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Sim J, Irvin J, Altorok N. 1,25-Dihydroxyvitamin D Mediated Hypercalcemia in Seminoma. Am J Med Sci 2024:S0002-9629(24)01409-5. [PMID: 39179106 DOI: 10.1016/j.amjms.2024.08.015] [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: 04/08/2024] [Revised: 08/12/2024] [Accepted: 08/13/2024] [Indexed: 08/26/2024]
Abstract
Hypercalcemia has rarely been associated with seminomas. Due to the limited data available, the pathophysiology of hypercalcemia in seminoma has not been established in literature. We present a case of a 59-year-old male who presented with weakness, abdominal fullness, fatigue, constipation, and a 14 lb unintentional weight loss. On initial presentation he was found to be hypercalcemia with calcium of 16.2 mg/dL (normal 8.6-10.3 mg/dL). Subsequently, a metastatic seminoma was discovered with no evidence of bony metastasis. 1,25-dihydroxyvitamin D was elevated at >200 pg/mL (reference 19.9-79.3 pg/mL). PTH was suppressed at 11 pg/mL (reference 12-88 pg/mL). PTHrP was normal at 1.0 pmol/L (reference ≤4.2 pmol/L), 25-hydroxy vitamin D was low at 22.6 ng/mL (reference 30-100 ng/mL), and phosphorus was normal at 3.9 mg/dL (reference 2.4-4.9 mg/dL). These findings indicate 1,25-dihydroxyvitamin D mediated hypercalcemia of malignancy. Hypercalcemia in seminoma has been reported in 11 cases, that we review in this report. However, few cases present sufficient data to conclude the pathophysiology of hypercalcemia. In all four cases that presented 1,25-hydroxyvitamin D levels, the levels were elevated, suggesting seminomas are associated with 1,25-hydroxyvitamin D mediated hypercalcemia. Interestingly, one case was associated with increased 1,25-hydroxyvitamin D and increased PTHrP levels, suggesting there may be multiple mechanisms of hypercalcemia in seminomas.
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Affiliation(s)
- Julianna Sim
- The University of Toledo College of Medicine and Life Sciences, Toledo, OH
| | - Jonathan Irvin
- The University of Toledo College of Medicine and Life Sciences, Toledo, OH
| | - Nezam Altorok
- Department of Internal Medicine, University of Toledo, Toledo, OH.
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Lakpour N, Ghods R, Abolhasani M, Saeednejad Zanjani L, Saliminejad K, Kalantari E, Saki S, Ranjbar MM, Balay-Goli L, Sadeghi MR, Madjd Z. Higher expression of SALL4-A isoform is correlated with worse outcomes and progression of the disease in subtype of testicular germ cell tumours. Biomarkers 2024; 29:324-339. [PMID: 38808385 DOI: 10.1080/1354750x.2024.2361796] [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: 03/01/2024] [Accepted: 05/25/2024] [Indexed: 05/30/2024]
Abstract
BACKGROUND The transcription factor SALL4 is associated with embryonic pluripotency and has proposed as a novel immunohistochemistry (IHC) marker for diagnosing germ cell tumours. SALL4 comprises three isoforms, and SALL4-A being the full-length isoform. Studying its isoforms could revolutionize testicular cancer prognosis and subtype differentiation. METHODS The expression and clinical significance of isoform 'A' of SALL4 was evaluated in 124 testicular germ cell tumours (TGCTs) subtypes, adjacent 67 normal tissues and 22 benign tumours, using immunohistochemistry on tissue microarrays (TMA). RESULTS A statistically significant higher expression of nuclear and cytoplasmic SALL4-A was detected in TGCTs histological subtypes and benign tumours compared to the normal tissues. Seminoma and yolk sac tumours had the highest nuclear and cytoplasmic expression of SALL4-A. A significant correlation was detected between the higher nuclear expression of SALL4-A and increased pT stages (P = 0.026) in seminomas. Whereas in embryonal carcinomas, cytoplasmic expression of SALL4-A was associated with the tumour recurrence (P = 0.04) and invasion of the epididymis (P = 0.011). CONCLUSIONS SALL4-A isoform expression in the cytoplasm and nucleus of TGCTs may be associated with histological differentiation. In the seminoma subtype of TGCTs, higher expression of SALL4-A may be used as a predictive indicator of poorer outcomes and prognosis.
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Affiliation(s)
- Niknam Lakpour
- Oncopathology Research Center, Iran University of Medical Sciences, Tehran, Iran
- Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
| | - Roya Ghods
- Oncopathology Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Molecular Medicine, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Abolhasani
- Department of Pathology, School of Medicine, Iran University of Medical Sciences, (IUMS), Tehran, Iran
| | - Leili Saeednejad Zanjani
- Oncopathology Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Pathology and Genomic Medicine, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Kioomars Saliminejad
- Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
| | - Elham Kalantari
- Oncopathology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Sima Saki
- Oncopathology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Leila Balay-Goli
- Monoclonal Antibody Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
| | - Mohammad Reza Sadeghi
- Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
| | - Zahra Madjd
- Oncopathology Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Molecular Medicine, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran
- Department of Pathology, School of Medicine, Iran University of Medical Sciences, (IUMS), Tehran, Iran
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Hammami MB, Rezk M, Dubey D. Paraneoplastic neurologic syndrome and autoantibody accompaniments of germ cell tumors. HANDBOOK OF CLINICAL NEUROLOGY 2024; 200:431-445. [PMID: 38494295 DOI: 10.1016/b978-0-12-823912-4.00001-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Paraneoplastic neurologic syndromes (PNSs) are a group of diseases affecting the central and/or peripheral nervous system caused by immune-mediated processes directed toward antigens with shared expression in tumor and neural tissue. Germ cell tumors (GCTs) are associated with PNSs with varied clinical phenotypes. Early diagnosis of PNS is vital to potentially uncover and treat underlying tumors, improving the chances of recovery, and preventing permanent neurologic complications. In this chapter, we outline the pathophysiology and epidemiology of PNS. We briefly provide a summary of GCTs in males and females. We review the neural-specific autoantibodies and PNSs associated with GCTs and their clinical and radiologic accompaniments. We also provide an overview of the treatment and prognosis of these disorders.
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Affiliation(s)
- M Bakri Hammami
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States; Jacobi Medical Center/Albert Einstein College of Medicine, Bronx, NY, United States
| | - Mohamed Rezk
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States; Department of Neurology, Mayo Clinic, Rochester, MN, United States
| | - Divyanshu Dubey
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States; Department of Neurology, Mayo Clinic, Rochester, MN, United States.
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Al-Khayal A, Noureldin Y, Alghafees M, Shafqat A, Sabbah BN, Elhossiny AH, Bakir M, Omar MA, Arabi TZ, Abdul Rab S, Alsaikhan B, Aldhalaan R, Alquirnas M, Alrabeeah K. A decade in focus: mixed germ cell tumors with choriocarcinoma components. Ann Med Surg (Lond) 2023; 85:5355-5358. [PMID: 37915675 PMCID: PMC10617832 DOI: 10.1097/ms9.0000000000001314] [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: 07/01/2023] [Accepted: 09/06/2023] [Indexed: 11/03/2023] Open
Abstract
Introduction This 10-year registry review aimed to investigate the clinical behaviour and outcomes of mixed germ cell tumours with choriocarcinoma components, a rare and aggressive subtype of testicular cancer, in Saudi Arabia. The study explores the demographic characteristics of affected patients, tumour profiles, and the mortality rate associated with this malignancy. Methods Utilizing data from the Saudi Cancer Registry, the authors identified 33 cases of mixed germ cell tumours with choriocarcinoma components among 1001 testicular cancer cases recorded between 2008 and 2017. Demographic information, including age, marital status, region of residency, year of diagnosis, and 10-year survival status, were collected. Tumour factors, such as the basis of diagnosis, origin site, behaviour, grade, extension, and laterality, were also analyzed. Results The majority of cases (78.8%) occurred in the young age group (18-45 years), and most tumours (97%) originated in normally descended testes. Grade IV (undifferentiated anaplastic) tumours and distant metastasis were present in 45.5% of patients. All cases exhibited malignant tumour behaviour. The overall mortality rate was 15%, with a mean time from diagnosis to death of 7.72 months (range: 0.5-21.5 months). Conclusion Mixed germ cell tumours with choriocarcinoma components are rare and tend to affect younger populations. These tumours demonstrate aggressive clinical behaviour, with a significant proportion presenting with high-grade lesions and metastasis at diagnosis. The observed mortality rate underscores the poor prognosis associated with this malignancy. Our study provides essential insights into the clinical characteristics of this rare tumour subtype in the Saudi Arabian population, emphasizing the need for further research to identify prognostic factors and optimize management strategies for affected patients.
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Affiliation(s)
- Abdullah Al-Khayal
- Department of Urology, King Abdulaziz Medical City
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences
- King Abdullah International Medical Research Center
| | | | - Mohammad Alghafees
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences
| | - Areez Shafqat
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | | | | | - Mohamad Bakir
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | | | | | | | - Bader Alsaikhan
- Department of Urology, King Abdulaziz Medical City
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences
- King Abdullah International Medical Research Center
| | - Reema Aldhalaan
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Muhannad Alquirnas
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences
| | - Khalid Alrabeeah
- Department of Urology, King Abdulaziz Medical City
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences
- King Abdullah International Medical Research Center
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Dhillon D, Moynihan HV, Santoro G, Lien K, Dayan MJ. A Rare Case of Post-orchidectomy Arterial Injury With Rapidly Enlarging Scrotal Hematoma Treated With Coil Embolization. Cureus 2023; 15:e47914. [PMID: 38034169 PMCID: PMC10683932 DOI: 10.7759/cureus.47914] [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: 10/29/2023] [Indexed: 12/02/2023] Open
Abstract
Testicular cancer is the most common solid tumor in young adult males. Radical inguinal orchidectomy is the gold standard for the diagnosis and treatment of testicular cancer, which is confined to the scrotum and is generally well tolerated. An uncommon, but known, complication of radical orchidectomy is scrotal hematoma. Scrotal hematoma from radical orchidectomy is commonly self-limited and typically self-resolving. We present a rare case of metastatic testicular malignancy diagnosed with radical inguinal orchidectomy complicated by a rapidly enlarging scrotal hematoma, successfully treated with surgical evacuation and image-guided arterial embolization.
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Affiliation(s)
- Diljot Dhillon
- Interventional Radiology, Zucker School of Medicine at Hofstra/Northwell at Mather Hospital, Port Jefferson, USA
| | - Harrison V Moynihan
- Interventional Radiology, Zucker School of Medicine at Hofstra/Northwell at Mather Hospital, Port Jefferson, USA
| | - Giovanni Santoro
- Interventional Radiology, Zucker School of Medicine at Hofstra/Northwell at Mather Hospital, Port Jefferson, USA
| | - Kenny Lien
- Interventional Radiology, Zucker School of Medicine at Hofstra/Northwell at Mather Hospital, Port Jefferson, USA
| | - Michael J Dayan
- Interventional Radiology, Zucker School of Medicine at Hofstra/Northwell at Mather Hospital, Port Jefferson, USA
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Sharma A, Reddy R, Pramanik R, Sahoo RK, Kaushal S, Kp H, Kumar S, Kumar L, Sharma A, Batra A. Primary mediastinal germ cell tumors (PMGCT): A real-world analysis from a tertiary cancer care centre in India. Cancer Invest 2023:1-7. [PMID: 36927242 DOI: 10.1080/07357907.2023.2188947] [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: 03/18/2023]
Abstract
BACKGROUND Primary mediastinal GCT (PMGCT) is a rare entity and comprises 10-15% of all mediastinal tumors . We present our institutional experience of MGCT treated with multimodality management. MATERIALS AND METHODS We conducted a retrospective analysis between 2010 to 2020 of all mediastinal germ cell tumors registered at our center. Data on patient demographics, treatments received, treatment toxicities and response were recorded. Overall survival and relapse free survival were estimated using Kaplan-Meier methods. RESULTS A total of 30 patients were identified. The median age was 25.5 (range, 18-45) years. Common presenting features included cough (70%) and shortness of breath (70%) . Histology wise, 60% patients were non seminomatous histology whereas 33.3% patients were Seminoma.Twenty seven (90%) patients received chemotherapy as the first-line treatment, of whom five patients (16.6%) underwent surgery and radiation therapy subsequently. Median follow-up was 26.9 months. Thirteen patients (43.3%) had complete response (43.3%) and 8 patients had partial response (26.7%), while three patients (5.5%) had progressive disease. Three year relapse free survival rate was 69.6% (95% confidence interval [CI], 42.8-85.6%). Overall survival (OS) at 3 years was 73.4% (95% CI, 49.4- 87.3%). Patients with seminoma had a 3 year OS of 90.0% (95% CI, 47.3-98.5%) compared to those with non-seminoma (63.53% [95% CI, 32.3-83.3%]). CONCLUSIONS Multiagent chemotherapy is the backbone of treatement in PMGCT. Seminomatous PMGCT have excellent prognosis, while further improvement is needed in those with non-seminomatous tumor.
