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Assi AK, Awwad HH, Baraghithi NI, Khaled ZA, Odeh AM. A Rare Case of a Non-seminomatous Testicular Cancer Metastasis to the Duodenum: A Case Report. Cureus 2024; 16:e59332. [PMID: 38817519 PMCID: PMC11137609 DOI: 10.7759/cureus.59332] [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: 04/30/2024] [Indexed: 06/01/2024] Open
Abstract
Testicular cancer is among the most common solid tumors in young men. Gastrointestinal tract (GIT) metastasis of testicular cancer has been rarely reported. In addition, metastasis occurs most commonly through retroperitoneal lymph nodes. Manifestations like abdominal pain and obstruction can be present if metastasis to GIT was considered. We report here a case of a 34-year-old male who was admitted to our GIT unit complaining of episodic epigastric pain. Computed Tomogram (CT) scan demonstrated a soft tissue like lesion involving the lumen of duodenum. Moreover, the patient had a right radical orchiectomy 18 months prior to the presentation due to a stage IA non-seminomatous germ cell tumor with no lymphovascular invasion and free surgical margins. Esophagogastroduodenoscopy (EGD) revealed a malignant appearing duodenal lesion and biopsy showed that it was compatible with germ cell tumor. Metastatic embryonal carcinoma to duodenum was diagnosed and confirmed by immunohistochemical stains. Then, the patient's situation was discussed and decided to be on a plan of four cycles of chemotherapy regimens. Testicular malignancy metastasis to GIT is uncommon, but it's important to know that there is a contact between GIT and testicular lymphatic drainage through para-aortic lymph nodes. So, even if it's rare to occur, it's still possible, and we should always be concerned about it. Mostly, diagnosis of testicular tumors begins with evaluating tumor markers such as alpha-fetoprotein (AFP), beta-subunit of human chorionic gonadotropin (B-hCG), and lactate dehydrogenase (LDH). But in contrast, all of these markers were within the normal range of their values in our case. Suspicion for metastasis and GIT involvement must be raised when dealing with a young male who had a history of testicular tumor such as embryonal carcinoma which was reported here in our case. That is very essential for avoiding potential complications and saving time in order to start management.
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Affiliation(s)
- Anas K Assi
- Faculty of Medicine, Al-Quds University, Jerusalem, PSE
| | | | | | | | - Abdulrahim M Odeh
- Gastroenterology and Hepatology, Istishari Arab hospital, Ramallah, PSE
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2
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Krasic J, Skara Abramovic L, Himelreich Peric M, Vanjorek V, Gangur M, Zovko D, Malnar M, Masic S, Demirovic A, Juric B, Ulamec M, Coric M, Jezek D, Kulis T, Sincic N. Testicular Germ Cell Tumor Tissue Biomarker Analysis: A Comparison of Human Protein Atlas and Individual Testicular Germ Cell Tumor Component Immunohistochemistry. Cells 2023; 12:1841. [PMID: 37508506 PMCID: PMC10378501 DOI: 10.3390/cells12141841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 07/06/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
The accurate management of testicular germ cell tumors (TGCTs) depends on identifying the individual histological tumor components. Currently available data on protein expression in TGCTs are limited. The human protein atlas (HPA) is a comprehensive resource presenting the expression and localization of proteins across tissue types and diseases. In this study, we have compared the data from the HPA with our in-house immunohistochemistry on core TGCT diagnostic genes to test reliability and potential biomarker genes. We have compared the protein expression of 15 genes in TGCT patients and non-neoplastic testicles with the data from the HPA. Protein expression was converted into diagnostic positivity. Our study discovered discrepancies in three of the six core TGCT diagnostic genes, POU5F1, KIT and SOX17 in HPA. DPPA3, CALCA and TDGF1 were presented as potential novel TGCT biomarkers. MGMT was confirmed while RASSF1 and PRSS21 were identified as biomarkers of healthy testicular tissue. Finally, SALL4, SOX17, RASSF1 and PRSS21 dysregulation in the surrounding testicular tissue with complete preserved spermatogenesis of TGCT patients was detected, a potential early sign of neoplastic transformation. We highlight the importance of a multidisciplinary collaborative approach to fully understand the protein landscape of human testis and its pathologies.
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Affiliation(s)
- Jure Krasic
- Croatian Institute for Brain Research, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Lucija Skara Abramovic
- Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Department of Virology, Croatian Institute of Public Health, 10000 Zagreb, Croatia
| | - Marta Himelreich Peric
- Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Health Centre Zagreb-West, 10000 Zagreb, Croatia
| | - Vedran Vanjorek
- Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Marko Gangur
- Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Dragana Zovko
- Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Marina Malnar
- Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Silvija Masic
- Ljudevit Jurak Clinical Department of Pathology and Cytology, University Clinical Hospital Center Sestre Milosrdnice, 10000 Zagreb, Croatia
| | - Alma Demirovic
- Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Ljudevit Jurak Clinical Department of Pathology and Cytology, University Clinical Hospital Center Sestre Milosrdnice, 10000 Zagreb, Croatia
- School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Bernardica Juric
- Ljudevit Jurak Clinical Department of Pathology and Cytology, University Clinical Hospital Center Sestre Milosrdnice, 10000 Zagreb, Croatia
| | - Monika Ulamec
- Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Ljudevit Jurak Clinical Department of Pathology and Cytology, University Clinical Hospital Center Sestre Milosrdnice, 10000 Zagreb, Croatia
- Department of Pathology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Marijana Coric
- Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Department of Pathology and Cytology, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
| | - Davor Jezek
- Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Department of Histology and Embryology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Tomislav Kulis
- Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Department of Urology, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
- Department of Urology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Nino Sincic
- Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Department of Biology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
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3
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Dumitru AV, Țăpoi DA, Halcu G, Munteanu O, Dumitrascu DI, Ceaușu MC, Gheorghișan-Gălățeanu AA. The Polyvalent Role of CD30 for Cancer Diagnosis and Treatment. Cells 2023; 12:1783. [PMID: 37443818 PMCID: PMC10341339 DOI: 10.3390/cells12131783] [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: 06/09/2023] [Revised: 07/01/2023] [Accepted: 07/03/2023] [Indexed: 07/15/2023] Open
Abstract
CD30, also known as TNFRSF8 (tumor necrosis factor receptor superfamily member 8), is a protein receptor that is heavily glycosylated inside the Golgi apparatus, as well as a tumor marker that is found on the surface of specific cells in the body, including certain immune cells and cancer ones. This review aims to shed light on the critical importance of CD30, from its emergence in the cell to its position in diagnosing various diseases, including Hodgkin lymphoma, where it is expressed on Hodgkin and Reed-Sternberg cells, as well as embryonal carcinoma, anaplastic large cell lymphoma (ALCL), and cutaneous T-cell lymphoma (CTCL). In addition to its role in positive diagnosis, targeting CD30 has been a promising approach treating CD30-positive lymphomas, and there is ongoing research into the potential use of CD30-targeted therapies for autoimmune disorders. We aim to elaborate on CD30's roles as a tumor marker, supporting thus the hypothesis that this receptor might be the aim of cytostatic treatment.
