Anaplastic variant of classical seminoma of the testis: northern Israel oncology center experience and brief review of literature

Elastographic Imaging of Anaplastic Seminoma of Testis With Its Ultrasound and Doppler Correlation: A Case Report

The commonest solid tumour in men between the ages of 15 and 44 is testicular cancer. Germ cell tumours, which are then subdivided into seminomatous and non-seminomatous tumours, are its primary histological kind. In the fourth decade of a man's life, seminoma accounts for 55% of testicular cancer. Anaplastic seminoma, which accounts for 5% to 15% of testicular seminoma, is an uncommon kind of seminoma. The anaplastic variant of classical seminoma is an uncommon type of seminoma. In order to increase confidence in diagnosing and differentiating benign from malignant lesions and localising lesions in the testis, tissue elastography has arisen as a definite, important supplementary method. We present a case report of anaplastic seminoma with its classical imaging findings on strain elastography and its correlation with ultrasound and doppler.

Mediastinal type B3 thymoma combined with germ cell tumor: cytologic diagnosis

Primary mediastinal thymoma combined with germ cell tumor (GCT) is extremely rare, and is likely to be misdiagnosed. Here we report a case of mediastinal type B3 thymoma combined with seminoma in which the seminoma component was missed by histologic examination and initially diagnosed by using a pleural effusion sample. The patient was a 46 year old male with chest distress, cough, and supraclavicular lymph node enlargement. A large anterior mediastinal mass was revealed by diagnostic imaging. The tumor was completely removed by thoracotomy. Grossly, a solid mass about 10 cm × 8 cm × 5 cm with cystic degeneration was found. Histologic examination revealed Type B3 thymoma accompanying with multiple lymph node metastases. One year later, CT scan found an irregular mass on the right side of anterior-superior mediastinum with a large amount of effusion in the right side pleural cavity. Cytologic examination and immunostains of the pleural effusion sample revealed metastatic seminoma. Then the original surgical sample was reviewed and the seminoma component also was found besides the thymoma. To the best of our knowledge, this is the first description of type B3 thymoma combined with seminoma, diagnosed by histology and pleural effusion together. We also present a literature review.

Handling and reporting of orchidectomy specimens with testicular cancer: areas of consensus and variation among 25 experts and 225 European pathologists

AIMS

The handling and reporting of testicular tumours is difficult due to their rarity.

METHODS AND RESULTS

A survey developed by the European Network of Uro-Pathology (ENUP) and sent to its members and experts to assess the evaluation of testicular germ cell tumours. Twenty-five experts and 225 ENUP members replied. Areas of disagreement included immaturity in teratomas, reported by 32% of experts but 68% of ENUP. Although the presence of rete testis invasion was reported widely, the distinction between pagetoid and stromal invasion was made by 96% of experts but only 63% of ENUP. Immunohistochemistry was used in more than 50% of cases by 68% of ENUP and 12% of experts. Staging revealed the greatest areas of disagreement. Invasion of the tunica vaginalis without vascular invasion was interpreted as T1 by 52% of experts and 67% of ENUP, but T2 by the remainder. Tumour invading the hilar adipose tissue adjacent to the epididymis without vascular invasion was interpreted as T1: 40% of experts, 43% of ENUP; T2: 36% of experts, 30% of ENUP; and T3: 24% of experts, 27% of ENUP.

CONCLUSIONS

There is remarkable consensus in many areas of testicular pathology. Significant areas of disagreement included staging and reporting of histological types, both of which have the potential to impact on therapy.