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Affiliation(s)
- Aparna Sharma
- Department of Medical Oncology, Dr, B.R.A. IRCH, All India Institute of Medical Sciences, New Delhi
| | - Rohit Reddy
- Department of Medical Oncology, Dr, B.R.A. IRCH, All India Institute of Medical Sciences, New Delhi
| | - Raja Pramanik
- Department of Medical Oncology, Dr, B.R.A. IRCH, All India Institute of Medical Sciences, New Delhi
| | - Ranjit Kumar Sahoo
- Department of Medical Oncology, Dr, B.R.A. IRCH, All India Institute of Medical Sciences, New Delhi
| | - Seema Kaushal
- Department of Pathology , All India Institute of Medical Sciences, New Delhi
| | - Haresh Kp
- Department of Radiation Oncology, Dr, B.R.A. IRCH, All India Institute of Medical Sciences, New Delhi
| | - Sunil Kumar
- Department of Surgical Oncology, Dr, B.R.A. IRCH, All India Institute of Medical Sciences, New Delhi
| | - Lalit Kumar
- Department of Medical Oncology, Dr, B.R.A. IRCH, All India Institute of Medical Sciences, New Delhi
| | - Atul Sharma
- Department of Medical Oncology, Dr, B.R.A. IRCH, All India Institute of Medical Sciences, New Delhi
| | - Atul Batra
- Department of Medical Oncology, Dr, B.R.A. IRCH, All India Institute of Medical Sciences, New Delhi
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Tahri Y, Moueqqit O, Mokhtari M, Ramdani M, Nadir M, Bennani A, Barki A. Unusual Presentation of Embryonal Carcinoma of the Testis: A Case Report. Cureus 2023; 15:e35175. [PMID: 36960258 PMCID: PMC10029701 DOI: 10.7759/cureus.35175] [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: 02/19/2023] [Indexed: 02/21/2023] Open
Abstract
Embryonal carcinoma is a rare and aggressive type of non-seminomatous germ cell tumor that typically affects young to middle-aged individuals. It is often discovered by the patient or during routine medical exams as a painless or occasionally painful lump. Other revealing symptoms, such as lumbar pain or renal colic, are very uncommon in the literature. In this case report, we aim to highlight a case of embryonal carcinoma in a 21-year-old patient, which was discovered following the diagnostic workup of a left lumbar pain episode.
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Affiliation(s)
- Youness Tahri
- Urology, Mohammed VI University Hospital, Oujda, MAR
- Urology, Faculty of Medicine and Pharmacy of Oujda, Mohammed First University of Oujda, Oujda, MAR
| | - Othman Moueqqit
- General Medicine, Faculty of Medicine and Pharmacy of Oujda, Mohammed First University of Oujda, Oujda, MAR
| | | | | | - Miry Nadir
- Pathology, Mohammed VI University Hospital, Oujda, MAR
- Pathology, Faculty of Medicine and Pharmacy of Oujda, Mohammed First University of Oujda, Oujda, MAR
| | - Amal Bennani
- Anatomopathology, Faculty of Medicine and Pharmacy of Oujda, Mohammed First University of Oujda, Oujda, MAR
| | - Ali Barki
- Urology, Mohammed VI University Hospital, Oujda, MAR
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8
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Asgari F, Golmohammadi P, Taheri D, Kazem Aghamir SM. 23-Year-Old Male with Testis Cancer with Spontaneous Ruptured Teratocarcinoma and No History of Trauma: A Case Report. Case Rep Oncol 2023; 16:262-266. [PMID: 37123610 PMCID: PMC10134056 DOI: 10.1159/000530502] [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: 11/14/2022] [Accepted: 03/21/2023] [Indexed: 05/02/2023] Open
Abstract
Teratocarcinoma is one type of testis cancer that can be represented in the youth population and usually shows itself with swelling of the testis and edema and a rise of BHCG and alpha-fetoprotein, but spontaneous rupture is a rare manifestation. A 23-year-old man was referred to the Sina Hospital with complaints of testis pain and swelling. Laboratory findings were alpha f.p more than 2,000, BHCG titer 255.21, and LDH 504. Sonography findings showed the right testis had been detected with a heterogeneous mass with vascularity and cystic area with microcalcification, measuring 76*69 mm. During surgery, we faced rupture tumor that was unusual and rare. The radical orchidectomy was done successfully without any complications. After the surgery, pathology showed teratocarcinoma of the right testis, and a 6-month observation and follow-up were done without any complication.
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Affiliation(s)
- Fardin Asgari
- Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Pedram Golmohammadi
- Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Diana Taheri
- Isfahan Kidney Disease Research Center, Department of Pathology, Isfahan University of Medical Sciences, Isfahan, Iran
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9
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Hu Z, Yan X, Dai J, Li Y, Lu M. Contrast-enhanced ultrasound in the diagnosis of a solitary neck mass: a case report of metastatic seminoma. J Int Med Res 2022; 50:3000605221135482. [DOI: 10.1177/03000605221135482] [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] Open
Abstract
Seminoma accounting for approximately 98% of malignant testicular tumours and it typically presents as a painless, palpable solid mass in the testis. Seminomas presenting only as a solitary neck mass are very rare. This case report describes a previously healthy 35-year-old male that presented with a 3-month history of the incidental discovery of a mass in his right neck. He had no testicular symptoms. He underwent neck ultrasound, contrast-enhanced ultrasound, computed tomography and positron emission tomography. Serum human chorionic gonadotropin (3.90 mIU/ml) was raised and alpha-fetoprotein (3.79 ng/ml) was within normal limits. Clinical examination and imaging examinations did not find any suspicious signs of testicular cancer. Biopsy from the neck mass confirmed the diagnosis of metastatic seminoma. The case report presents the ultrasound and contrast-enhanced ultrasound characteristics of seminoma and provides an update of the literature regarding this very rare metastatic site for seminomas.
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Affiliation(s)
- Ziyue Hu
- Department of Ultrasound, Sichuan Cancer Hospital Institute, Sichuan Cancer Centre, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
| | - Xiang Yan
- Department of Ultrasound, North Sichuan Medical College, Nanchong, Sichuan Province, China
| | - Jiulong Dai
- Department of Ultrasound, Sichuan Cancer Hospital Institute, Sichuan Cancer Centre, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
| | - Yanjie Li
- Department of Ultrasound, Sichuan Cancer Hospital Institute, Sichuan Cancer Centre, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
| | - Man Lu
- Department of Ultrasound, Sichuan Cancer Hospital Institute, Sichuan Cancer Centre, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
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10
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Schieda N, Oto A, Allen BC, Akin O, Barker SJ, Fulgham PF, Gettle LM, Maranchie JK, Patel BN, Schuster DM, Smith D, Turkbey IB, Lockhart ME. ACR Appropriateness Criteria® Staging and Surveillance of Testicular Cancer: 2021 Update. J Am Coll Radiol 2022; 19:S194-S207. [PMID: 35550802 DOI: 10.1016/j.jacr.2022.02.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 02/01/2023]
Abstract
The staging and surveillance of testicular cancer is a complex topic, which integrates clinical, biochemical, and imaging components. The use of imaging for staging and surveillance of testicular cancer is individually tailored to each patient by considering tumor histology and prognosis. This document discusses the rationale for use of imaging by imaging modality during the initial staging of testicular seminoma and nonseminoma tumors and during the planned surveillance of stage IA and IB testicular cancer by histological subtype integrating clinical suspicion for disease recurrence in surveillance protocols. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
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Affiliation(s)
- Nicola Schieda
- Ottawa Hospital Research Institute and the Department of Radiology, The University of Ottawa, Ottawa, Ontario, Canada.
| | - Aytekin Oto
- Panel Chair, University of Chicago, Chicago, Illinois
| | - Brian C Allen
- Panel Vice-Chair, Duke University Medical Center, Durham, North Carolina
| | - Oguz Akin
- Memorial Sloan Kettering Cancer Center, New York, New York; Director of Body MRI
| | - Samantha J Barker
- University of Minnesota, Minneapolis, Minnesota; Director of Body Ultrasound M Health Fairview
| | - Pat F Fulgham
- Urology Clinics of North Texas, Dallas, Texas; American Urological Association; Chairman of the Department of Urology, Texas Health Presbyterian Hospital of Dallas
| | | | | | - Bhavik N Patel
- Stanford University Medical Center, Stanford, California; Director of AI
| | | | - Dan Smith
- The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada, Primary care physician
| | - Ismail B Turkbey
- National Institutes of Health, Bethesda, Maryland; Staff Clinician at NIH
| | - Mark E Lockhart
- Specialty Chair, University of Alabama at Birmingham, Birmingham, Alabama; Chair, ACR Appropriateness Committee
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11
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Veeraballi S, Kumanayaka DD, Omour B, Paige A, Shaaban H. A Rare Case of Sarcomatoid Variant of Mixed Germ Cell Tumor of the Testis Presenting With Malignant Hypercalcemia and Tumor Lysis Syndrome. Cureus 2021; 13:e19749. [PMID: 34938626 PMCID: PMC8684799 DOI: 10.7759/cureus.19749] [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] [Accepted: 11/19/2021] [Indexed: 11/05/2022] Open
Abstract
Hypercalcemia of malignancy is relatively common in several cancers. However, in testicular cancer, paraneoplastic hypercalcemia is uncommon. We describe the first case of severe tumor lysis syndrome associated with hypercalcemia from bone metastasis of testicular origin. Classically, tumor lysis syndrome is associated with hypocalcemia. This was a diagnostic and therapeutic challenge.
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Affiliation(s)
| | | | - Bader Omour
- Internal Medicine, Saint Michael's Medical Center, Newark, USA
| | - Amy Paige
- Internal Medicine, Saint Michael's Medical Center, Newark, USA
| | - Hamid Shaaban
- Hematology/Oncology, Saint Michael's Medical Center, Newark, USA
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12
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Saeednejad Zanjani L, Razmi M, Fattahi F, Kalantari E, Abolhasani M, Saki S, Madjd Z, Mohsenzadegan M. Overexpression of melanoma-associated antigen A2 has a clinical significance in embryonal carcinoma and is associated with tumor progression. J Cancer Res Clin Oncol 2021; 148:609-631. [PMID: 34837545 DOI: 10.1007/s00432-021-03859-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 11/14/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Melanoma-associated antigen A2 (MAGE-A2) is a member of the cancer-testis antigen family differentially overexpressed in a variety of malignancies and is associated with tumor development. However, clinical significance and prognostic value of MAGE-A2 in different histological subtypes of testicular germ cell tumors (TGCTs) have not been explored. MATERIALS AND METHODS Here, we aimed to investigate the clinical significance and prognostic impact of MAGE-A2 expression in TGCTs compared to benign tumors as well as adjacent normal tissues and then between seminomas and non-seminomas groups using immunohistochemistry on tissue microarrays. RESULTS The results indicated a statistically significant difference between overexpression of MAGE-A2 and histological subtypes of TGCTs. A statistically significant association was found between a high level of nuclear expression of MAGE-A2 protein and advanced pT stage (P = 0.022), vascular invasion (P = 0.037), as well as involvement of rete testis (P = 0.022) in embryonal carcinomas. Increased nuclear expression of MAGE-A2 was observed to be associated with more aggressive behaviors and tumor progression rather than cytoplasmic expression in these cases. Further, high level nuclear expression of MAGE-A2 had shorter disease-specific survival (DSS) or progression-free survival (PFS) compared to patients with moderate and low expression of MAGE-A2, however, without a statistically significant association. CONCLUSION Our results confirm that increased nuclear expression of MAGE-A2 has a clinical significance in embryonal carcinomas and is associated with progression of disease. Moreover, MAGE-A2 may act as a potential predictive biomarker for the prognosis in embryonal carcinomas if follow-up period becomes longer. Further investigations for the biological function of MAGE-A2 are required in future studies.
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Affiliation(s)
| | - Mahdieh Razmi
- Oncopathology Research Center, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Fahimeh Fattahi
- Oncopathology Research Center, Iran University of Medical Sciences (IUMS), Tehran, Iran
- Department of Molecular Medicine, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Elham Kalantari
- Oncopathology Research Center, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Maryam Abolhasani
- Oncopathology Research Center, Iran University of Medical Sciences (IUMS), Tehran, Iran
- Hasheminejad Kidney Center, Iran University of Medical Sciences, (IUMS), Tehran, Iran
| | - Sima Saki
- Oncopathology Research Center, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Zahra Madjd
- Oncopathology Research Center, Iran University of Medical Sciences (IUMS), Tehran, Iran
- Department of Molecular Medicine, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Monireh Mohsenzadegan
- Department of Medical Laboratory Sciences, Faculty of Allied Medical Sciences, Iran University of Medical Sciences (IUMS), Tehran, Iran.