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Affiliation(s)
- Adrian Vasile Dumitru
- Department of Pathology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.V.D.); (M.C.C.)
- Department of Pathology, University Emergency Hospital, 050098 Bucharest, Romania
| | - Dana Antonia Țăpoi
- Department of Pathology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.V.D.); (M.C.C.)
- Department of Pathology, University Emergency Hospital, 050098 Bucharest, Romania
| | - Georgian Halcu
- Department of Pathology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.V.D.); (M.C.C.)
- Department of Pathology, Colțea Clinical Hospital, 030171 Bucharest, Romania
| | - Octavian Munteanu
- Department of Anatomy, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Department of Obstetrics and Gynecology, University Emergency Hospital, 050098 Bucharest, Romania
| | - David-Ioan Dumitrascu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| | - Mihail Constantin Ceaușu
- Department of Pathology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.V.D.); (M.C.C.)
- Department of Pathology, Alexandru Trestioreanu Institute of Oncology, 022328 Bucharest, Romania
| | - Ancuța-Augustina Gheorghișan-Gălățeanu
- Department of Cellular and Molecular Biology and Histology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- C.I. Parhon National Institute of Endocrinology, 011863 Bucharest, Romania
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Siegmund SE, Mehra R, Acosta AM. An update on diagnostic tissue-based biomarkers in testicular tumors. Hum Pathol 2023; 133:32-55. [PMID: 35932825 DOI: 10.1016/j.humpath.2022.07.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 07/25/2022] [Indexed: 11/04/2022]
Abstract
Testicular cancer is rare overall but comprises the most common solid malignancy diagnosed in young men aged ∼20-40 years. Most testicular neoplasms generally fall into 2 broad categories: germ cell tumors (GCTs; ∼95%) and sex cord-stromal tumors (SCSTs ∼5%). Given the relative rarity of these tumors, diagnostic biomarkers are highly relevant for their diagnosis. Over the past several decades, diagnostic biomarkers have improved dramatically through targeted immunohistochemical and molecular characterization. Despite these recent advances, most markers are not perfectly sensitive or entirely specific. Therefore, they need to be used in combination and interpreted in context. In this review, we summarize tissue-based biomarkers relevant to the pathologist, with a focus on practical diagnostic issues that relate to testicular GCT and SCST.
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Affiliation(s)
- Stephanie E Siegmund
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
| | - Rohit Mehra
- Department of Pathology and Michigan Center for Translational Pathology, University of Michigan Hospital and Health Systems, 1500, East Medical Center Drive, Ann Arbor, MI 48109, USA.
| | - Andres M Acosta
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
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Hajeh H, Aboaid H, Fox K, Cobos E, Heidari A. What You See Is Not What You Get: Germ Cell Tumor Mimicking Disseminated Coccidioidomycosis. J Investig Med High Impact Case Rep 2023; 11:23247096231191872. [PMID: 37559378 PMCID: PMC10413900 DOI: 10.1177/23247096231191872] [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: 05/20/2023] [Revised: 07/07/2023] [Accepted: 07/14/2023] [Indexed: 08/11/2023] Open
Abstract
We present the case of a 30-year-old man with no prior medical history who presented to the hospital with a myriad of symptoms such as shortness of breath, generalized weakness, lower limb weakness, and urinary retention. He was recently diagnosed with "disseminated coccidioidomycosis" by an outside provider on an outpatient basis and started on fluconazole orally. However, due to a lack of improvement and significant symptoms, he was sent to the hospital to initiate liposomal amphotericin B treatment. After a comprehensive workup, an alternative diagnosis was suspected and eventually confirmed as metastatic germ cell carcinoma. Due to the vast dissemination and his poor functional status despite chemotherapy initiation, the patient elected for palliative care and expired shortly after at hospice. This case demonstrates the similarity of clinical findings between disseminated infections and malignancies.
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Affiliation(s)
| | - Hazem Aboaid
- UCLA—Kern Medical, Bakersfield, CA, USA
- Valley Fever Institute, Bakersfield, CA, USA
| | - Kasey Fox
- UCLA—Kern Medical, Bakersfield, CA, USA
| | | | - Arash Heidari
- UCLA—Kern Medical, Bakersfield, CA, USA
- Valley Fever Institute, Bakersfield, CA, USA
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