary tumour or control samples. In TGCT patient plasma samples, we detected increased expression of miR-218-5p, miR-31-5p, miR-517a-3p and miR-375-5p when compared to healthy individuals. We propose that miR-218-5p, miR-31-5p, miR-375-5p, miR-517-3p, miR-20b-5p and miR-378a-3p represent a new panel of biomarkers for better prediction of chemoresistance and more aggressive phenotypes potentially underlying metastatic spread in non-seminomatous TGCTs. In addition, we provide predictions of the targets and functional and regulatory networks of selected miRNAs.
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25
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Cecilia C, Ardiansyah D, Fadil. A rare case of brain metastatic of primary mediastinal yolk sac tumor. Radiol Case Rep 2023; 18:1041-1045. [PMID: 36684631 PMCID: PMC9849995 DOI: 10.1016/j.radcr.2022.12.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/06/2022] [Accepted: 12/10/2022] [Indexed: 01/07/2023] Open
Abstract
Primary yolk sac tumors are extragonadal germ cell tumors commonly seen in children and young adults. They are more common in men. Germ cells tumor on histopathological characteristics is classified as seminoma and non-seminomatous (NSGC). The rarest form of NSGC is an extragonadal yolk sac tumor of mediastinum. Clinical presentations are not specific and may imitate other chronic disease such as other malignancies or tuberculosis such as chest discomfort, vena cava superior syndrome, fever, weight loss, and chronic cough. Immunohistochemistry showed a positive result in Alpha-fetoprotein and pan-cytokeratin. Due to its rarity, brain metastases' clinical signs and symptoms, anatomical sites, and characteristics are less well documented. However, the metastatic brain process gave similar histological findings to the primary site. Additional radiological and laboratory tests can be carried out to identify other metastatic processes. Standardized treatment of primary mediastinal sac tumors with brain metastasis has not yet been established. Combining chemotherapy, surgery and radiation treatment could improve overall outcomes and prognosis. We present a scarce case of primary mediastinal yolk sac tumor with metastatic brain process in a 32-year-old male with a short survival period.
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26
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Parwani AV, Patel A, Zhou M, Cheville JC, Tizhoosh H, Humphrey P, Reuter VE, True LD. An update on computational pathology tools for genitourinary pathology practice: A review paper from the Genitourinary Pathology Society (GUPS). J Pathol Inform 2023; 14:100177. [PMID: 36654741 PMCID: PMC9841212 DOI: 10.1016/j.jpi.2022.100177] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 12/20/2022] [Accepted: 12/20/2022] [Indexed: 12/31/2022] Open
Abstract
Machine learning has been leveraged for image analysis applications throughout a multitude of subspecialties. This position paper provides a perspective on the evolutionary trajectory of practical deep learning tools for genitourinary pathology through evaluating the most recent iterations of such algorithmic devices. Deep learning tools for genitourinary pathology demonstrate potential to enhance prognostic and predictive capacity for tumor assessment including grading, staging, and subtype identification, yet limitations in data availability, regulation, and standardization have stymied their implementation.
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Affiliation(s)
- Anil V. Parwani
- The Ohio State University, Columbus, Ohio, USA
- Corresponding author.
| | - Ankush Patel
- The Ohio State University, 2441 60th Ave SE, Mercer Island, Washington 98040, USA
| | - Ming Zhou
- Tufts University, Medford, Massachusetts, USA
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27
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Bozkurt M, Aghalarov S, Atci MM, Selvi O, Canat HL. A new biomarker for lung metastasis in non-seminomatous testicular cancer: De Ritis Ratio. Aktuelle Urol 2022; 53:540-544. [PMID: 36302549 DOI: 10.1055/a-1926-9698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE We aimed to show that the De Ritis Ratio (DRR) may be a new biomarker for lung metastasis in non-seminomatous Testicular Cancers (TC). MATERIAL AND METHODS Patients who underwent radical orchiectomy due to TC between January 2010 and January 2021 were included in the study. Demographic characteristics, preoperative laboratory and radiological findings and pathological data of the patients were recorded. The DRR was calculated from preoperative peripheral blood analysis. RESULTS A total of 124 patients with non-seminomatous TC were included. Mean patient age was 30.67±7.45 years, and the mean tumour diameter was 4.69±2.55 cm. 61 patients had T1, 51 had T2, and 12 had T3 disease. 42 of them had lung metastasis; 82 of them had no lung metastasis. The optimal DRR threshold was 1.21 for lung metastasis. [Area Under the Curve (AUC): 0.724 with a sensitivity of 81% and specificity of 74%]. DRR was determined as an independent prognostic factor for lung metastasis in univariate and multivariate analyses (p=0.002). CONCLUSIONS A high preoperative DRR can be used to detect the presence of lung metastases in non-seminomatous TCs.
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Affiliation(s)
- Muammer Bozkurt
- Urology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
| | | | | | - Oguzhan Selvi
- Medical oncology, Prof Dr Cemil Tascioglu City Hospital, Istanbul, Turkey
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28
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Dashora A, Wagner T, Berney DM. Testicular Tumors: New Developments in Germ Cell and Sex Cord Stromal Tumors. Surg Pathol Clin 2022; 15:729-743. [PMID: 36344186 DOI: 10.1016/j.path.2022.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
This article reviews the recent advances and potential future changes in the classification of testicular germ cell and sex cord stromal tumors, highlighting changes in the classification system and terminology with description on newer entities. A discussion on approaching difficult areas and diagnostic pitfalls is also included along with the utility of ancillary investigations. Areas with limited knowledge are highlighted to providing direction for future studies and a bulleted summary in the form of critical care points is provided.
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Affiliation(s)
- Abhishek Dashora
- Department of Cellular Pathology, Barts Health NHS Trust, London, United Kingdom
| | - Thomas Wagner
- Department of Pathology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Daniel M Berney
- Department of Cellular Pathology, Barts Health NHS Trust, London, United Kingdom; Department of Molecular Oncology, Barts Health Cancer and Barts Health NHS Trust, London, United Kingdom.
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29
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Berney DM, Cree I, Rao V, Moch H, Srigley JR, Tsuzuki T, Amin MB, Comperat EM, Hartmann A, Menon S, Netto GJ, Rubin MA, Turajlic S, Raspollini MR, Tickoo SK. An introduction to the WHO 5th edition 2022 classification of testicular tumours. Histopathology 2022; 81:459-466. [PMID: 35502823 PMCID: PMC9544657 DOI: 10.1111/his.14675] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/21/2022] [Accepted: 05/02/2022] [Indexed: 11/29/2022]
Abstract
The 5th edition of the World Health Organisation Blue Book was published recently and includes a comprehensive update on testicular tumours. This builds upon the work of the 4th edition, retaining its structure and main nomenclature, including the use of the term 'germ cell neoplasia in situ' (GCNIS) for the pre-invasive lesion of most germ cell tumours and division from those not derived from GCNIS. While there have been important developments in understanding the molecular underpinnings of testicular cancer, this updated classification paradigm and approach remains rooted in morphology. Nomenclature changes include replacement of the term 'primitive neuroectodermal tumour' by 'embryonic neuroectodermal tumour' based on the non-specificity of the former term and to separate these tumours clearly from Ewing sarcoma. Seminoma is placed in a germinoma family of tumours emphasising relation to those tumours at other sites. Criteria for the diagnosis of 'teratoma with somatic transformation' have been modified to not include variable field size assessments. The word 'carcinoid' has been changed to 'neuroendocrine tumour', with most examples in the testis now classified as 'prepubertal type testicular neuroendocrine tumour'. For sex cord-stromal tumours, the use of mitotic counts per high-power field has been changed to per mm2 for malignancy assessments, and the new entities, 'signet ring stromal tumour' and 'myoid gonadal stromal tumour', are defined. Well-differentiated papillary mesothelial tumour has now been defined as tumour type with a favourable prognosis. Sertoliform cystadenoma has been removed as an entity from testicular adnexal tumours and placed with Sertoli cell tumours.