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13
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Establishment and characterization of an ovarian yolk sac tumor patient-derived xenograft model. Pediatr Surg Int 2021; 37:1031-1040. [PMID: 34031745 DOI: 10.1007/s00383-021-04895-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/23/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The lack of appropriate preclinical models of ovarian yolk sac tumor (OYST) is currently hindering the pursuit of new methods of treatment and investigation of the pathogenesis of the disease. We developed and characterized an OYST patient-derived xenograft (PDX) model in this study. METHODS Tumor fragments from a patient with an OYST were implanted subcutaneously into BALB/c Nude mice. Engrafted xenografts were compared with the original tumor according to histology, immunohistochemistry, humanized identified, and drug efficacy testing with in vivo treatment programs. RESULTS There was a high degree of histologic and immunohistochemical (IHC) resemblance between the established PDX model and its corresponding human tumors. Bleomycin, etoposide, and cisplatin (JEB) chemotherapy regimens were effective in clinical patients and were effective in the OYST PDX model; therefore, the effect of PDX intervention was consistent with clinical outcomes of OYSTs. CONCLUSION We have successfully established an OYST PDX model. This OYST model preserves the basic molecular features of the primary human tumor, thereby providing a valuable method to preclinically evaluate new treatments and explore disease pathogenesis.
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14
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Venditti M, Arcaniolo D, De Sio M, Minucci S. Preliminary Investigation on the Involvement of Cytoskeleton-Related Proteins, DAAM1 and PREP, in Human Testicular Disorders. Int J Mol Sci 2021; 22:ijms22158094. [PMID: 34360857 PMCID: PMC8347498 DOI: 10.3390/ijms22158094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/22/2021] [Accepted: 07/23/2021] [Indexed: 02/07/2023] Open
Abstract
Herein, for the first time, the potential relationships between the cytoskeleton-associated proteins DAAM1 and PREP with different testicular disorders, such as classic seminoma (CS), Leydig cell tumor (LCT), and Sertoli cell-only syndrome (SOS), were evaluated. Six CS, two LCT, and two SOS tissue samples were obtained during inguinal exploration in patients with a suspect testis tumor based on clinical examination and ultrasonography. DAAM1 and PREP protein levels and immunofluorescent localization were analyzed. An increased DAAM1 protein level in CS and SOS as compared to non-pathological (NP) tissue was observed, while LCT showed no significant differences. Conversely, PREP protein level increased in LCT, while it decreased in CS and SOS compared to NP tissue. These results were strongly supported by the immunofluorescence staining, revealing an altered localization and signal intensity of DAAM1 and PREP in the analyzed samples, highlighting a perturbed cytoarchitecture. Interestingly, in LCT spermatogonia, a specific DAAM1 nuclear localization was found, probably due to an enhanced testosterone production, as confirmed by the increased protein levels of steroidogenic enzymes. Finally, although further studies are needed to verify the involvement of other formins and microtubule-associated proteins, this report raised the opportunity to indicate DAAM1 and PREP as new potential markers, supporting the cytoskeleton dynamics changes occurring during normal and/or pathological cell differentiation.
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Affiliation(s)
- Massimo Venditti
- Dipartimento di Medicina Sperimentale, Sez, Fisiologia Umana e Funzioni Biologiche Integrate “F. Bottazzi”, Università degli Studi della Campania “Luigi Vanvitelli”, Via Costantinopoli 16, 80138 Napoli, Italy
- Correspondence: (M.V.); (S.M.)
| | - Davide Arcaniolo
- Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Università degli Studi della Campania “Luigi Vanvitelli”, Via Luigi De Crecchio 2, 80138 Napoli, Italy; (D.A.); (M.D.S.)
| | - Marco De Sio
- Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Università degli Studi della Campania “Luigi Vanvitelli”, Via Luigi De Crecchio 2, 80138 Napoli, Italy; (D.A.); (M.D.S.)
| | - Sergio Minucci
- Dipartimento di Medicina Sperimentale, Sez, Fisiologia Umana e Funzioni Biologiche Integrate “F. Bottazzi”, Università degli Studi della Campania “Luigi Vanvitelli”, Via Costantinopoli 16, 80138 Napoli, Italy
- Correspondence: (M.V.); (S.M.)
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15
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Green DB, Rosa FGL, Craig PG, Khani F, Lam ET. Metastatic Mature Teratoma and Growing Teratoma Syndrome in Patients with Testicular Non-Seminomatous Germ Cell Tumors. Korean J Radiol 2021; 22:1650-1657. [PMID: 34402242 PMCID: PMC8484155 DOI: 10.3348/kjr.2020.1391] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 04/14/2021] [Accepted: 05/10/2021] [Indexed: 11/17/2022] Open
Abstract
Metastatic mature teratoma is a common radiologic and histopathologic finding after chemotherapy for metastatic non-seminomatous germ cell tumors. The leading theory for these residual tumors is the selective chemotherapy resistance of teratomas versus the high chemotherapy sensitivity of the embryonal components. Growing teratoma syndrome is a relatively rare phenomenon defined as an enlarging residual mass histologically proven to be a mature teratoma in the setting of normal serum tumor markers. Metastatic mature teratomas should be resected because of their malignant potential and occasional progression to growing teratoma syndrome with the invasion of the surrounding structures. CT is the preferred imaging modality for post-chemotherapy surveillance and should cover all sites of potential metastatic disease. This article reviews the clinical, pathologic, and multimodality imaging features of metastatic mature teratomas in patients with primary testicular non-seminomatous germ cell tumors.
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Affiliation(s)
- Daniel B Green
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA.
| | - Francisco G La Rosa
- Department of Pathology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Paul G Craig
- Department of Radiology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Francesca Khani
- Department of Pathology & Laboratory Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Elaine T Lam
- Division of Medical Oncology, Department of Medicine, University of Colorado School of Medicine, UCHealth Tony Grampsas Urologic Cancer Care Clinic, Anschutz Medical Campus, Aurora, CO, USA
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16
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Lin HW, Feng HX, Chen L, Yuan XJ, Tan Z. Maternal exposure to environmental endocrine disruptors during pregnancy is associated with pediatric germ cell tumors. NAGOYA JOURNAL OF MEDICAL SCIENCE 2021; 82:323-333. [PMID: 32581410 PMCID: PMC7276410 DOI: 10.18999/nagjms.82.2.315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This study aimed to evaluate the efficacy of interventions to reduce patient misidentification incidents classified as level 2 and over (adverse events occurred for patients) with the step-by-step problem-solving method. All incidents related to patient misidentification were selected, and relevant information was collected from the original electronic incident reports. We then conducted an eight-step problem-solving process with the aim of reducing patient misclassification and improving patient safety. Step 1: the number of misidentification-related incident reports and the percentage of these reports in the total incident reports increased each year. Step 2: the most frequent misidentification type was sample collection tubes, followed by drug administration and hospital meals. Step 3: we set a target of an 20% decrease in patient misidentification cases classified as level 2 or over compared with the previous year, and established this as a hospital priority. Step 4: we found that discrepancies in patient identification procedures were the most important causes of misidentification. Step 5: we standardized the patient identification process to achieve an 10% reduction in misidentification. Step 6: we disseminated instructional videos to all staff members. Step 7: we confirmed there was an 18% reduction in level 2 and over patient misidentification compared with the previous year. Step 8: we intend to make additional effort to decrease misidentification of patients by a further 10%. Level 2 and over patient misidentification can be reduced by a patient identification policy using a step-by-step problem-solving procedure. This study aimed to evaluate the efficacy of interventions to reduce patient misidentification incidents with step-by-step problem-solving method. Continued seamless efforts to eliminate patient misidentification are mandatory for this activity.
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Affiliation(s)
- Hou-Wei Lin
- Department of Pediatric Urology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.,Department of Pediatric Surgery, Jiaxing Maternity and Child Health Care Hospital, Zhejiang, China
| | - Hai-Xia Feng
- Department of Pediatric gastroenterology and nutrition, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Lin Chen
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiao-Jun Yuan
- Department of Pediatric Hematology/Oncology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhen Tan
- Department of Pediatric Hematology/Oncology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
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17
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Zhou J, Wang S, Zhu L, Zhou L, Zeng H, Gan Y, Wang C. Terminal Deoxynucleotidyl Transferase Commonly Expresses in Germ Cell Tumors: Evaluation on a Large Series from Multiple Centers. Int J Gen Med 2021; 14:119-129. [PMID: 33469349 PMCID: PMC7813462 DOI: 10.2147/ijgm.s285757] [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: 11/25/2020] [Accepted: 12/30/2020] [Indexed: 11/23/2022] Open
Abstract
Aim The concrete features of expression of terminal deoxynucleotidyl transferase (TdT) are needed to be revealed in male and female germ cell tumors (GCTs). Methods TdT immunostaining was performed in 195 GCTs, and the tumor and/or tumorous components included seminomas, germ cell neoplasias in situ (GCNISs), dysgerminomas, embryonal carcinomas (ECs), extragonadal germinomas, yolk sac tumors (YSTs), teratomas, and spermatocytic tumors. Twenty-one sex cord-stromal tumors were also added. Expression of the classical germ cell tumor markers (PLAP, OCT4, SALL4, CD117, and D2-40) was compared to that of TDT. Results Nearly all (tumors or tumorous components) seminomas (99%, 107/108), GCNISs (98%, 51/52), dysgerminomas (94%, 17/18), ECs (100%, 15/15), and extragonadal germinomas (100%, 11/11) were positive for TdT. None of the cells in YSTs (0/38), teratomas (0/19), spermatocytic tumors (0/1), or sex cord-stromal tumors (0/21) were immunoreactive for TdT staining. The normal testicular and ovarian gonadal tissues were also negative for TdT. However, TdT presented with significant loss of antigen immunoreactivity in the paraffin-embedded tissues older than 3 years, giving rise to weak or moderate staining in a subset of cases. The expressions of TdT showed no significances with PLAP, OCT4, SALL4, CD117, and D2-40 during the diagnosis of the most GCTs (P>0.05), except for with PLAP, SALL4, or CD117 in YST (P=0.000 each), and D117 (P=0.000) or D2-40 (P=0.006) in ECs. Conclusion Our findings further verify that TdT can serve as a new GCT marker for seminomas, GCNISs, dysgerminomas, ECs, and extragonadal germinomas, with a highly positive rate. Awareness of TdT positivity in GCTs contributes to the prevention of erroneous diagnoses, particularly in the setting of core needle biopsies. To determine the properties where TdT staining may not be apparent in some old archived paraffin-embedded tissues, one could circumvent the potential misinterpretations of false-negative immunohistochemistry results.
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Affiliation(s)
- Jun Zhou
- Department of Pathology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China
| | - Suying Wang
- Department of Pathology, Ningbo Clinical and Pathological Diagnostic Center, Ningbo, Zhejiang, People's Republic of China
| | - Lun Zhu
- Department of Pathology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China
| | - Luting Zhou
- Department of Pathology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China
| | - Hong Zeng
- Department of Pathology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, People's Republic of China
| | - Yongli Gan
- Department of Pathology, Ningbo Clinical and Pathological Diagnostic Center, Ningbo, Zhejiang, People's Republic of China
| | - Chaofu Wang
- Department of Pathology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China
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18
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Ameli F, Panahi P, Soleimani V. Burned-out Post Pubertal Teratoma Presenting as a Liver Metastases in a 34-Year-Old Male. IRANIAN JOURNAL OF PATHOLOGY 2020; 16:232-236. [PMID: 33936236 PMCID: PMC8085282 DOI: 10.30699/ijp.2020.128407.2402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 09/19/2020] [Indexed: 11/08/2022]
Abstract
Germ cell teratomas belong to non-seminomatous germ cell tumors and account for 95% of malignant testicular tumors. Regarding the current World Health Organization (WHO) criteria, testicular teratomas are divided into prepubertal and post-pubertal subtypes based on patients’ age. The term “burned-out testicular tumor” is a very rare condition referring to a regressed testicular tumor which presents with its metastases without any clinical finding in the testicle. Metastasis can be the presentation of post-pubertal teratoma in 22-37% of cases. In scar associated teratoma (burn-out component), the metastasis rate is 66%. We reported a rare case of post-pubertal teratoma in a 34-year-old male who presented with multiple liver masses initially. Liver biopsy revealed poorly differentiated adenocarcinoma probably of gastrointestinal (GI) tract origin. The upper and lower GI endoscopy were normal. Scrotal ultrasonography showed a hypoechoic cystic intratesticular lesion in the left testis. The patient underwent radical orchiectomy and the histopathologic examination revealed post-pubertal teratoma with burned out component. The patient underwent proper treatment and is still under follow up. As a result, in a young male patient who presented with a retroperitoneal mass or poorly differentiated carcinomas of an unknown primary site, using light microscopy and immunohistochemical profiling alone may be inadequate. Therefore, scrotal screening and physical examination of the scrotum and bilateral testis should be considered to exclude possibility of a metastatic progression from a testicular germ cell neoplasia.
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Affiliation(s)
- Fereshteh Ameli
- Department of Pathology, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Iran
| | - Pooneh Panahi
- Department of Pathology, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Iran
| | - Vahid Soleimani
- Department of Pathology, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Iran
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19
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Origin of Subsequent Malignant Neoplasms in Patients with History of Testicular Germ Cell Tumor. Cancers (Basel) 2020; 12:cancers12123755. [PMID: 33327406 PMCID: PMC7764868 DOI: 10.3390/cancers12123755] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 12/05/2020] [Accepted: 12/10/2020] [Indexed: 12/20/2022] Open
Abstract
Simple Summary Although testicular germ cell tumor (TGCT) carries a high cure rate, some patients still die from it. We investigated the genetic landscape and cellular origins of cancers that develop later in life after treatment for TGCT and found evidence that a common progenitor cell might be responsible for both. This study shows the possible importance of stem-like cells in the development of cancer. Abstract Although genetic changes may be pivotal in the origin of cancer, cellular context is paramount. This is particularly relevant in a progenitor germ cell tumor and its differentiated mature teratoma counterpart when it concerns tumor heterogeneity and cancer dormancy in subsequent second malignancies (subsequent malignant neoplasms (SMNs)). From our tumor registry database, we identified 655 testicular germ cell tumor (TGCT) patients who developed SMNs between January 1990 and September 2018. Of the 113 solid organ SMNs, 42 had sufficient tumor tissue available for fluorescence in situ hybridization (FISH) analysis of isochromosome 12p [i(12p)]. We identified seven additional patients for targeted DNA and RNA sequencing of teratomas and adjacent somatic transformation. Finally, we established cell lines from freshly resected post-chemotherapy teratomas and evaluated the cells for stemness expression by flow cytometry and by the formation of teratomas in a xenograft model. In our cohort, SMNs comprising non-germ cell tumors occurred about 18 years after a diagnosis of TGCT. Of the 42 SMNs examined, 5 (12%) contained i(12p) and 16 (38%) had 12p gain. When comparing a teratoma and adjacent somatic transformation, targeted DNA and RNA sequencing demonstrated high concordance. Studies of post-chemotherapy teratoma-derived cell lines revealed cancer-initiating cells expressing multipotency as well as early differentiation markers. For the first time, we demonstrated the prevalence of i(12p) in SMNs and the presence of progenitor cells embedded within mature teratomas after chemotherapy. Our findings suggest a progenitor stem-like cell of origin in SMN and TGCT and highlight the importance of cellular context in this disease.
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20
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Ma Y, Zhang W, Qiao Z, Yang T. Endoscopic ultrasound-guided fine-needle aspiration for the diagnosis of a case of a huge abdominal mass. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2020; 113:143-144. [PMID: 33222481 DOI: 10.17235/reed.2020.7305/2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Testicular mixed germ cell tumor is characterized by high degree of malignancy and prone to metastasis, the common of which is retroperitoneal lymph node metastasis. At present, EUS has a very important diagnostic value for mediastinal, enterocoelia and retroperitoneal lymph node metastasis of malignant tumors. It also has a positive value for the space occupying of parenchyma or cavity organ and can be used for the puncture operation of multiple lesions under real-time ultrasound monitoring with high safety and small complications.
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Affiliation(s)
- Yimin Ma
- Gastroenterology, Gaochun People's Hospital of Nanjing
| | - Wen Zhang
- Gastroenterology, Suzhou Ninth People's Hospital
| | - Zhenguo Qiao
- Gastroenterology, Suzhou Ninth People's Hospital
| | - Tian Yang
- Gastroenterology, Affiliated Drum Tower Hospital of Nanjing University
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21
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Spencer Chapman M, May PC, Olavarria E, Nadal Melsio E. Three distinct hematological malignancies from a single germ cell tumor: a case report. J Med Case Rep 2020; 14:222. [PMID: 33198808 PMCID: PMC7670628 DOI: 10.1186/s13256-020-02558-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 10/14/2020] [Indexed: 11/12/2022] Open
Abstract
Background The association between non seminomatous germ cell tumors (GCTs) and hematological malignancies of rare lineage has been described in the literature. In some of these cases there is evidence that the leukemia derives from a pluripotent primitive clone present in the original germ cell tumor. Case presentation We present a highly unusual case of a 23-year-old man of South Asian origin with a history of Klinefelter’s syndrome who initially developed mediastinal non seminomatous GCT. Following treatment with surgery and standard chemotherapy he went on to develop three different hematological malignancies of distinct lineages in sequential fashion over a short time period. Despite treatment with multiple intensive chemotherapy regimens and a matched unrelated donor allogeneic stem cell transplant, he died 41 months after initial diagnosis of his GCT and 10 months after the first diagnosis of hematological malignancy. Conclusions This is an extreme case that highlights the pluripotency and aggressiveness of these GCT-derived hematological malignancies, and the need for novel therapeutic approaches.
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Affiliation(s)
- M Spencer Chapman
- Cancer, Ageing & Somatic Mutation Programme, Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, UK. .,Haematology Department, Hammersmith Hospital, Imperial NHS Trust, London, UK.
| | - P C May
- Centre for Haematology, Department of Immunology & Inflammation, Imperial College London, London, UK
| | - E Olavarria
- Haematology Department, Hammersmith Hospital, Imperial NHS Trust, London, UK
| | - E Nadal Melsio
- SIHMDS, Hammersmith Hospital, Imperial NHS Trust, London, UK
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22
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Vigodner M, Lucas B, Kemeny S, Schwartz T, Levy R. Identification of sumoylated targets in proliferating mouse spermatogonia and human testicular seminomas. Asian J Androl 2020; 22:569-577. [PMID: 32217837 PMCID: PMC7705977 DOI: 10.4103/aja.aja_11_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 01/17/2020] [Indexed: 11/19/2022] Open
Abstract
Spermatogenesis is regulated by a complex network of posttranslation modifications. Sumoylation (a modification by small ubiquitin-like modifiers, or SUMO proteins) was identified as an important cellular event in different cell types. SUMO proteins are highly expressed in the testis, and their role during spermatogenesis has begun to be elucidated. Given the important role of sumoylation in the regulation of mitosis and cancer progression in other tissues, the aim of the current study was to identify the targets of SUMO in proliferating mouse spermatogonia and human seminoma tissues and to initially examine the level of sumoylation in relation to the proliferative activity of the tissues. Using freshly purified spermatogonia and C18-4 spermatogonia cell line, mass spectrometry analysis identified several SUMO targets implicated into the proliferation of spermatogonia (such as heat shock protein 60 [HSP60] and prohibitin). Tissue array and western blot approaches showed that SUMO expression is a prominent feature of human seminomas and that the proliferative activity of the tumor tissues was positively correlated with the level of SUMO expression. Downregulation of sumoylation with si-RNA was not sufficient to significantly affect the proliferation of C18-4 spermatogonia; however, SUMO overexpression increased the proliferation rate of the cells. These data suggest that cells are more sensitive to an elevated level of SUMO, and that this situation may lead to an upregulated cellular proliferation and, possibly, cancer. Mass spectrometry analysis identified around a hundred SUMO targets in seminoma samples. Notably, many of the identified proteins (such as proliferating cell nuclear antigen [PCNA], DNA topoisomerase 2-alpha [Top2A], prohibitin, 14-3-3 protein, and others) were implicated in oncogenic transformation and cancer progression.
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Affiliation(s)
- Margarita Vigodner
- Department of Biology, Stern College, Yeshiva University, New York, NY 10016, USA
- Department of Developmental and Molecular Biology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Benjamin Lucas
- Department of Biology, Stern College, Yeshiva University, New York, NY 10016, USA
| | - Stav Kemeny
- Department of Biology, Stern College, Yeshiva University, New York, NY 10016, USA
| | - Tamar Schwartz
- Department of Biology, Stern College, Yeshiva University, New York, NY 10016, USA
| | - Rebecca Levy
- Department of Biology, Stern College, Yeshiva University, New York, NY 10016, USA
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23
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Walravens-Evans J, Yao M, Grannò S, Arul D, Chitale S. Primary pure angiosarcoma of the testis: a vanishingly rare malignancy. Case report and literature review. BMC Urol 2020; 20:175. [PMID: 33129286 PMCID: PMC7602293 DOI: 10.1186/s12894-020-00747-7] [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: 05/19/2020] [Accepted: 10/21/2020] [Indexed: 11/15/2022] Open
Abstract
Background Primary pure angiosarcoma of the testis is an exceptionally rare testicular malignancy, which is poorly understood. We present the fifth and youngest case in the current medical literature. Additionally, all cases of angiosarcoma of the testicle, both occurring with associated germ cell tumour and without, were compared in an extended tabular format. Case presentation A 56-year old man presented with unilateral scrotal pain, swelling and erythema. Ultrasonography revealed two testicular lesions with a high suspicion of malignancy but serum tumour markers were negative. A radical orchidectomy was performed with clear surgical margins. Diagnosis of primary pure angiosarcoma of the testis was confirmed on subsequent histopathology. Conclusions Primary pure angiosarcoma is a rare testicular neoplasm. We present the fifth case in the literature. Clinical and radiological features are non-specific. The diagnosis is purely histological, with the pathologist choosing immunohistochemistry based on abnormal morphology. Local invasiveness is variable but metastatic sites are typical for extra-gonadal angiosarcomas. Primary pure testicular angiosarcoma diagnosis confers a relatively better prognosis compared to angiosarcoma arising in the context of a testicular germ cell tumour. While extra-gonadal angiosarcomas are associated with high rates of local recurrence following resection, in all cases of testicular angiosarcoma there were no local recurrences following radical orchidectomy. Surgical resection remains the most effective treatment for both subtypes of testicular angiosarcoma.
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Affiliation(s)
- J Walravens-Evans
- Kingston Hospital NHS Foundation Trust, Galsworthy Road, Surrey, KT2 7QB, UK.
| | - M Yao
- Department of Urology, Kent and Canterbury Hospital, Ethelbert Road, Canterbury, CT1 3NG, UK
| | - S Grannò
- UCL School of Life and Medical Sciences, Gower St, London, WC1E 6BT, UK
| | - D Arul
- Department of Pathology, Whittington Hospital, Magdala Avenue, London, N19 5NF, UK
| | - S Chitale
- Department of Urology, Whittington Hospital, Magdala Avenue, London, N19 5NF, UK
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24
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Wei J, Yin Y, Zhou J, Chen H, Peng J, Yang J, Tang Y. METTL3 potentiates resistance to cisplatin through m 6 A modification of TFAP2C in seminoma. J Cell Mol Med 2020; 24:11366-11380. [PMID: 32857912 PMCID: PMC7576266 DOI: 10.1111/jcmm.15738] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 06/23/2020] [Accepted: 07/30/2020] [Indexed: 12/13/2022] Open
Abstract
Testicular germ cell tumours (TGCTs) rank as the most common malignancy in men aged 20‐34 years, and seminomas are the most type of TGCTs. As a crucial anti‐tumour agent with explicit toxicity, cisplatin may render resistance through intertwined mechanisms, even in disease entities with high curative ratio, such as seminoma. Previously, we established cisplatin‐resistant seminoma TCam‐2 (TCam‐2/CDDP) cells and showed that epigenetic regulations, such as non‐coding RNA (ncRNA) interactions, might orchestrate cell fate decisions in the cisplatin treatment context in seminoma. N6‐methyladenosine (m6A) is the most prevalent internal modification in mRNA. In the present study, we assessed cisplatin resistance in seminoma from the perspective of m6A, another manner of epigenetic modification. The global m6A enrichment of TCam‐2 and TCam‐2/CDDP was depicted. Then, we elucidated whether transcription factor‐activating enhancer‐binding protein 2C (TFAP2C) was functionally m6A‐modified by methyltransferase‐like protein 3 (METTL3), which acted as an m6A ‘writer’, and insulin‐like growth factor 2 mRNA‐binding protein 1 (IGF2BP1), which acted as an m6A ‘reader’. Enhanced stability of TFAP2C mRNA promoted seminoma cell survival under cisplatin treatment burden probably through up‐regulation of DNA repair‐related genes. Hopefully, this study will help improve our understanding of the subtleties of the tumour cellular coping strategy in response to chemotherapy. Targeting factors that are involved in m6A methylation may be an effective strategy for circumventing cisplatin resistance in seminoma.
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Affiliation(s)
- Jingchao Wei
- Department of Urology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Yinghao Yin
- Department of Urology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Jun Zhou
- Department of Urology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Hanfei Chen
- Department of Urology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Jingxuan Peng
- Department of Urology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Jianfu Yang
- Department of Urology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Yuxin Tang
- Department of Urology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.,Guangdong Provincial Key Laboratory of Biomedical Imaging, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
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Low level expression of human telomerase reverse transcriptase predicts cancer-related death and progression in embryonal carcinoma. J Cancer Res Clin Oncol 2020; 146:2753-2775. [PMID: 32681293 DOI: 10.1007/s00432-020-03319-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 07/09/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION hTERT (human telomerase reverse transcriptase) is a catalytic subunit of the enzyme telomerase and has a role in cell proliferation, cellular senescence, and human aging. MATERIALS AND METHODS The purpose of this study was to evaluate the expression and significance of hTERT protein expression as a prognostic marker in different histological subtypes of testicular germ cell tumors (TGCTs), including 46 embryonal carcinomas, 46 yolk sac tumors, 38 teratomas, 84 seminomas as well as two main subtypes of seminomas and non-seminomas using tissue microarray (TMA) technique. RESULTS The results showed that there is a statistically significance difference between the expression of hTERT and various histological subtypes of TGCTs (P < 0.001). In embryonal carcinoma, low level expression of hTERT protein was significantly associated with advanced pT stage (P = 0.023) as well as tunica vaginalis invasion (P = 0.043). Moreover, low level expression of hTERT protein was found to be a significant predictor of worse DSS (log rank: P = 0.011) and PFS (log rank: P = 0.011) in the univariate analysis. Additionally, significant differences were observed (P =0.021, P =0.018) with 5-year survival rates for DSS and PFS of 66% and 70% for moderate as compared to 97% and 97% for high hTERT protein expression, respectively. CONCLUSION We showed that hTERT protein expression was associated with more aggressive tumor behavior in embryonal carcinoma patients. Also, hTERT may be a novel worse prognostic indicator of DSS or PFS, if the patients are followed up for more time periods.