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Affiliation(s)
- Daniel M Berney
- Department of Molecular OncologyBarts Cancer Institute, Barts and The London School of Medicine and Dentistry, QMUL and Barts Health NHS TrustLondonUK
| | - Ian Cree
- WHO Classification of Tumours GroupInternational Agency for Research on Cancer, World Health OrganizationLyonFrance
| | - Vishal Rao
- Basavatarakam Indo American Cancer Hospital and Research InstituteHyderabadIndia
| | - Holger Moch
- Department of Pathology and Molecular PathologyUniversity Hospital Zurich and University ZurichZurichSwitzerland
| | | | - Toyonori Tsuzuki
- Department of Surgical PathologyAichi Medical University, School of MedicineNagakuteJapan
| | - Mahul B Amin
- Department of Pathology and Laboratory MedicineThe University of Tennessee Health Sciences CenterMemphisTNUSA
- Department of UrologyUniversity of Southern California, Keck School of MedicineLos AngelesCAUSA
| | - Eva M Comperat
- Department of PathologyGeneral Hospital, Medical UniversityViennaAustria
- Department of Pathology Tenon HospitalSorbonne UniversityParisFrance
| | - Arndt Hartmann
- Institute of PathologyUniversity Hospital Erlangen, Friedrich‐Alexander UniversityErlangenGermany
| | - Santosh Menon
- Tata Memorial CentreHomi Bhabha National InstituteMumbaiIndia
| | - George J Netto
- University of Alabama at Birmingham, PathologyBirminghamALUSA
| | - Mark A Rubin
- University of Bern, Director of the Department for BioMedical ResearchBernSwitzerland
| | | | - Maria R Raspollini
- Histopathology and Molecular DiagnosticsUniversity Hospital CareggiFlorenceItaly
| | - Satish K Tickoo
- Memorial Sloan‐Kettering Cancer Center, PathologyNew YorkNYUSA
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30
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Martín-Abreu CM, González-Villa I, Lorenzo-Barreto JE, Álvarez Argüelles-Cabrera H, Salido-Ruiz EC, Oramas-Rodríguez JM. [Gastric metastases with a choriocarcinoma component from a postpuberal teratoma with mature histology]. REVISTA ESPANOLA DE PATOLOGIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ANATOMIA PATOLOGICA Y DE LA SOCIEDAD ESPANOLA DE CITOLOGIA 2022; 55 Suppl 1:S49-S53. [PMID: 36075663 DOI: 10.1016/j.patol.2020.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 04/16/2020] [Accepted: 04/29/2020] [Indexed: 06/15/2023]
Abstract
Germ cell tumors are the most frequent neoplasia in young males. The aims of this study is to describe a case in which a postpuberal teratoma suffers a transformation to choriocarcinoma and metastasize to stomach. We have made a systematic review in PubMed and consensus documents to study this mismatch between the tumour, metastasis and the exception of gastric metastatic affectation. We describe three options to explain this discordance: a mixed germ cells tumour, a burned out tumour or a germ cells tumour derived from a malignant germ cell tumour precursor or different clonal strains. After made a thorough investigation we conclude that the most truly option is the last one as we extensive explain below. Once the gastric metastatic lesions are extremely rare and reach to <5%, but there are not conclusive assessments.
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Affiliation(s)
- Carla M Martín-Abreu
- Servicio de Oncología Médica, Hospital Universitario de Canarias, San Cristóbal de la Laguna, Santa Cruz de Tenerife, España.
| | - Isabel González-Villa
- Servicio de Anatomía Patológica, Hospital Universitario de Canarias, San Cristóbal de la Laguna, Santa Cruz de Tenerife, España
| | - José Enrique Lorenzo-Barreto
- Servicio de Oncología Médica, Hospital Universitario de Canarias, San Cristóbal de la Laguna, Santa Cruz de Tenerife, España
| | - Hugo Álvarez Argüelles-Cabrera
- Servicio de Anatomía Patológica, Hospital Universitario de Canarias, San Cristóbal de la Laguna, Santa Cruz de Tenerife, España
| | - Eduardo C Salido-Ruiz
- Servicio de Anatomía Patológica, Hospital Universitario de Canarias, San Cristóbal de la Laguna, Santa Cruz de Tenerife, España
| | - Juana M Oramas-Rodríguez
- Servicio de Oncología Médica, Hospital Universitario de Canarias, San Cristóbal de la Laguna, Santa Cruz de Tenerife, España
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31
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Onal B, Gultekin MH, Simsekoglu MF, Selcuk B, Gurbuz A. Biomarkers in Urological Cancers. Biomark Med 2022. [DOI: 10.2174/9789815040463122010005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Urological tumours have become one of the most common cancers in the
last decade. It is important to apply an approach that evaluates many factors related to
the patient and the disease carefully to minimize cancer-associated morbidity and
mortality. The clinical use of cancer biomarkers is a valuable part of the clinical
management of urological cancers. These biomarkers may lead to optimized detection,
treatment, and follow-up of urological cancers. With the development of molecular
research, newly developed biomarkers and next-generation sequencing have also
contributed to patient management. In this chapter, we will present biomarkers in the
most common urological cancers under subheadings of bladder cancer, prostate cancer,
kidney cancer, and testicular cancer. Additionally, due to the development that
occurred in the next-generation sequencing (NGS), all the above-mentioned
malignancies are evaluated with regard to NGS.