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Distinct Proteomic Profile of Spermatozoa from Men with Seminomatous and Non-Seminomatous Testicular Germ Cell Tumors. Int J Mol Sci 2020; 21:ijms21144817. [PMID: 32650378 PMCID: PMC7404221 DOI: 10.3390/ijms21144817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/19/2020] [Accepted: 07/01/2020] [Indexed: 12/14/2022] Open
Abstract
Testicular germ cell tumors (TGCTs) are predominant in young males (15–44 years). Seminomatous and non-seminomatous TGCTs account for about 98% of all TGCTs cases. In this study, we aimed to compare the sperm proteome of patients with seminomatous and non-seminomatous TGCTs to identify possible protein biomarkers that could help distinguish between them in a non-invasive manner. We analyzed semen samples from patients with seminomatous or non-seminomatous TGCTs (n = 15/group) that were cryopreserved before the start of cancer treatment. Quantitative proteomic analysis was conducted on pooled samples (n = 3/group) and a total of 258 differentially expressed proteins (DEPs) were identified. The overexpression of acrosin precursor (ACR) and chaperonin containing TCP1 subunit 6B (CCT6B) as well as the underexpression of S100 calcium-binding protein A9 (S100A9) in the spermatozoa of patients with non-seminomatous TGCTs were validated by western blotting conducted on individual samples (n = 6 for seminomatous group and n = 6 for non-seminomatous group). Our overall results suggest an association between the higher and faster invasiveness of non-seminomatous TGCTs and the altered protein expressions, providing important information for future studies.
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Law C, AlshiekhAli Z, Taylor N, Howlett D. Supraclavicular left neck mass: an unusual presentation of metastatic testicular cancer in two older men. BMJ Case Rep 2020; 13:e233368. [PMID: 32327457 PMCID: PMC7202787 DOI: 10.1136/bcr-2019-233368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2020] [Indexed: 11/04/2022] Open
Abstract
Two male patients, aged 55 and 75 years, were referred to the ENT and haematology team respectively, with an asymptomatic left supraclavicular neck mass. Investigations revealed metastatic primary testicular seminoma. CT contrast study of the thorax, abdomen and pelvis demonstrated an additional left para-aortic nodal mass in both cases. The initial presentation of a solitary left neck lump from a metastatic testicular seminoma is extremely unusual, especially in an older age group. The pattern of metastatic spread to the supraclavicular neck nodes from a single para-aortic lymph node is also an interesting finding. Although the majority of seminomas present in younger patients in the early stages when confined to the testis, seminoma can also occur in older patients and can present in an atypical manner. The ability to recognise an atypical presentation in an older patient is invaluable for prompt diagnosis, treatment and follow-up of disease. This case also highlights the importance of a multisystematic structured and an open-minded approach to investigating and diagnosing a neck mass.
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Affiliation(s)
- Chinnoi Law
- Department of Radiology, Eastbourne District General Hospital, Brighton, UK
| | - Zainab AlshiekhAli
- Pathology Department, Eastbourne District General Hospital, Eastbourne, UK
| | | | - David Howlett
- Department of Radiology, Eastbourne District General Hospital, Brighton, UK
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28
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Suciu MD, Marica NA, Oniu T, Tomuta AI, Badea R. Embryonal carcinoma of an intraabdominal testicular tumor on an undescended testicle: a case report. Med Pharm Rep 2020; 93:213-218. [PMID: 32478330 PMCID: PMC7243893 DOI: 10.15386/mpr-1293] [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: 01/29/2019] [Revised: 02/14/2020] [Accepted: 03/13/2020] [Indexed: 12/05/2022] Open
Abstract
Cryptorchidism, as a singular pathology or associated with other dysgenesis syndromes, is one of the main factors of risk for the development of the testicular tumors. Although there are a great number of cases of undescended testicles that are diagnosed and treated during the first 6-12 months of life, there are rare cases of adults who are undiagnosed and untreated from this anomaly, which can present a high risk of malignancy. In this study we present the case of a 36-year-old patient, diagnosed at puberty with left cryptorchidism, untreated, who also hadevidenced a large intraabdominal tumoral mass associated with it. The tumoral mass had its origin in the undescended left testicle. Surgical excision of the tumor and retroperitoneal lymphadenectomy was performed. The histological result revealed embryonal carcinoma, without lymphnode metastasis. Adult patients with untreated cryptorchidism should be thoroughly investigated, as they have a high risk of developing testicular cancer.
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Affiliation(s)
- Mihai Domnutiu Suciu
- Institute of Urology and Renal Transplantation, Cluj-Napoca, Romania
- Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Nucu Alexandru Marica
- Institute of Urology and Renal Transplantation, Cluj-Napoca, Romania
- Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | | | | | - Radu Badea
- Department of Medical Imaging, Iuliu Hatieganu University of Medicine and Pharmacy, "Prof. Dr. Octavian Fodor", Regional Institute of Gastroenterology and Hepatology Cluj-Napoca, Romania
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29
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Kamat M, Shetye S, Singh NP, Nattey K, Barman S. Testicular mixed germ cell tumour with isolated skip metastasis to unilateral pleura: First case reported in the literature. Int J Surg Case Rep 2019; 63:108-112. [PMID: 31581033 PMCID: PMC6796680 DOI: 10.1016/j.ijscr.2019.08.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 08/06/2019] [Accepted: 08/18/2019] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Testicular germ cell tumours metastasize in a very predictable fashion involving the retroperitoneal lymph nodes first followed by either lymphatic spread via thoracic duct or hematogenous spread to distant organs like lungs, liver and brain. PRESENTATION OF CASE We encountered a case of 21-year-old gentleman with mixed germ cell tumour of testis who later presented with respiratory complaints which turned out to be a metastatic differentiated teratoma of unilateral pleura without involvement of retroperitoneal lymph nodes or any other organs. DISCUSSION Skip Metastasis to unilateral pleura is an extremely rare entity for testicular mixed germ cell tumour and no case has been reported in the literature so far.
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Affiliation(s)
| | | | | | | | - Seema Barman
- Nanavati Superspeciality Hospital, Mumbai, India.
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30
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Schmidtova S, Kalavska K, Gercakova K, Cierna Z, Miklikova S, Smolkova B, Buocikova V, Miskovska V, Durinikova E, Burikova M, Chovanec M, Matuskova M, Mego M, Kucerova L. Disulfiram Overcomes Cisplatin Resistance in Human Embryonal Carcinoma Cells. Cancers (Basel) 2019; 11:E1224. [PMID: 31443351 PMCID: PMC6769487 DOI: 10.3390/cancers11091224] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 08/20/2019] [Accepted: 08/20/2019] [Indexed: 12/17/2022] Open
Abstract
Cisplatin resistance in testicular germ cell tumors (TGCTs) is a clinical challenge. We investigated the underlying mechanisms associated with cancer stem cell (CSC) markers and modalities circumventing the chemoresistance. Chemoresistant models (designated as CisR) of human embryonal carcinoma cell lines NTERA-2 and NCCIT were derived and characterized using flow cytometry, gene expression, functional and protein arrays. Tumorigenicity was determined on immunodeficient mouse model. Disulfiram was used to examine chemosensitization of resistant cells. ALDH1A3 isoform expression was evaluated by immunohistochemistry in 216 patients' tissue samples. Chemoresistant cells were significantly more resistant to cisplatin, carboplatin and oxaliplatin compared to parental cells. NTERA-2 CisR cells exhibited altered morphology and increased tumorigenicity. High ALDH1A3 expression and increased ALDH activity were detected in both refractory cell lines. Disulfiram in combination with cisplatin showed synergy for NTERA-2 CisR and NCCIT CisR cells and inhibited growth of NTERA-2 CisR xenografts. Significantly higher ALDH1A3 expression was detected in TGCTs patients' tissue samples compared to normal testicular tissue. We characterized novel clinically relevant model of chemoresistant TGCTs, for the first time identified the ALDH1A3 as a therapeutic target in TGCTs and more importantly, showed that disulfiram represents a viable treatment option for refractory TGCTs.
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Affiliation(s)
- Silvia Schmidtova
- Cancer Research Institute, Biomedical Research Center, University Science Park for Biomedicine, Slovak Academy of Sciences, Dubravska cesta 9, 845 05 Bratislava, Slovakia.
| | - Katarina Kalavska
- Cancer Research Institute, Biomedical Research Center, University Science Park for Biomedicine, Slovak Academy of Sciences, Dubravska cesta 9, 845 05 Bratislava, Slovakia
- Department of Oncology, Faculty of Medicine, Comenius University and National Cancer Institute, Klenova 1, 833 10 Bratislava, Slovakia
- Translational Research Unit, Faculty of Medicine, Comenius University, Klenova 1, 833 10 Bratislava, Slovakia
| | - Katarina Gercakova
- Cancer Research Institute, Biomedical Research Center, University Science Park for Biomedicine, Slovak Academy of Sciences, Dubravska cesta 9, 845 05 Bratislava, Slovakia
| | - Zuzana Cierna
- Department of Pathology, Faculty of Medicine, Comenius University, Sasinkova 4, 811 08 Bratislava, Slovakia
| | - Svetlana Miklikova
- Cancer Research Institute, Biomedical Research Center, University Science Park for Biomedicine, Slovak Academy of Sciences, Dubravska cesta 9, 845 05 Bratislava, Slovakia
| | - Bozena Smolkova
- Cancer Research Institute, Biomedical Research Center, University Science Park for Biomedicine, Slovak Academy of Sciences, Dubravska cesta 9, 845 05 Bratislava, Slovakia
| | - Verona Buocikova
- Cancer Research Institute, Biomedical Research Center, University Science Park for Biomedicine, Slovak Academy of Sciences, Dubravska cesta 9, 845 05 Bratislava, Slovakia
| | - Viera Miskovska
- Department of Oncology, Faculty of Medicine, Comenius University and St. Elisabeth Cancer Institute, Kolarska 12, 812 50 Bratislava, Slovakia
| | - Erika Durinikova
- Cancer Research Institute, Biomedical Research Center, University Science Park for Biomedicine, Slovak Academy of Sciences, Dubravska cesta 9, 845 05 Bratislava, Slovakia
| | - Monika Burikova
- Cancer Research Institute, Biomedical Research Center, University Science Park for Biomedicine, Slovak Academy of Sciences, Dubravska cesta 9, 845 05 Bratislava, Slovakia
| | - Michal Chovanec
- Department of Oncology, Faculty of Medicine, Comenius University and National Cancer Institute, Klenova 1, 833 10 Bratislava, Slovakia
- Translational Research Unit, Faculty of Medicine, Comenius University, Klenova 1, 833 10 Bratislava, Slovakia
| | - Miroslava Matuskova
- Cancer Research Institute, Biomedical Research Center, University Science Park for Biomedicine, Slovak Academy of Sciences, Dubravska cesta 9, 845 05 Bratislava, Slovakia
| | - Michal Mego
- Department of Oncology, Faculty of Medicine, Comenius University and National Cancer Institute, Klenova 1, 833 10 Bratislava, Slovakia
- Translational Research Unit, Faculty of Medicine, Comenius University, Klenova 1, 833 10 Bratislava, Slovakia
| | - Lucia Kucerova
- Cancer Research Institute, Biomedical Research Center, University Science Park for Biomedicine, Slovak Academy of Sciences, Dubravska cesta 9, 845 05 Bratislava, Slovakia
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31
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DNA damage in aging, the stem cell perspective. Hum Genet 2019; 139:309-331. [PMID: 31324975 DOI: 10.1007/s00439-019-02047-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 07/05/2019] [Indexed: 02/07/2023]
Abstract
DNA damage is one of the most consistent cellular process proposed to contribute to aging. The maintenance of genomic and epigenomic integrity is critical for proper function of cells and tissues throughout life, and this homeostasis is under constant strain from both extrinsic and intrinsic insults. Considering the relationship between lifespan and genotoxic burden, it is plausible that the longest-lived cellular populations would face an accumulation of DNA damage over time. Tissue-specific stem cells are multipotent populations residing in localized niches and are responsible for maintaining all lineages of their resident tissue/system throughout life. However, many of these stem cells are impacted by genotoxic stress. Several factors may dictate the specific stem cell population response to DNA damage, including the niche location, life history, and fate decisions after damage accrual. This leads to differential handling of DNA damage in different stem cell compartments. Given the importance of adult stem cells in preserving normal tissue function during an individual's lifetime, DNA damage sensitivity and accumulation in these compartments could have crucial implications for aging. Despite this, more support for direct functional effects driven by accumulated DNA damage in adult stem cell compartments is needed. This review will present current evidence for the accumulation and potential influence of DNA damage in adult tissue-specific stem cells and propose inquiry directions that could benefit individual healthspan.