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Affiliation(s)
- Bulent Onal
- Department of Urology, Cerrahpasa School of Medicine, Istanbul University - Cerrahpasa,
Istanbul, Turkey
| | - Mehmet Hamza Gultekin
- Department of Urology, Cerrahpasa School of Medicine, Istanbul University - Cerrahpasa,
Istanbul, Turkey
| | - Muhammed Fatih Simsekoglu
- Department of Urology, Cerrahpasa School of Medicine, Istanbul University - Cerrahpasa,
Istanbul, Turkey
| | - Berin Selcuk
- Department of Urology, Cerrahpasa School of Medicine, Istanbul University - Cerrahpasa,
Istanbul, Turkey
| | - Ahmet Gurbuz
- Department of Urology, Cerrahpasa School of Medicine, Istanbul University - Cerrahpasa,
Istanbul, Turkey
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32
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Vrouwe JPM, Hennus PML, Hamdy NAT, Osanto S, Willemse PM. Risk of osteoporosis in testicular germ cell tumour survivors: A systematic review of the literature. BJUI COMPASS 2022; 4:24-43. [PMID: 36569500 PMCID: PMC9766871 DOI: 10.1002/bco2.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 06/26/2022] [Accepted: 07/10/2022] [Indexed: 12/27/2022] Open
Abstract
Context Testicular germ cell tumour (TGCT) survivors are potentially at risk of developing osteoporosis, because of increased risk for disturbed bone remodelling associated with hypogonadism and anti-cancer treatment. A number of studies show bone loss and increased fracture risk in TGCT survivors, but data are scarce. There are no clinical guidelines or recommendations issued to address skeletal health in this group of patients potentially at high risk for osteoporosis. Objective To conduct a systematic review of available literature addressing bone health in TGCT patients. Subgroup analysis was performed to identify risk factors for bone loss and increased fracture risk. Evidence Acquisition Relevant databases, including MEDLINE, Embase and the Cochrane Library, including all English written comparative studies addressing bone health in TGCT patients, were searched up to December 2021 and a narrative synthesis was undertaken. Risk of bias (RoB) was assessed using Cochrane ROBINS-I tool. Evidence Synthesis Ten studies (eight cross-sectional and two longitudinal), recruiting a total of 1997 unique TGCT patients, were identified and included in the analysis. Bone health was reported in various ways in different studies, and subgroups were defined heterogeneously, resulting in a widely varying prevalence of osteoporosis of up to 73.2% of patients. Six studies reported low BMD associated with higher luteinizing hormone levels and one study showed a correlation between follow up duration and bone loss. Conclusions TGCT survivors are at risk of developing osteoporosis and sustaining fragility fractures. Chemotherapy, pituitary-gonadal axis dysfunction and ageing are key risk factors, although available data are scarce. With increasing survival of TGCT patients, a clear unmet need has been identified to systematically evaluate and monitor skeletal health in larger numbers of survivors in order to develop best clinical practice guidelines to manage the insidious but potentially preventable and treatable skeletal complications of TGCT.
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Affiliation(s)
- Josephina P. M. Vrouwe
- Department of Medical OncologyLeiden University Medical CentreLeidenThe Netherlands,Centre for Human Drug ResearchLeidenThe Netherlands
| | - Pauline M. L. Hennus
- Department of UrologyUniversity Medical Centre UtrechtUtrechtThe Netherlands,Department of UrologyAmphia HospitalBredaThe Netherlands
| | - Neveen A. T. Hamdy
- Department of Medicine, Division of Endocrinology, and Center for Bone QualityLeiden University Medical CentreLeidenThe Netherlands
| | - Susanne Osanto
- Department of Medical OncologyLeiden University Medical CentreLeidenThe Netherlands
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Tsili AC, Sofikitis N, Pappa O, Bougia CK, Argyropoulou MI. An Overview of the Role of Multiparametric MRI in the Investigation of Testicular Tumors. Cancers (Basel) 2022; 14:cancers14163912. [PMID: 36010905 PMCID: PMC9405843 DOI: 10.3390/cancers14163912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 08/07/2022] [Accepted: 08/11/2022] [Indexed: 11/25/2022] Open
Abstract
Simple Summary Although conventional ultrasonography remains the primary imaging modality for the assessment of testicular tumors, multiparametric MRI of the scrotum, which combines morphologic and functional data, serves as a powerful adjunct. Based on the recommendations issued by the Scrotal and Penile Imaging Working Group of the European Society of Urogenital Radiology, scrotal MRI is strongly recommended after equivocal US findings. In cases of testicular masses, the main clinical indications are as follows: lesion characterization when sonographic findings are non-diagnostic, discrimination between germ-cell and non-germ-cell testicular tumors, local staging of testicular tumors in patients who are candidates for testis-sparing surgery, and preoperative histological characterization of testicular germ-cell tumors in selected cases. This article aims to provide an overview of the role of multiparametric MRI in the investigation of testicular tumors. Abstract Conventional ultrasonography represents the mainstay of testis imaging. In cases in which ultrasonography is inconclusive, scrotal MRI using a multiparametric protocol may be used as a useful problem-solving tool. MRI of the scrotum is primarily recommended for differentiating between benign and malignant testicular masses when sonographic findings are ambiguous. This technique is also accurate in the preoperative local staging of testicular tumors and, therefore, is recommended in patients scheduled for testis-sparing surgery. In addition, MRI may provide valuable information regarding the histological characterization of testicular germ-cell tumors, in selected cases. Scrotal MRI may also help in the differentiation between testicular germ-cell neoplasms and non-germ-cell neoplasms. Axial T1-weighted imaging, axial and coronal T2-weighted imaging, axial diffusion-weighted imaging, and coronal subtracted dynamic contrast-enhanced imaging are the minimum requirements for scrotal MRI. A variety of MRI techniques—including diffusion tensor imaging, magnetization transfer imaging, proton MR spectroscopy, volumetric apparent diffusion coefficient histogram analysis, and MRI-based radiomics—are being investigated for testicular mass characterization, providing valuable supplementary diagnostic information. In the present review, we aim to discuss clinical indications for scrotal MRI in cases of testicular tumors, along with MRI findings of common testicular malignancies.
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Affiliation(s)
- Athina C. Tsili
- Department of Clinical Radiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, University Campus, 451 10 Ioannina, Greece
- Correspondence: or
| | - Nikolaos Sofikitis
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, University Campus, 451 10 Ioannina, Greece
| | - Ourania Pappa
- Department of Clinical Radiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, University Campus, 451 10 Ioannina, Greece
| | - Christina K. Bougia
- Department of Clinical Radiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, University Campus, 451 10 Ioannina, Greece
| | - Maria I. Argyropoulou
- Department of Clinical Radiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, University Campus, 451 10 Ioannina, Greece
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Oliver TRW, Chappell L, Sanghvi R, Deighton L, Ansari-Pour N, Dentro SC, Young MD, Coorens THH, Jung H, Butler T, Neville MDC, Leongamornlert D, Sanders MA, Hooks Y, Cagan A, Mitchell TJ, Cortes-Ciriano I, Warren AY, Wedge DC, Heer R, Coleman N, Murray MJ, Campbell PJ, Rahbari R, Behjati S. Clonal diversification and histogenesis of malignant germ cell tumours. Nat Commun 2022; 13:4272. [PMID: 35953478 PMCID: PMC9372159 DOI: 10.1038/s41467-022-31375-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 06/13/2022] [Indexed: 12/21/2022] Open
Abstract
Germ cell tumours (GCTs) are a collection of benign and malignant neoplasms derived from primordial germ cells. They are uniquely able to recapitulate embryonic and extraembryonic tissues, which carries prognostic and therapeutic significance. The developmental pathways underpinning GCT initiation and histogenesis are incompletely understood. Here, we study the relationship of histogenesis and clonal diversification in GCTs by analysing the genomes and transcriptomes of 547 microdissected histological units. We find no correlation between genomic and histological heterogeneity. However, we identify unifying features including the retention of fetal developmental transcripts across tissues, expression changes on chromosome 12p, and a conserved somatic evolutionary sequence of whole genome duplication followed by clonal diversification. While this pattern is preserved across all GCTs, the developmental timing of the duplication varies between prepubertal and postpubertal cases. In addition, tumours of younger children exhibit distinct substitution signatures which may lend themselves as potential biomarkers for risk stratification. Our findings portray the extensive diversification of GCT tissues and genetic subclones as randomly distributed, while identifying overarching transcriptional and genomic features.
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Affiliation(s)
- Thomas R W Oliver
- Wellcome Sanger Institute, Hinxton, UK
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | | | | | - Naser Ansari-Pour
- Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- MRC Molecular Haematology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Stefan C Dentro
- Wellcome Sanger Institute, Hinxton, UK
- European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Cambridge, UK
| | | | | | | | | | | | | | - Mathijs A Sanders
- Wellcome Sanger Institute, Hinxton, UK
- Department of Hematology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | | | - Thomas J Mitchell
- Wellcome Sanger Institute, Hinxton, UK
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Isidro Cortes-Ciriano
- European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Cambridge, UK
| | - Anne Y Warren
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - David C Wedge
- Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Manchester Cancer Research Centre, Division of Cancer Sciences, University of Manchester, Manchester, UK
| | - Rakesh Heer
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Newcastle Urology, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Nicholas Coleman
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Department of Pathology, University of Cambridge, Cambridge, UK
| | - Matthew J Murray
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Department of Pathology, University of Cambridge, Cambridge, UK
| | | | | | - Sam Behjati
- Wellcome Sanger Institute, Hinxton, UK.
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
- Department of Paediatrics, University of Cambridge, Cambridge, UK.
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35
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Valentino WL, Cendrowski K, Mandava V, Wei J. A massive retroperitoneal mature teratoma from a "burned-out" testicular teratoma and seminoma. Radiol Case Rep 2022; 17:2732-2736. [PMID: 35669228 PMCID: PMC9166378 DOI: 10.1016/j.radcr.2022.04.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 04/25/2022] [Accepted: 04/28/2022] [Indexed: 11/23/2022] Open
Abstract
Germ cell tumors are the most common nonhematologic malignancy of young men which often present with metastasis to the retroperitoneum, however a primary retroperitoneal mass should also be considered. The case presented herein reports a 42-year-old male presenting with a massive heterogenous retroperitoneal mass determined to be a mature cystic teratoma. Further investigation revealed a multifocal right testicular mass containing both a viable pure seminoma and a fibrous scar demonstrating germ cell neoplasia in situ thus representing the rare phenomenon of a "burned-out" mixed germ cell testicular tumor. When the radiologist is faced with a large retroperitoneal fat-containing mass, the differential includes a renal angiomyolipoma, liposarcoma, or germ cell tumor (whether primary or secondary). If pathology reveals a germ cell tumor, it is imperative to perform a thorough evaluation of the gonads, as it is much more common for a retroperitoneal germ cell tumor to be a metastasis from the gonads, rather than primary in origin.
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Affiliation(s)
- William L Valentino
- Riverside Community Hospital, 4445 Magnolia Avenue, Riverside, CA, 92501, USA
- HCA Healthcare, Nashville, TN, USA
| | - Kristina Cendrowski
- Riverside Community Hospital, 4445 Magnolia Avenue, Riverside, CA, 92501, USA
- HCA Healthcare, Nashville, TN, USA
| | - Veena Mandava
- Riverside Community Hospital, 4445 Magnolia Avenue, Riverside, CA, 92501, USA
- HCA Healthcare, Nashville, TN, USA
| | - Justin Wei
- Riverside Community Hospital, 4445 Magnolia Avenue, Riverside, CA, 92501, USA
- HCA Healthcare, Nashville, TN, USA
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36
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Decoding germ cell tumours for clinicians. Curr Opin Urol 2022; 32:364-372. [PMID: 35749784 DOI: 10.1097/mou.0000000000000999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW Germ-cell tumours of the testis affect predominantly younger males aged between 15 and 40 years, with nearly 74,500 new cases estimated globally in 2020. Their rarity and the complex morphology, mean that, in nonexpert hands, there is a significant risk of misdiagnosis of both type and staging of these neoplasms. RECENT FINDINGS There have been significant changes in the 2016 WHO classification of Testicular tumours that need to be understood by both pathologists and clinicians for streamlining management. Standardised structured reporting guidelines and discussion at the multidisciplinary-team meetings lead to subsequently better health outcomes and patient safety. SUMMARY Therefore, communication with high-quality reports and understanding of clinicians of what constitutes an adequate report, is the key to ensure proper management of these patients. We attempt to discuss the key updates and pathological features that influence management and need to be communicated with clarity and precision.
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37
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Hermann AL, L’Herminé-Coulomb A, Irtan S, Audry G, Cardoen L, Brisse HJ, Vande Perre S, Pointe HDL. Imaging of Pediatric Testicular and Para-Testicular Tumors: A Pictural Review. Cancers (Basel) 2022; 14:3180. [PMID: 35804952 PMCID: PMC9265135 DOI: 10.3390/cancers14133180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 02/04/2023] Open
Abstract
Pre- and post-pubertal testicular tumors are two distinct entities in terms of epidemiology, diagnosis and treatment. Most pre-pubertal tumors are benign; the most frequent are teratomas, and the most common malignant tumors are yolk-sac tumors. Post-pubertal tumors are similar to those found in adults and are more likely to be malignant. Imaging plays a pivotal role in the diagnosis, staging and follow-up. The appearance on ultrasonography (US) is especially helpful to differentiate benign lesions that could be candidates for testis-sparing surgery from malignant ones that require radical orchidectomy. Some specific imaging patterns are described for benign lesions: epidermoid cysts, mature cystic teratomas and Leydig-cell tumors. Benign tumors tend to be well-circumscribed, with decreased Doppler flow on US, but malignancy should be suspected when US shows an inhomogeneous, not-well-described lesion with internal blood flow. Imaging features should always be interpreted in combination with clinical and biological data including serum levels of tumor markers and even intra-operative frozen sections in case of conservative surgery to raise any concerns of malignity. This review provides an overview of imaging features of the most frequent testicular and para-testicular tumor types in children and the value of imaging in disease staging and monitoring children with testicular tumors or risk factors for testicular tumors.
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Affiliation(s)
- Anne-Laure Hermann
- Department of Pediatric and Prenatal Imaging, Armand-Trousseau Hospital, APHP, Sorbonne University, 75012 Paris, France; (S.V.P.); (H.D.L.P.)
| | - Aurore L’Herminé-Coulomb
- Department of Pathology, Armand-Trousseau Hospital, APHP, Sorbonne University, 75012 Paris, France;
| | - Sabine Irtan
- Department of Pediatric Surgery, Armand-Trousseau Hospital, APHP, Sorbonne University, 75012 Paris, France;
| | - Georges Audry
- Department of Imaging, Institut Curie, 75005 Paris, France; (G.A.); (L.C.); (H.J.B.)
| | - Liesbeth Cardoen
- Department of Imaging, Institut Curie, 75005 Paris, France; (G.A.); (L.C.); (H.J.B.)
| | - Hervé J. Brisse
- Department of Imaging, Institut Curie, 75005 Paris, France; (G.A.); (L.C.); (H.J.B.)
| | - Saskia Vande Perre
- Department of Pediatric and Prenatal Imaging, Armand-Trousseau Hospital, APHP, Sorbonne University, 75012 Paris, France; (S.V.P.); (H.D.L.P.)
| | - Hubert Ducou Le Pointe
- Department of Pediatric and Prenatal Imaging, Armand-Trousseau Hospital, APHP, Sorbonne University, 75012 Paris, France; (S.V.P.); (H.D.L.P.)