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32
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Singh AP, Tanger R, Mishra D, Ansari M, Gupta AK, Shukla AK. Testicular Mixed Germ Cell Tumor in a Newborn Child: A Rare Case. J Indian Assoc Pediatr Surg 2019; 24:144-146. [PMID: 31105405 PMCID: PMC6417042 DOI: 10.4103/jiaps.jiaps_87_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Testicular tumors are rare in children but highly treatable and usually curable. Seminomas are extremely rare in prepubertal children. Among nonseminomatous germ cell tumors, the most common are teratomas and yolk sac tumors. Mixed germ cell tumor (MGCT) contains more than one germ cell component. MGCT is very rare in prepubertal age group. Here, we are presenting a case of MGCT in a newborn child with a review of literature. It is the first reported case in the world literature.
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Affiliation(s)
- Aditya Pratap Singh
- Department of Pediatric Surgery, SMS Medical College, Jaipur, Rajasthan, India
| | - Ramesh Tanger
- Department of Pediatric Surgery, SMS Medical College, Jaipur, Rajasthan, India
| | - Deepika Mishra
- Department of Pathology, SMS Medical College, Jaipur, Rajasthan, India
| | - Maryem Ansari
- Department of Pathology, SMS Medical College, Jaipur, Rajasthan, India
| | - Arun Kumar Gupta
- Department of Pediatric Surgery, SMS Medical College, Jaipur, Rajasthan, India
| | - Arvind Kumar Shukla
- Department of Pediatric Surgery, SMS Medical College, Jaipur, Rajasthan, India
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33
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Mukendi AM, Friedman R, Ismail A. Malignant epidural spinal cord compression secondary to testicular cancer (mixed choriocarcinoma and seminoma) in the immediate post radical orchidectomy period. Clin Case Rep 2019; 7:955-959. [PMID: 31110723 PMCID: PMC6509927 DOI: 10.1002/ccr3.2131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 01/21/2019] [Accepted: 03/14/2019] [Indexed: 11/29/2022] Open
Abstract
Acute spinal cord compression in the immediate postoperative period from a possible choriocarcinoma syndrome (CCS) on hemorrhagic epidural spinal metastasis has never been described before and needs to be promptly recognized and managed. A low hemoglobin associated with choriocarcinoma should raise suspicion of this syndrome.
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Affiliation(s)
- Alain Mwamba Mukendi
- Urology Department, Chris Hani Baragwanath Academic HospitalUniversity of the WitwatersrandSowetoSouth Africa
| | - Robin Friedman
- Urology Department, Chris Hani Baragwanath Academic HospitalUniversity of the WitwatersrandSowetoSouth Africa
| | - Abdullah Ismail
- Anatomical Pathology Department, Chris Hani Baragwanath Academic HospitalUniversity of the WitwatersrandSowetoSouth Africa
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34
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Li R, Li H. Poor prognosis of retroperitoneal mixed extragonadal germ cell tumors in an HIV-infected man with severe immunosuppression and bilateral cryptorchidism: a case report. BMC Cancer 2019; 19:244. [PMID: 30885154 PMCID: PMC6423750 DOI: 10.1186/s12885-019-5456-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 03/12/2019] [Indexed: 11/26/2022] Open
Abstract
Background Nonseminomatous germ cell tumors (NSGCTs) represent one of the main groups of germ cell tumors (GCTs), and they have a more invasive course than seminomatous GCTs. Human immunodeficiency virus (HIV) positivity is considered to be a risk factor for testicular seminoma patients, but reports about HIV-infected individuals with NSGCTs are rare. Case presentation We report a case of a retroperitoneal mixed extragonadal germ cell tumor in an HIV-infected man who has been diagnosed with bilateral cryptorchidism since birth. A 30-year-old man presented with a large heterogeneously mixed echo mass located in the right lower abdomen according to an abdominal ultrasound; he was HIV-positive and had a low CD4 count of 70 cells/ml in the followed test, which suggested severe immunosuppression, and ultrasound-guided biopsy histology revealed a malignant yolk sac tumor of the testis. First, the patient received combination antiretroviral therapy; then, to relieve his symptoms, an exploratory laparotomy and retroperitoneal neoplasm resection under general anesthesia were performed for subsequent treatment. The postoperative histopathological examination indicated that the patient exhibited malignant mixed GCTs of the undescended testis that were composed predominantly of yolk sac tumors with foci of embryonal cell carcinoma and seminoma; It is a rare type in various GCTs, especially in HIV-infected patients. After the operation, the patient underwent computed tomography follow-up scans at 1 week and 2 weeks, and the results showed that the size of the right inguinal mass gradually increased, which suggested a poor outcome. To limit the growth of the tumors, right inguinal mass resection under local anesthesia was performed 17 days after the initial operation, and pathological examination revealed mixed GCT metastasis. Subsequently, the patient received salvage chemotherapy with a regimen of cisplatin, etoposide, and ifosfamide. Unfortunately, the patient died 1 week after the first cycle of chemotherapy because of severe immunosuppression, a low platelet count and cancer cachexia. Conclusions Because of severe immunosuppression, the treatment of advanced extragonadal NSGCTs in an HIV-infected patient resulted in a poor prognosis. This outcome should be considered in further research, and appropriate management for achieving long-term survival needs to be established.
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Affiliation(s)
- Ruili Li
- Department of Radiology, Beijing Youan Hospital, Capital Medical University, No. 8, Xi Tou Tiao, Youanmen Wai, Fengtai District, Beijing, 100069, China
| | - Hongjun Li
- Department of Radiology, Beijing Youan Hospital, Capital Medical University, No. 8, Xi Tou Tiao, Youanmen Wai, Fengtai District, Beijing, 100069, China.
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35
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Tavella VJ, Walters JN, Crofton LM, LeRoith T. Mixed germ cell tumor composed of a tridermic testicular teratoma and seminoma in a rooster. J Vet Diagn Invest 2019; 31:395-398. [PMID: 30862303 DOI: 10.1177/1040638719838001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
A 5-y-old backyard Araucana-Americana rooster was presented to the regional diagnostic laboratory with a history of progressive lethargy and respiratory signs. Autopsy revealed a single large mass of testicular origin in the coelomic cavity, causing compression of other organs. Histologically, the mass was 1 neoplasm with mixed components of 2 different germ cell tumors, namely a teratoma composed of elements of all 3 primordial germ cell lines (ectoderm, mesoderm, and endoderm), and a seminoma consisting of round or polygonal cells arranged in sheets supported by a scant fibrovascular stroma. Teratomas and seminomas are both considered to be uncommon neoplasms in poultry medicine. A testicular teratoma is composed of mature embryonic tissue derived from at least 2 of the 3 germinal layers. Seminomas and teratomas both arise from the germinal epithelium of seminiferous tubules and are classified as germ cell tumors. This neoplastic mass thus is a rare case of a mixed germ cell tumor.
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Affiliation(s)
- Vincent J Tavella
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA (Tavella, LeRoith).,Harrisonburg Regional Animal Health Laboratory, Division of Animal and Food Industry Services, Virginia Department of Agriculture and Consumer Services, Harrisonburg, VA (Walters, Crofton)
| | - Jessica N Walters
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA (Tavella, LeRoith).,Harrisonburg Regional Animal Health Laboratory, Division of Animal and Food Industry Services, Virginia Department of Agriculture and Consumer Services, Harrisonburg, VA (Walters, Crofton)
| | - Lisa M Crofton
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA (Tavella, LeRoith).,Harrisonburg Regional Animal Health Laboratory, Division of Animal and Food Industry Services, Virginia Department of Agriculture and Consumer Services, Harrisonburg, VA (Walters, Crofton)
| | - Tanya LeRoith
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA (Tavella, LeRoith).,Harrisonburg Regional Animal Health Laboratory, Division of Animal and Food Industry Services, Virginia Department of Agriculture and Consumer Services, Harrisonburg, VA (Walters, Crofton)
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36
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Grande G, Milardi D, Martini M, Cenci T, Gulino G, Mancini F, Bianchi A, Pontecorvi A, Pierconti F. Protein Expression of PTTG-1, OCT-4, and KLF-4 in Seminoma: A Pilot Study. Front Endocrinol (Lausanne) 2019; 10:619. [PMID: 31572301 PMCID: PMC6749154 DOI: 10.3389/fendo.2019.00619] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 08/27/2019] [Indexed: 01/29/2023] Open
Abstract
Seminomas are the most frequent kind of testicular germ cell tumors (TGCTs), accounting for 50% of tumor diagnosis in young men, whereas non-seminomas account for 40% and mixed forms for 10% of cases. It is currently supposed that TGCTs evolve from a pre-invasive stage of carcinoma in situ (CIS). Octamer-binding transcription factor 4 (OCT4) is essential for self-renewal of stem cells. It is considered as a major regulator of cell pluripotency. Prior studies have shown that seminoma expresses OCT4. Transcription factor Krüppel-like factor 4 (KLF4) has moreover associated with embryonic stem cell maintenance. Finally, we previously demonstrated the expression of PTTG1 in CIS and seminomas. In this pilot study, we compared the combined expression of PTTG1 with KLF4 and OCT4 in seminoma, in order to validate our hypotesis that PTTG1 marks a specific population of stem cells in neoplastic tissue, strictly related with tumor. Formalin-fixed and paraffin-embedded testicular tissues by 5 patients who underwent an orchidectomy for seminoma have been collected and immunofluorescence analysis was performed using antibody rabbit monoclonal PTTG-1 and mouse monoclonal OCT4 or mouse monoclonal KLF4 antibody. In seminoma we observed that tumor cells strongly express OCT-4 in all seminomas and in the intratubular areas of seminoma. Expression of KLF-4 was observed in many tumor cells. PTTG1 marks some specific OCT4- and KLF4-positive tumor cells, mainly localized at the periphery of the neoplasm. In the intertubular infiltration areas nests of cells expressing both OCT4/KLF4 and PTTG1 have been observed. This is the first identification of a cell population in seminoma characterized for being OCT4, KLF4, and PTTG1 positive cells in seminoma, associated with cancer invasiveness. Further investigation is needed to elucidate if a functional abrogation of PTTG1 might be used in order to offer new therapeutic approaches in the clinical workout of seminoma.
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Affiliation(s)
- Giuseppe Grande
- Division of Endocrinology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- International Scientific Institute Paul VI, Rome, Italy
| | - Domenico Milardi
- Division of Endocrinology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- International Scientific Institute Paul VI, Rome, Italy
- *Correspondence: Domenico Milardi
| | - Maurizio Martini
- Division of Anatomic Pathology and Histology, School of Medicine, Catholic University of Rome, Rome, Italy
| | - Tonia Cenci
- Division of Anatomic Pathology and Histology, School of Medicine, Catholic University of Rome, Rome, Italy
| | - Gaetano Gulino
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | | | - Antonio Bianchi
- Division of Endocrinology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Alfredo Pontecorvi
- Division of Endocrinology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- International Scientific Institute Paul VI, Rome, Italy
| | - Francesco Pierconti
- Division of Anatomic Pathology and Histology, School of Medicine, Catholic University of Rome, Rome, Italy
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Hale GR, Teplitsky S, Truong H, Gold SA, Bloom JB, Agarwal PK. Lymph node imaging in testicular cancer. Transl Androl Urol 2018; 7:864-874. [PMID: 30456189 PMCID: PMC6212624 DOI: 10.21037/tau.2018.07.18] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Testicular cancer is a rare malignancy mainly affecting young men. Survival for testicular cancer remains high due to the effectiveness of multimodal treatment options. Accurate imaging is imperative to both treatment and follow-up. Both computed tomography (CT) and magnetic resonance imaging (MRI) suffer from size cut-offs as the only distinguishing characteristic of benign vs. malignant lymph nodes and may miss up to 30% of micro-metastatic disease. While functional [positron emission tomography (PET)] imaging may rule out disease in patients with seminoma who have undergone chemotherapy, there is insufficient evidence to recommend its use in other settings. This review highlights the uses and pitfalls of conventional imaging during staging, active surveillance, and post-treatment phases of both seminomatous and non-seminomatous germ cell tumors (NSGCT).