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38
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Budina A, Sharma T. Placental Site Trophoblastic Tumor in Mediastinal Recurrence of Mixed Germ Cell Tumor of the Testis: Report of a Case and Review of the Literature. Int J Surg Pathol 2022:10668969221105615. [PMID: 35702046 DOI: 10.1177/10668969221105615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We present a rare case of a 42-year-old man diagnosed with a placental site trophoblastic tumor in combination with teratoma in a mediastinal recurrence of a testicular germ cell tumor post-orchiectomy and chemotherapy. To the best of our knowledge, this is the eighth case of placental site trophoblastic tumor in a male reported so far in the English literature. The purpose of this case report is to add data to the existing literature, review the literature, discuss the differential diagnoses with emphasis on morphologic and immunohistochemical differences between trophoblastic tumors, and highlight the management implications of a correct diagnosis.
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Affiliation(s)
- Anna Budina
- Department of Pathology and Laboratory Medicine, 6572Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Tisya Sharma
- Department of Pathology and Laboratory Medicine, 6572Hospital of the University of Pennsylvania, Philadelphia, PA, USA
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39
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Bumbasirevic U, Bojanic N, Simic T, Milojevic B, Zivkovic M, Kosanovic T, Kajmakovic B, Janicic A, Durutovic O, Radovanovic M, Santric V, Zekovic M, Coric V. Interplay between Comprehensive Inflammation Indices and Redox Biomarkers in Testicular Germ-Cell Tumors. J Pers Med 2022; 12:833. [PMID: 35629255 PMCID: PMC9143453 DOI: 10.3390/jpm12050833] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/16/2022] [Accepted: 05/17/2022] [Indexed: 11/16/2022] Open
Abstract
Sustained and dysregulated inflammation, concurrent tumor-induced immune suppression, and oxidative stress are profoundly involved in cancer initiation, presentation, and perpetuation. Within this prospective study, we simultaneously analyzed the preoperative indices of systemic inflammatory response and the representative byproducts of oxidative DNA, protein, and lipid damage with the aim of evaluating their clinical relevance among patients diagnosed with testicular germ-cell tumors (GCT). In the analytical cohort (n = 88, median age 34 years), neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and C-reactive protein (CRP) were significantly altered in patients with a higher tumor stage (p < 0.05). Highly suggestive correlations were found between NLR, dNLR, and SII and modified nucleoside 8-OHdG. CRP and albumin-to-globulin ratio (AGR) significantly correlated with thiols group level and maximal tumor dimension (p < 0.05). Based on receiver operating characteristic (ROC) curve analyses, all the evaluated pre-orchiectomy inflammation markers demonstrated strong performance in predicting metastatic disease; optimal cut-off points were determined for each indicator. Although further large-scale studies are warranted, inflammatory and redox indices may both complement the established tumor markers and standard clinicopathological prognostic variables and contribute to enhanced personalized risk-assessment among testicular GCT patients.
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Affiliation(s)
- Uros Bumbasirevic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (U.B.); (N.B.); (B.M.); (M.Z.); (B.K.); (A.J.); (O.D.); (M.R.); (V.S.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
| | - Nebojsa Bojanic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (U.B.); (N.B.); (B.M.); (M.Z.); (B.K.); (A.J.); (O.D.); (M.R.); (V.S.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
| | - Tatjana Simic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
- Institute of Medical and Clinical Biochemistry, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Department of Medical Sciences, Serbian Academy of Sciences and Arts, 11000 Belgrade, Serbia
| | - Bogomir Milojevic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (U.B.); (N.B.); (B.M.); (M.Z.); (B.K.); (A.J.); (O.D.); (M.R.); (V.S.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
| | - Marko Zivkovic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (U.B.); (N.B.); (B.M.); (M.Z.); (B.K.); (A.J.); (O.D.); (M.R.); (V.S.)
| | - Tijana Kosanovic
- Radiology Department, The University Hospital ‘Dr. Dragisa Misovic-Dedinje’, 11000 Belgrade, Serbia;
| | - Boris Kajmakovic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (U.B.); (N.B.); (B.M.); (M.Z.); (B.K.); (A.J.); (O.D.); (M.R.); (V.S.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
| | - Aleksandar Janicic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (U.B.); (N.B.); (B.M.); (M.Z.); (B.K.); (A.J.); (O.D.); (M.R.); (V.S.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
| | - Otas Durutovic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (U.B.); (N.B.); (B.M.); (M.Z.); (B.K.); (A.J.); (O.D.); (M.R.); (V.S.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
| | - Milan Radovanovic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (U.B.); (N.B.); (B.M.); (M.Z.); (B.K.); (A.J.); (O.D.); (M.R.); (V.S.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
| | - Veljko Santric
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (U.B.); (N.B.); (B.M.); (M.Z.); (B.K.); (A.J.); (O.D.); (M.R.); (V.S.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
| | - Milica Zekovic
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, 11000 Belgrade, Serbia
| | - Vesna Coric
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
- Institute of Medical and Clinical Biochemistry, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
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40
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Pickett L, Liddy R, Davis N, Foran P, Singh J, Quinlan M. Regressed testicular germ cell tumour in a post-pubertal male. Urol Case Rep 2022; 42:101997. [PMID: 35070726 PMCID: PMC8761703 DOI: 10.1016/j.eucr.2022.101997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/28/2021] [Accepted: 01/06/2022] [Indexed: 11/30/2022] Open
Abstract
Testicular germ cell regression is a rare, generally metastatic phenomenon which describes the spontaneous, complete, or partial regression of a testicular germ cell tumour. As a result, studies have focused on defining specific histopathological criteria to establish if the resected testis is the primary source of the germ cell tumour. There are few publications which describe its presentation in the absence of distant metastases with elevated tumour markers and suspicious findings on testicular ultrasound. We present the clinical presentation and radiological features of a non-metastatic regressed testicular germ cell tumour following scrotal trauma in a post pubertal male.
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Oldenburg J, Berney DM, Bokemeyer C, Climent MA, Daugaard G, Gietema JA, De Giorgi U, Haugnes HS, Huddart RA, Leão R, Sohaib A, Gillessen S, Powles T. Testicular seminoma and non-seminoma: ESMO-EURACAN Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol 2022; 33:362-375. [PMID: 35065204 DOI: 10.1016/j.annonc.2022.01.002] [Citation(s) in RCA: 63] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 12/17/2021] [Accepted: 01/05/2022] [Indexed: 11/27/2022] Open
Affiliation(s)
- J Oldenburg
- Department of Oncology, Akershus University Hospital, Lørenskog; Faculty of Medicine, University of Oslo, Oslo, Norway
| | - D M Berney
- Department of Cellular Pathology, Barts Cancer Institute, Queen Mary University of London, London; Barts Health NHS Trust, London, UK
| | - C Bokemeyer
- Department of Oncology, Hematology, Bone Marrow Transplantation with section Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M A Climent
- Fundacion Instituto Valenciano de Oncología, València, Spain
| | - G Daugaard
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - J A Gietema
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - U De Giorgi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST),'Dino Amadori', Meldola, Italy
| | - H S Haugnes
- Department of Oncology, University Hospital of North Norway and UiT-The Arctic University, Tromsoe, Norway
| | - R A Huddart
- Institute of Cancer Research and Royal Marsden Foundation Trust, London, UK
| | - R Leão
- Department of Urology, Hospital de Braga, Hospital CUF Coimbra, Faculty of Medicine University of Coimbra, Coimbra, Portugal
| | - A Sohaib
- Department of Diagnostic Radiology, Royal Marsden Hospital, Sutton, Surrey, UK
| | - S Gillessen
- Oncology Institute of Southern Switzerland, EOC, Bellinzona; Faculty of Biomedical Sciences, USI, Lugano, Switzerland; Division of Cancer Medicine, University of Manchester, Manchester
| | - T Powles
- Barts Health NHS Trust, London, UK
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Ataikiru UO, Iacob ER, Miron I, Popoiu CM, Boia ES. A 10-year retrospective single-center study of alpha-fetoprotein and beta-human chorionic gonadotropin in Romanian children with (para)gonadal tumors and cysts. J Pediatr Endocrinol Metab 2022; 35:363-371. [PMID: 34968016 DOI: 10.1515/jpem-2021-0382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 12/06/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Malignant tumor is a top-ranking cause of pediatric (>1-year) mortality in America and Europe. Among pediatric tumors, germ cell tumors (GCT) and gonadal tumors rank fourth (6%) by the Surveillance, Epidemiology, and End Results (SEER) program (seer.cancer.gov). Continuous research on tumor markers harnesses their full potential in tumor detection and management. We evaluated the effectiveness of beta-human chorionic gonadotropin (β-hCG) and Alpha-fetoprotein (AFP) in Romanian children with (para)gonadal tumors and cysts, determining their accuracy in detecting malignancy, tumor-type, stage, complications, prognosis, and treatment response. METHODS A 10-year retrospective study of AFP and β-hCG in 134 children with cysts and (para)gonadal tumors aged one month to 17 years was performed. RESULTS AFP/β-hCG was unelevated in patients with cysts and nonmalignant tumors. Forty-eight/86 patients (43 GCT and 5 non-GCT) with malignant tumors had elevated AFP/β-hCG, 3/48 patients had recurrences, and 25/48 had mixed-GCT (68% had elevated AFP + β-hCG). All 30 patients with Yolk sac tumors (YST) or their components had elevated AFP. Area under the curve, sensitivity and specificity for GCT were: AFP + β-hCG- 0.828, 67.2%, 100%; AFP- 0.813, 64.1%, 100%; and β-hCG- 0.664, 32.8%, 100%. Two patients whose AFP/β-hCG levels remained elevated died. Common mixed-GCT components were YST-80% and embryonal carcinoma-72%. Thirty of 34 metastasis cases were GCT, with 26/34 patients having elevated AFP/β-hCG. CONCLUSIONS AFP/β-hCG detects malignant GCT and can determine tumor-type. GCT patients with markedly elevated AFP + β-hCG had poor prognosis, especially if recurrence or metastasis was present. Recurrence is unrelated to elevated AFP/β-hCG. The tumor components and quantity present determine AFP/β-hCG values in mixed-GCT.
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Affiliation(s)
- Usiwoma O Ataikiru
- Department of Pediatric Surgery and Orthopedics, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
- Department of Pediatric Surgery and Orthopedics, "Louis Turcanu" Emergency Childrens Hospital, Timisoara, Romania
| | - Emil R Iacob
- Department of Pediatric Surgery and Orthopedics, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
- Department of Pediatric Surgery and Orthopedics, "Louis Turcanu" Emergency Childrens Hospital, Timisoara, Romania
| | - Ingrith Miron
- Department of Pediatric Hematology and Oncology, Saint Mary Clinical Emergency Hospital for Children, Iasi, Romania
| | - Calin M Popoiu
- Department of Pediatric Surgery and Orthopedics, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
- Department of Pediatric Surgery and Orthopedics, "Louis Turcanu" Emergency Childrens Hospital, Timisoara, Romania
| | - Eugen S Boia
- Department of Pediatric Surgery and Orthopedics, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
- Department of Pediatric Surgery and Orthopedics, "Louis Turcanu" Emergency Childrens Hospital, Timisoara, Romania
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Shahrokh S, Tran D, Lines B, Bhuriwala MN. Testicular Germ Cell Tumor Composed of Seminoma and Teratoma Metastasizing as Choriocarcinoma to the Lung Successfully Treated With Salvage Chemotherapy and Bone-Marrow Transplant: A Case Report. Cureus 2022; 14:e22885. [PMID: 35399484 PMCID: PMC8982517 DOI: 10.7759/cureus.22885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2022] [Indexed: 11/05/2022] Open
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Myklebust MP, Søviknes AM, Halvorsen OJ, Thor A, Dahl O, Ræder H. MicroRNAs in Differentiation of Embryoid Bodies and the Teratoma Subtype of Testicular Cancer. Cancer Genomics Proteomics 2022; 19:178-193. [PMID: 35181587 DOI: 10.21873/cgp.20313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 01/14/2022] [Accepted: 01/20/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Testicular germ cell tumours (TGCTs) are the most frequent tumour type among young, adult men. TGCTs can be efficiently treated, but metastases of the teratoma subtype, for which there are no circulating biomarkers, represent a challenge. MATERIALS AND METHODS Global microRNA expression in teratoma tissue and embryoid bodies was assessed using next-generation sequencing. Levels of microRNAs identified as potential biomarkers were obtained from serum of patients with teratoma and matched healthy men. RESULTS We identified miR-222-5p, miR-200a-5p, miR-196b-3p and miR-454-5p as biomarker candidates from the tumour tissue and embryoid body screening but the expression of these microRNAs was very low in serum and not statistically different between patients and controls. miR-375-3p was highly expressed, being highest in patients with teratoma (p=0.012) but the levels of expression in serum from these patients and healthy controls overlapped. miR-371a-3p was not expressed in serum from patients with pure teratoma, only in patients with mixed tumours. CONCLUSION The microRNA profiles of the teratoma subtype of TGCT and embryoid bodies were obtained and assessed for candidate circulating biomarkers, but none with high sensitivity and specificity for teratoma were identified in our study. We conclude that neither the proposed teratoma marker miR-375-3p nor miR-371a-3p are suitable as circulating teratoma markers.