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Affiliation(s)
- Graham R Hale
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Seth Teplitsky
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Hong Truong
- Department of Urology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Samuel A Gold
- SUNY Downstate College of Medicine, Downstate Medical Center, Brooklyn, NY, USA
| | - Jonathan B Bloom
- Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Piyush K Agarwal
- Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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Avci IA, Altinel B. The Validity and Reliability of Health Belief Scale for Testicular Cancer Self-Examination. Am J Mens Health 2018; 12:531-538. [PMID: 26483292 PMCID: PMC5987953 DOI: 10.1177/1557988315611226] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study aimed to create a measurement tool for the determination of university students' health beliefs about testicular cancer (TC) and self-examination. This is a methodological and cross-sectional study. The study sample included 425 university students. Consents and approvals were obtained from the relevant institutions and the ethics committee prior to the research. The data were collected using an interview form that included questions about descriptive characteristics, family history of TC, and knowledge, beliefs, and practice of self-examination. The health belief model including 41 questions about self-examination and the interview form were administered to the students in their classrooms at a suitable time. Principal components analysis and varimax rotation were used for the examination of the structures of the factors. Accordingly, factor patterns, self-values, and the variance percentages they explained were evaluated. The average age of the participants is 22.2 ± 2.3 (min = 17; max = 40). Of them, 98.8% of the participants are single ( n = 420). Of them, 56.2% have heard about TC before, and 18.4% said they were informed about TC. Factor loading of the items in the first factor was 0.64 to 0.89, while it was 0.48 to 0.75 for the items in the second factor, 0.50 to 0.87 for the items in the third factor, 0.37 to 0.68 for the items in the fourth factor, 0.51 to 0.68 for the items in the fifth factor, and 0.65 to 0.79 for the items in the sixth factor. The health belief model scale may be used in TC screenings for males to measure susceptibility, seriousness, health motivation, barriers, benefits, and self-efficacy.
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Akyüz M, Topaktaş R, Ürkmez A, Koca O, Öztürk Mİ. Evaluation of germ-cell neoplasia in situ entity in testicular tumors. Turk J Urol 2018; 45:418-422. [PMID: 29799399 DOI: 10.5152/tud.2018.48855] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 01/22/2018] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Germ-cell neoplasia in situ (GCNIS) is accepted as the precursor of the testicular tumors. The aim in our study is to compare the lymphadenopathy and metastasis parameters in patients diagnosed with testicular tumor with or without GCNIS based on pathological evaluation. MATERIAL AND METHODS Data from 108 patients who underwent orchiectomy for testicular tumor between January 2007 and December 2014 in our clinic were retrospectively analyzed and included in the study. Patients were divided into two groups based on the pathology reports as GCNIS or not. Groups were compared regarding lymphadenopathy, metastasis, tumor marker levels, tumor size, lymphovascular invasion, rete testis invasion. Mann-Whitney U test was used for statistical evaluation. RESULTS Mean age of the patients included in the study were calculated as 34.6±9.3 years. Eighty-five (78.7%) patients had GCNIS, while 23 (21.3%) of them had not. In terms of metastasis, lymphadenopathy, marker levels, tumor size, lymphovascular invasion and rete testis invasion, no statistical significant difference were observed between two groups (p>0.05). CONCLUSION In our study, no statistical significant difference was observed on the prognostic factors concerning the GCNIS entity, which is reported frequently in testicular tumor pathologies. For presently these findings show us that GCNIS cannot be used as a prognostic factor.
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Affiliation(s)
- Mehmet Akyüz
- Department of Urology, Health Sciences University Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey
| | - Ramazan Topaktaş
- Department of Urology, Health Sciences University Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey
| | - Ahmet Ürkmez
- Department of Urology, Health Sciences University Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey
| | - Orhan Koca
- Department of Urology, Health Sciences University Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey
| | - Metin İshak Öztürk
- Department of Urology, Health Sciences University Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey
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40
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Brobeil A, Wagenlehner F, Gattenlöhner S. Expression of terminal deoxynucleotidyl transferase (TdT) in classical seminoma: a potential diagnostic pitfall. Virchows Arch 2018; 472:433-440. [PMID: 29455318 DOI: 10.1007/s00428-018-2313-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 01/01/2018] [Accepted: 01/28/2018] [Indexed: 11/25/2022]
Abstract
Seminomas are the most frequent testicular tumors and in spite of specific markers some histological subtypes can be diagnostically challenging due to the potential overlap of morphologic features and a variant antigen expression. Terminal deoxynucleotidyl transferase (TdT) is a DNA polymerase present in hematogones, thymic T cells, lymphoblastic lymphoma/leukemia (LBL), and in some cases of acute myeloid leukemia but so far has not been described to be expressed in seminomas. After observing a reactivity of TdT in one case of seminoma, we analyzed ten additional tumors by immunohistochemistry to determine their spectrum of reactivity for TdT. In all seminoma cases investigated (10/10) as well as in two tumor-associated germ cell neoplasias in situ (2/2) the TdT staining intensity was variable but was often moderate to strong and restricted to the nucleus. We conclude that TdT expression in seminomas could represent a diagnostic pitfall in the differential diagnosis of LBL, particularly because both may lack CD45 and/or CD20 expression and-concerning relapse in long-term survivors of testicular cancer-LBL is the most frequent secondary neoplasm in the patients.
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Affiliation(s)
- Alexander Brobeil
- Institute of Pathology, Justus-Liebig-University, 35392, Giessen, Germany.
- Institute of Pathology, Justus-Liebig-University, 35385, Giessen, Germany.
| | - Florian Wagenlehner
- Department of Urology, Pediatric Urology and Andrology, Justus-Liebig-University, 35392, Giessen, Germany
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41
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Spratt DE, Suresh K, Osawa T, Schipper M, Jackson WC, Abugharib A, Lebastchi A, Smith D, Montgomery JS, Palapattu GS, Priya Kunju L, Wu A, Lew M, Tomlins SA, Chinnaiyan AM, Weizer AZ, Hafez KS, Kaffenberger SD, Udager A, Mehra R. Detailed pathologic analysis on the co-occurrence of non-seminomatous germ cell tumor subtypes in matched orchiectomy and retroperitoneal lymph node dissections. Med Oncol 2018; 35:21. [PMID: 29387987 DOI: 10.1007/s12032-018-1090-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 01/19/2018] [Indexed: 11/30/2022]
Abstract
The frequency of co-occurrence between germ cell tumor (GCT) components in non-seminomatous germ cell tumor (NSGCT) orchiectomy specimens and their correlation with histologic findings in subsequent retroperitoneal lymph node dissection (RPLND) specimens have not been well characterized. The objective of the study was to report the first detailed clinicopathologic analysis of NSGCT orchiectomy and RPLND samples to determine the likelihood and agreement of the co-occurrence of GCT components. A total of 118 consecutive patients with NSGCT treated between 1988 and 2012 who underwent both orchiectomy and RPLND at a single academic tertiary care center were analyzed. Statistical analysis of co-occurrence likelihood and agreement of GCT components was performed, both within and between orchiectomy and RPLND specimens. Embryonal carcinoma was the most frequent component present in orchiectomy specimens, and there were multiple significant associations between orchiectomy GCT components; seminoma occurred less frequently with embryonal carcinoma (OR 0.29 [95% confidence interval (CI) 0.11-0.75]; p < 0.01), and teratoma more frequently occurred with choriocarcinoma (OR 9.64 [95% CI 1.22-76.12]; p = 0.01). Presence of teratoma in the orchiectomy specimen predicted for a fourfold increase in distant metastasis on multivariate analysis (HR 4.92 [1.14-18.9]; p = 0.02). The only significant association of co-occurrence in the RPLND specimen was between embryonal carcinoma and teratoma (OR 0.01 [95% CI 0-0.07]; p < 0.001), where it was significantly less likely for them to occur together. Our findings are limited by their retrospective nature. The co-occurrence of GCT components within orchiectomy specimens does not appear to be a completely random process. However, there is less agreement and more randomness between the occurrence of the GCT components in matched orchiectomy and RPLND samples. In this report, we look at the co-occurrence of different GCT components within matched orchiectomy and RPLND pathology specimens and show that co-occurrence is not a completely random process.
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Affiliation(s)
- Daniel E Spratt
- Department of Radiation Oncology, University of Michigan Health System, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.
| | - Krithika Suresh
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Takahiro Osawa
- Graduate School of Medicine, Hokkaido University, N15 W7 Kita-ku, Sapporo, 060-8638, Japan
| | - Matthew Schipper
- Department of Radiation Oncology, University of Michigan Health System, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.,Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - William C Jackson
- Department of Radiation Oncology, University of Michigan Health System, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA
| | - Ahmed Abugharib
- Department of Radiation Oncology, University of Michigan Health System, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA
| | - Amir Lebastchi
- Department of Urology, University of Michigan Health System, Ann Arbor, MI, USA
| | - David Smith
- Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA
| | | | - Ganesh S Palapattu
- Department of Urology, University of Michigan Health System, Ann Arbor, MI, USA.,Department of Urology, Medical University of Vienna, Vienna, Austria
| | - L Priya Kunju
- Department of Pathology, University of Michigan Health System, Ann Arbor, MI, USA
| | - Angela Wu
- Department of Pathology, University of Michigan Health System, Ann Arbor, MI, USA
| | - Madelyn Lew
- Department of Pathology, University of Michigan Health System, Ann Arbor, MI, USA
| | - Scott A Tomlins
- Department of Pathology, University of Michigan Health System, Ann Arbor, MI, USA
| | - Arul M Chinnaiyan
- Department of Pathology, University of Michigan Health System, Ann Arbor, MI, USA.,Michigan Center for Translational Pathology, Ann Arbor, MI, USA.,Howard Hughes Medical Institute, Ann Arbor, MI, USA
| | - Alon Z Weizer
- Department of Urology, University of Michigan Health System, Ann Arbor, MI, USA
| | - Khaled S Hafez
- Department of Urology, University of Michigan Health System, Ann Arbor, MI, USA
| | | | - Aaron Udager
- Department of Pathology, University of Michigan Health System, Ann Arbor, MI, USA
| | - Rohit Mehra
- Department of Pathology, University of Michigan Health System, Ann Arbor, MI, USA.,Michigan Center for Translational Pathology, Ann Arbor, MI, USA
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Rossi M, Colecchia D, Ilardi G, Acunzo M, Nigita G, Sasdelli F, Celetti A, Strambi A, Staibano S, Croce CM, Chiariello M. MAPK15 upregulation promotes cell proliferation and prevents DNA damage in male germ cell tumors. Oncotarget 2018; 7:20981-98. [PMID: 26988910 PMCID: PMC4991506 DOI: 10.18632/oncotarget.8044] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 01/29/2016] [Indexed: 12/09/2022] Open
Abstract
Germ cell tumors (GCT) are the most common malignancies in males between 15 and 35 years of age. Despite the high cure rate, achieved through chemotherapy and/or surgery, the molecular basis of GCT etiology is still largely obscure. Here, we show a positive correlation between MAPK15 (ERK8; ERK7) expression and specific GCT subtypes, with the highest levels found in the aggressive embryonal carcinomas (EC). Indeed, in corresponding cellular models for EC, MAPK15 enhanced tumorigenicity in vivo and promoted cell proliferation in vitro, supporting a role for this kinase in human GCT. At molecular level, we demonstrated that endogenous MAPK15 is necessary to sustain cell cycle progression of EC cells, by limiting p53 activation and preventing the triggering of p53-dependent mechanisms resulting in cell cycle arrest. To understand MAPK15-dependent mechanisms impinging on p53 activation, we demonstrate that this kinase efficiently protects cells from DNA damage. Moreover, we show that the ability of MAPK15 to control the autophagic process is necessary for basal management of DNA damage and for tumor formation controlled by the kinase. In conclusion, our findings suggest that MAPK15 overexpression may contribute to the malignant transformation of germ cells by controlling a “stress support” autophagic pathway, able to prevent DNA damage and the consequent activation of the p53 tumor suppressor. Moreover, in light of these results, MAPK15-specific inhibitors might represent new tools to enhance the therapeutic index of cytotoxic therapy in GCT treatment, and to increase the sensitivity to DNA-damaging drugs in other chemotherapy-resistant human tumors.