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Affiliation(s)
| | - Anne Mette Søviknes
- Center for Diabetes Research, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Ole Johan Halvorsen
- Gade Laboratory for Pathology, Department of Clinical Medicine, Centre for Cancer Biomarkers CCBIO, University of Bergen, Bergen, Norway
| | - Anna Thor
- Department of Urology and CLINTEC Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Olav Dahl
- Department of Oncology and Medical Physics, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Helge Ræder
- Center for Diabetes Research, Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Pediatrics, Haukeland University Hospital, Bergen, Norway
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Bumbasirevic U, Bojanic N, Pljesa-Ercegovac M, Zivkovic M, Djukic T, Zekovic M, Milojevic B, Kajmakovic B, Janicic A, Simic T, Coric V. The Polymorphisms of Genes Encoding Catalytic Antioxidant Proteins Modulate the Susceptibility and Progression of Testicular Germ Cell Tumor. Cancers (Basel) 2022; 14:cancers14041068. [PMID: 35205816 PMCID: PMC8870690 DOI: 10.3390/cancers14041068] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/14/2022] [Accepted: 02/18/2022] [Indexed: 01/11/2023] Open
Abstract
Simple Summary Testicular cancer is the most common malignancy in the population of young and reproductively active men. The risk factors for its occurrence are not fully elucidated. Undescended testicle remains the main risk factor; however, more precise molecular studies associate genetic variations with susceptibility to testicular tumor development and progression. In this study, we found that specific variations in genes encoding antioxidant defense proteins confer risks of testicular cancer development and progression and, therefore, helps to identify subjects at higher risk, as well as those requiring additional diagnostics and more intensive forms of treatment. Abstract The simultaneous analysis of redox biomarkers and polymorphisms encoding for regulatory and catalytic antioxidant proteins was performed in order to evaluate their potential role in the development of testicular germ cell tumor (GCT), as well as the progression of the disease. NRF2 (rs6721961), GSTM3 (rs1332018), SOD2 (rs4880) and GPX3 (rs8177412) polymorphisms were assessed in 88 patients with testicular GCT (52 with seminoma) and 88 age-matched controls. The plasma levels of 8-hydroxy-2′-deoxyguanosine (8-OHdG), thiol groups and the plasma activity of glutathione peroxidase were measured. A significant association between variant GPX3*TC+CC genotype and risk of overall testicular GCT, as well as seminoma development, was found. Moreover, carriers of variant SOD2*TT genotype were at almost 3-fold increased risk of seminoma development. Interestingly, combined SOD2*TT/GPX3*TC+CC genotype conferred a 7-fold higher risk for testicular GCT development. Finally, variant GSTM3*AC+CC genotype was associated with a higher risk for the development of advanced diseased. The presence of assessed genetic variants was not associated with significantly higher levels of redox biomarkers in both testicular GCT patients, as well as in those diagnosed with seminoma. In conclusion, the polymorphic expression of certain antioxidant enzymes might affect susceptibility toward testicular GCT development, as well as the progression of the disease.
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Affiliation(s)
- Uros Bumbasirevic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (U.B.); (N.B.); (M.Z.); (B.M.); (B.K.); (A.J.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.P.-E.); (T.D.)
| | - Nebojsa Bojanic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (U.B.); (N.B.); (M.Z.); (B.M.); (B.K.); (A.J.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.P.-E.); (T.D.)
| | - Marija Pljesa-Ercegovac
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.P.-E.); (T.D.)
- Institute of Medical and Clinical Biochemistry, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Marko Zivkovic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (U.B.); (N.B.); (M.Z.); (B.M.); (B.K.); (A.J.)
| | - Tatjana Djukic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.P.-E.); (T.D.)
- Institute of Medical and Clinical Biochemistry, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Milica Zekovic
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, 11000 Belgrade, Serbia;
| | - Bogomir Milojevic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (U.B.); (N.B.); (M.Z.); (B.M.); (B.K.); (A.J.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.P.-E.); (T.D.)
| | - Boris Kajmakovic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (U.B.); (N.B.); (M.Z.); (B.M.); (B.K.); (A.J.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.P.-E.); (T.D.)
| | - Aleksandar Janicic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (U.B.); (N.B.); (M.Z.); (B.M.); (B.K.); (A.J.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.P.-E.); (T.D.)
| | - Tatjana Simic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.P.-E.); (T.D.)
- Institute of Medical and Clinical Biochemistry, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Department of Medical Sciences, Serbian Academy of Sciences and Arts, 11000 Belgrade, Serbia
- Correspondence: (T.S.); (V.C.); Tel.: +381-113643250 (T.S.); +381-113643273 (V.C.)
| | - Vesna Coric
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.P.-E.); (T.D.)
- Institute of Medical and Clinical Biochemistry, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Correspondence: (T.S.); (V.C.); Tel.: +381-113643250 (T.S.); +381-113643273 (V.C.)
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Shahrokh S, Shahin M, Abolhasani M, Arefpour AM. Burned-Out Testicular Tumor Presenting as a Retroperitoneal Mass: A Case Report. Cureus 2022; 14:e21603. [PMID: 35228961 PMCID: PMC8870314 DOI: 10.7759/cureus.21603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2022] [Indexed: 11/18/2022] Open
Abstract
Spontaneous primary tumor regression, or burned-out tumors, refers to the presence of a metastatic tumor with the histological regression of the primary lesion. The burned-out phenomenon has been reported in various malignancies, with testicular germ cell tumors (GCTs) accounting for a significant share of these cases. However, burned-out testicular tumors are a rare clinical phenomenon and are generally difficult to diagnose, as there is no evidence of primary testicular cancer. Here, we describe the case of a 42-year-old male who presented to our hospital complaining of right abdomen and groin pain for several months. On physical exam, the patient had normal genital and rectal exams. An abdominal-pelvic computed tomography (CT) scan of his abdomen and pelvis revealed a large retroperitoneal mass with radiographic characteristics of a sarcoma. Given his groin pain, the patient had a testicular ultrasound, which revealed scar tissue in the right testicle. His testicular tumor markers showed elevated β-human chorionic gonadotropin (β-hCG) and lactate dehydrogenase (LDH) but normal α-fetoprotein (AFP). He underwent right radical inguinal orchiectomy, with pathologic examination of the testicle revealing a burned-out testicular tumor. The patient was then treated with four cycles of bleomycin, etoposide, and cisplatin (BEP). His post-treatment tumor markers were normalized; however, his abdomen-pelvic CT scan showed a persistent mass. The patient underwent retroperitoneal lymph node dissection (RPLND) with the removal of 12 lymph nodes. However, pathologic evaluation of the lymph nodes revealed no evidence of neoplastic cells. The patient has remained disease-free after five years of follow-up. This report highlights the potential of burned-out testicular tumors in young and middle-aged men presenting with a retroperitoneal mass. Furthermore, it underscores the importance of obtaining testicular ultrasound in these patients to rule out regressed testicular tumors.
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Therapeutical interference with the epigenetic landscape of germ cell tumors: a comparative drug study and new mechanistical insights. Clin Epigenetics 2022; 14:5. [PMID: 34996497 PMCID: PMC8742467 DOI: 10.1186/s13148-021-01223-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 12/18/2021] [Indexed: 12/18/2022] Open
Abstract
Background Type II germ cell tumors (GCT) are the most common solid cancers in males of age 15 to 35 years. Treatment of these tumors includes cisplatin-based therapy achieving high cure rates, but also leading to late toxicities. As mainly young men are suffering from GCTs, late toxicities play a major role regarding life expectancy, and the development of therapy resistance emphasizes the need for alternative therapeutic options. GCTs are highly susceptible to interference with the epigenetic landscape; therefore, this study focuses on screening of drugs against epigenetic factors as a treatment option for GCTs.
Results We present seven different epigenetic inhibitors efficiently decreasing cell viability in GCT cell lines including cisplatin-resistant subclones at low concentrations by targeting epigenetic modifiers and interactors, like histone deacetylases (Quisinostat), histone demethylases (JIB-04), histone methyltransferases (Chaetocin), epigenetic readers (MZ-1, LP99) and polycomb-repressive complexes (PRT4165, GSK343). Mass spectrometry-based analyses of the histone modification landscape revealed effects beyond the expected mode-of-action of each drug, suggesting a wider spectrum of activity than initially assumed. Moreover, we characterized the effects of each drug on the transcriptome of GCT cells by RNA sequencing and found common deregulations in gene expression of ion transporters and DNA-binding factors. A kinase array revealed deregulations of signaling pathways, like cAMP, JAK-STAT and WNT. Conclusion Our study identified seven drugs against epigenetic modifiers to treat cisplatin-resistant GCTs. Further, we extensively analyzed off-target effects and modes-of-action, which are important for risk assessment of the individual drugs. Supplementary Information The online version contains supplementary material available at 10.1186/s13148-021-01223-1.
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Wu R, Liu X, Song Y, Yi S, Chen W, Fu W, Zhu J. Spontaneous Rupture of Rhabdomyosarcoma of the Testis With Unilateral Ptosis: A Case Report and Literature Review. Front Pediatr 2022; 10:904275. [PMID: 35837241 PMCID: PMC9273775 DOI: 10.3389/fped.2022.904275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 06/06/2022] [Indexed: 11/13/2022] Open
Abstract
Spontaneous rupture of testicular rhabdomyosarcoma is very rare. We report a case of spontaneous testicular rupture that was pathologically confirmed as rhabdomyosarcoma with unilateral blepharoptosis. The patient, a 19-year-old male, and his father had weakness of the left eyelid muscle. The patient was suspected to have a right inguinal hernia by a family doctor but was not treated further. 2 days later, there was skin itching in the right inguinal area, accompanied by redness, swelling and discomfort of the right scrotum, and the patient went to the local hospital again. Ultrasound examination showed that a contusion of the right testis may have been complicated with orchitis. Oral levofloxacin was ineffective. In addition, the swelling of scrotal increased significantly. He came to the emergency room of our hospital and also was treated with levofloxacin, but the pain was still not relieved. CT and ultrasound examination could not identify the cause of the disease. Exploration of the right scrotum was performed under general anesthesia and confirmed that the right testis had spontaneously ruptured. The pathological diagnosis was rhabdomyosarcoma of the right testis. Testicular rhabdomyosarcoma is clinically rare, and spontaneous rupture is even rarer. The pathogenesis of the disease needs to be further studied, and the diagnosis should be made on a case-by-case basis. Overall, the prognosis of testicular rhabdomyosarcoma is poor. As seen in this case, further study is required to determine whether there is some association between testicular rhabdomyosarcoma and ptosis. Unfortunately, the patient's family rejected a genetic examination because of financial difficulty. We only report a single case of this rare phenomenon here.
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Affiliation(s)
- Ronghua Wu
- Department of Urology, Xinqiao Hospital of Army Medical University, Chongqing, China
| | - Xing Liu
- Department of Urology, Xinqiao Hospital of Army Medical University, Chongqing, China
| | - Yajun Song
- Department of Urology, Xinqiao Hospital of Army Medical University, Chongqing, China
| | - Shanhong Yi
- Department of Urology, Xinqiao Hospital of Army Medical University, Chongqing, China
| | - Wei Chen
- Department of Urology, Xinqiao Hospital of Army Medical University, Chongqing, China
| | - Wanlei Fu
- Department of Pathology, Xinqiao Hospital of Army Medical University, Chongqing, China
| | - Jingzhen Zhu
- Department of Urology, Xinqiao Hospital of Army Medical University, Chongqing, China
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Rao BV, Ranjitha VN, Khemani R, Fonseca D, Murthy SS, Giridhar A, Jayakarthik Y, Sharma R, V. N. Raju KV, Rao TS, Sundaram C. The core four - A panel of immunohistochemistry markers to diagnose and subtype testicular germ cell tumors. Urol Ann 2022; 14:21-26. [PMID: 35197698 PMCID: PMC8815357 DOI: 10.4103/ua.ua_69_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 09/21/2021] [Indexed: 11/27/2022] Open
Abstract
Context: Immunohistochemistry (IHC) to differentiate germ cell tumors. Aims: The aim of the study is to differentiate seminomatous and nonseminomatous germ cell tumors (GCTs) with morphological overlap using a minimal and affordable panel of IHC markers. Settings and Design: This is a retrospective observational study. Subjects and Methods: All testicular GCTs (TGCT) which were diagnosed on biopsies and/or resection specimens (prechemotherapy) between January 2014 and June 2019. The demographic, clinical, and imaging findings were noted from the medical records. Hematoxylin and eosin (H and E)-stained sections were reviewed for morphology. The IHC markers constituted Octamer-binding transcription factor (OCT) 3/4, glypican 3 (GPC3), CD117, CD30, placental-like alkaline phosphatase, Sal-like protein 4, and β-human chorionic gonadotropin (HCG). IHC markers were performed in various combinations depending on the morphology, and a panel constituting OCT 3/4, CD117, GPC3, and CD30 was performed on cases with diagnostic dilemma and morphological overlaps. Statistical Analysis Used: Sensitivity, specificity, positive (PPV), and negative predictive value (NPV) were calculated for suggested panel of IHC OCT 3/4, CD117, GPC3, and CD30. Results: The study included 36 patients with TGCT with a mean age of 27 (15–58) years. Nonseminomatous tumors were the most common (86%). The concise panel was performed in 20/36 (56%) tumors to resolve the diagnosis. The sensitivity, specificity, PPV, and NPV for OCT3/4 were 80%, 55%, 31%, and 92% in seminomas and 65%, 100%, 100%, and 46% in embryonal carcinomas (EC), for CD117 was 89%, 82%, 73%, and 93% in seminomas and 60%, 77%, 60%, and 77% in yolk sac tumors (YST), for GPC3 was 95%, 90%, 95%, and 90% in YST, CD30 96%, 100%, 100%, and 91% in ECs, respectively. Conclusions: Designing a novel concise and affordable IHC panel constituting OCT 3/4, CD117, GPC3, and CD30 has good sensitivity and specificity in differentiating seminomas, YST, and EC, respectively. Additional markers, namely β-HCG, can be used in identifying the choriocarcinoma component.
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Testicular Tumors: A 15-Year Archive Review and Histopathological Evaluation. JOURNAL OF CONTEMPORARY MEDICINE 2021. [DOI: 10.16899/jcm.929096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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