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Affiliation(s)
- Matteo Rossi
- Istituto Toscano Tumori (ITT), Core Research Laboratory (CRL), AOU Senese, Siena, Italy
| | - David Colecchia
- Istituto Toscano Tumori (ITT), Core Research Laboratory (CRL), AOU Senese, Siena, Italy.,Istituto di Fisiologia Clinica (IFC), Consiglio Nazionale delle Ricerche (CNR), Siena, Italy
| | - Gennaro Ilardi
- Dipartimento di Scienze Biomediche Avanzate, Università di Napoli "Federico II", Napoli, Italy
| | - Mario Acunzo
- Department of Molecular Virology, Immunology and Medical Genetics, Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| | - Giovanni Nigita
- Department of Molecular Virology, Immunology and Medical Genetics, Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| | - Federica Sasdelli
- Istituto Toscano Tumori (ITT), Core Research Laboratory (CRL), AOU Senese, Siena, Italy.,Istituto di Fisiologia Clinica (IFC), Consiglio Nazionale delle Ricerche (CNR), Siena, Italy
| | - Angela Celetti
- Istituto di Endocrinologia e Oncologia Sperimentale "G. Salvatore", CNR, Napoli, Italy
| | - Angela Strambi
- Istituto Toscano Tumori (ITT), Core Research Laboratory (CRL), AOU Senese, Siena, Italy
| | - Stefania Staibano
- Dipartimento di Scienze Biomediche Avanzate, Università di Napoli "Federico II", Napoli, Italy
| | - Carlo Maria Croce
- Department of Molecular Virology, Immunology and Medical Genetics, Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| | - Mario Chiariello
- Istituto Toscano Tumori (ITT), Core Research Laboratory (CRL), AOU Senese, Siena, Italy.,Istituto di Fisiologia Clinica (IFC), Consiglio Nazionale delle Ricerche (CNR), Siena, Italy
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Min X, Feng Z, Wang L, Cai J, Yan X, Li B, Ke Z, Zhang P, You H. Characterization of testicular germ cell tumors: Whole-lesion histogram analysis of the apparent diffusion coefficient at 3T. Eur J Radiol 2018; 98:25-31. [DOI: 10.1016/j.ejrad.2017.10.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 10/26/2017] [Accepted: 10/31/2017] [Indexed: 01/12/2023]
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44
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Elmore SA, Aeffner F, Bangari DS, Crabbs TA, Fossey S, Gad SC, Haschek WM, Hoane JS, Janardhan K, Kovi RC, Pearse G, Wancket LM, Quist EM. Proceedings of the 2017 National Toxicology Program Satellite Symposium. Toxicol Pathol 2017; 45:799-833. [PMID: 29113559 PMCID: PMC5743204 DOI: 10.1177/0192623317733924] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The 2017 annual National Toxicology Program Satellite Symposium, entitled "Pathology Potpourri," was held in Montreal, Quebec, Canada at the Society of Toxicologic Pathology's 36th annual meeting. The goal of this symposium was to present and discuss challenging diagnostic pathology and/or nomenclature issues. This article presents summaries of the speakers' talks along with select images that were used by the audience for voting and discussion. Various lesions and other topics covered during the symposium included renal papillary degeneration in perinatally exposed animals, an atriocaval mesothelioma, an unusual presentation of an alveolar-bronchiolar carcinoma, a paraganglioma of the organ of Zuckerkandl (also called an extra-adrenal pheochromocytoma), the use of human muscle samples to illustrate the challenges of manual scoring of fluorescent staining, intertubular spermatocytic seminomas, medical device pathology assessment and discussion of the approval process, collagen-induced arthritis, incisor denticles, ameloblast degeneration and poorly mineralized enamel matrix, connective tissue paragangliomas, microcystin-LR toxicity, perivascular mast cells in the forebrain thalamus unrelated to treatment, and 2 cases that provided a review of the International Harmonization of Nomenclature and Diagnostic Criteria (INHAND) bone nomenclature and recommended application of the terminology in routine nonclinical toxicity studies.
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Affiliation(s)
- Susan A. Elmore
- National Toxicology Program, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
| | | | | | - Torrie A. Crabbs
- Experimental Pathology Laboratories, Inc., Research Triangle Park, North Carolina
| | | | | | - Wanda M. Haschek
- University of Illinois, Department of Pathobiology, Urbana, Illinois
| | | | | | - Ramesh C. Kovi
- Experimental Pathology Laboratories, Inc., Research Triangle Park, North Carolina
| | - Gail Pearse
- GlaxoSmithKline, Ware, Hertfordshire, United Kingdom
| | | | - Erin M. Quist
- Experimental Pathology Laboratories, Inc., Research Triangle Park, North Carolina
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Xiao GQ, Priemer DS, Wei C, Aron M, Yang Q, Idrees MT. ZBTB16 is a sensitive and specific marker in detection of metastatic and extragonadal yolk sac tumour. Histopathology 2017; 71:562-569. [PMID: 28581124 DOI: 10.1111/his.13276] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 05/24/2017] [Accepted: 06/01/2017] [Indexed: 12/20/2022]
Abstract
AIMS Accurate histological diagnosis and classification of germ cell tumours (GCTs) is key to informing successful therapeutic and surveillance strategy. The modern therapeutic approach for yolk sac tumour (YST) is highly curative. Because YST takes on a large morphological spectrum, it can be confused for other GCT subtypes as well as somatic carcinomas, particularly when YST presents in an extragonadal or a metastatic setting. Currently available immunohistochemical markers are limited by suboptimal sensitivity and specificity. We reported recently that ZBTB16 is a sensitive and specific marker for testicular YST. ZBTB16 is absent in other GCTs and in most common somatic carcinomas, including those of gastrointestinal, pancreatobillary, respiratory, genitourinary and gynaecological tracts. The purpose of this study is to investigate the diagnostic utility of ZBTB16 in the settings of metastatic and extragonadal YST. METHODS AND RESULTS We studied 32 archived metastatic and four extragonadal primary YSTs as well as 51 somatic malignancies for their immunohistochemical expression of ZBTB16. For comparison, α-fetoprotein (AFP) and glypican-3 were also studied in parallel. Our results demonstrated an overall sensitivity of 91.6% for ZBTB16 in detecting metastatic and extragonadal YSTs. The non-YST elements (teratoma and embryonal carcinoma) in 15 YST-containing metastatic mixed GCTs were non-reactive. With the exception of occasional myoepithelial cells of salivary gland carcinoma, all the 51 somatic malignancies were negative for ZBTB16. CONCLUSIONS ZBTB16 is a sensitive and specific marker for YST and is diagnostically superior to AFP and glypican-3 in metastatic and extragonadal settings.
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Affiliation(s)
- Guang-Qian Xiao
- Department of Pathology, Keck Medical Center of the University of Southern California, Los Angeles, CA, USA
| | - David S Priemer
- Department of Pathology, Indiana University, Indianapolis, IN, USA
| | - Christina Wei
- Department of Pathology, Keck Medical Center of the University of Southern California, Los Angeles, CA, USA
| | - Manju Aron
- Department of Pathology, Keck Medical Center of the University of Southern California, Los Angeles, CA, USA
| | - Qi Yang
- Department of Pathology, University of Rochester Medical Center, Rochester, NY, USA
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Panza S, Santoro M, De Amicis F, Morelli C, Passarelli V, D'Aquila P, Giordano F, Cione E, Passarino G, Bellizzi D, Aquila S. Estradiol via estrogen receptor beta influences ROS levels through the transcriptional regulation of SIRT3 in human seminoma TCam-2 cells. Tumour Biol 2017; 39:1010428317701642. [PMID: 28459202 DOI: 10.1177/1010428317701642] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2023] Open
Abstract
Human testis, gonocytes, and adult germ cells mainly express estrogen receptor beta, and estrogen receptor beta loss is associated with advanced tumor stage; however, the molecular mechanisms of estrogen receptor beta-protective effects are still to be defined. Herein, we provide evidence that in human seminoma TCam-2 cells, E2 through estrogen receptor beta upregulates the mitochondrial deacetylase sirtuin-3 at protein and messenger RNA levels. Specifically, E2 increases sirtuin-3 expression through a transcriptional mechanism due to the occupancy of sirtuin-3 promoter by estrogen receptor beta, together with the transcription factor Sp1 as evidenced by Chip reChIp assay. This complex binds to a GC cluster located between -128 bp/+1 bp and is fundamental for E2 effects, as demonstrated by Sp1 small interfering RNA studies. Beside, after 24 h, E2 stimulus significantly increased activities of superoxide dismutase and catalase to scavenge reactive oxygen species produced by 30 min of E2 stimulus. In summary, this article indicates a novel functional interplay between estrogen receptor beta and sirtuin-3 counteracting reactive oxygen species production in TCam-2 cells. Our findings thus show that an important tumor-suppressive pathway through estrogen receptor beta is target of E2, actually proposing a distinctive protecting action against seminoma. Future studies may lead to additional strategies for the current therapy of seminoma.
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Affiliation(s)
- Salvatore Panza
- 1 Centro Sanitario, University of Calabria, Rende, Italy
- 2 Department of Pharmacy, Health and Nutrition Sciences, University of Calabria, Rende, Italy
| | - Marta Santoro
- 1 Centro Sanitario, University of Calabria, Rende, Italy
- 2 Department of Pharmacy, Health and Nutrition Sciences, University of Calabria, Rende, Italy
| | - Francesca De Amicis
- 1 Centro Sanitario, University of Calabria, Rende, Italy
- 2 Department of Pharmacy, Health and Nutrition Sciences, University of Calabria, Rende, Italy
| | - Catia Morelli
- 1 Centro Sanitario, University of Calabria, Rende, Italy
- 2 Department of Pharmacy, Health and Nutrition Sciences, University of Calabria, Rende, Italy
| | - Valentina Passarelli
- 1 Centro Sanitario, University of Calabria, Rende, Italy
- 2 Department of Pharmacy, Health and Nutrition Sciences, University of Calabria, Rende, Italy
| | | | - Francesca Giordano
- 2 Department of Pharmacy, Health and Nutrition Sciences, University of Calabria, Rende, Italy
| | - Erika Cione
- 2 Department of Pharmacy, Health and Nutrition Sciences, University of Calabria, Rende, Italy
| | | | | | - Saveria Aquila
- 1 Centro Sanitario, University of Calabria, Rende, Italy
- 2 Department of Pharmacy, Health and Nutrition Sciences, University of Calabria, Rende, Italy
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Dikici AS, Er ME, Alis D, Samanci C, Ustabasioglu FE, Demirdag C, Durak H, Kantarci F, Mihmanli I. Is There Any Difference Between Seminomas and Nonseminomatous Germ Cell Tumors on Shear Wave Elastography? A Preliminary Study. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2016; 35:2575-2580. [PMID: 27872413 DOI: 10.7863/ultra.15.12067] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2015] [Revised: 01/29/2016] [Accepted: 02/29/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES The purpose of this study was to evaluate the ability of shear wave elastography (SWE) to differentiate seminomas from nonseminomatous germ cell tumors. METHODS Approval for this retrospective study was obtained from the local Ethics Committee of Istanbul University Cerrahpasa Medical School. Fifteen patients with malignant testicular lesions were examined by grayscale sonography, color or power Doppler sonography, and SWE between February 2011 and October 2015. The size of each lesion, Doppler signal parameters, echogenicity, presence of microlithiasis, unifocality or multifocality, and histopathologic findings were the main factors evaluated. RESULTS The mean age of the patients was 33 years (range, 25-55 years). There were no differences between seminomas and nonseminomatous germ cell tumors in terms of Doppler signals, echogenicity, microlithiasis, or focality. Only the homogeneous and heterogeneous echogenicity patterns differed significantly. However, a significant difference was evident in SWE-derived quantitative data. CONCLUSIONS Seminomas and nonseminomatous germ cell tumors do not differ significantly on grayscale or Doppler sonography, except in terms of homogeneity. However, SWE seems to differentiate seminomas from nonseminomatous germ cell tumors.
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Affiliation(s)
- Atilla Suleyman Dikici
- Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Mehmet Emin Er
- Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Deniz Alis
- Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Cesur Samanci
- Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | | | - Cetin Demirdag
- Department of Urology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Haydar Durak
- Department of Pathology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Fatih Kantarci
- Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
| | - Ismail Mihmanli
- Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
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48
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Abstract
This article reviews the most frequently encountered tumor of the testis; pure and mixed malignant testicular germ cell tumors (TGCT), with emphasis on adult (postpubertal) TGCTs and their differential diagnoses. We additionally review TGCT in the postchemotherapy setting, and findings to be integrated into the surgical pathology report, including staging of testicular tumors and other problematic issues. The clinical features, gross pathologic findings, key histologic features, common differential diagnoses, the use of immunohistochemistry, and molecular alterations in TGCTs are discussed.
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49
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ZBTB16: a novel sensitive and specific biomarker for yolk sac tumor. Mod Pathol 2016; 29:591-8. [PMID: 26916077 DOI: 10.1038/modpathol.2016.46] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 01/26/2016] [Accepted: 01/26/2016] [Indexed: 02/06/2023]
Abstract
Although the function of zinc finger and BTB domain containing 16 (ZBTB16) in spermatogenesis is well documented, expression of ZBTB16 in germ cell tumors has not yet been studied. The aim of this study was to investigate the immunohistochemical expression and diagnostic utility of ZBTB16 in germ cell tumors. A total of 67 adult germ cell tumors were studied (62 testicular germ cell tumors, 2 ovarian yolk sac tumors, 1 mediastinal yolk sac tumor, and 2 retroperitoneal metastatic yolk sac tumors). The 62 testicular primary germ cell tumors are as follows: 34 pure germ cell tumors (20 seminomas, 8 embryonal carcinomas, 2 teratomas, 1 choriocarcinoma, 1 carcinoid, and 2 spermatocytic tumors) and 28 mixed germ cell tumors (composed of 13 embryonal carcinomas, 15 yolk sac tumors, 15 teratomas, 7 seminomas, and 3 choriocarcinomas in various combinations). Thirty-five cases contained germ cell neoplasia in situ. Yolk sac tumor was consistently reactive for ZBTB16. Among the 15 testicular yolk sac tumors in mixed germ cell tumors, all displayed moderate to diffuse ZBTB16 staining. ZBTB16 reactivity was present regardless of the histologic patterns of yolk sac tumor and ZBTB16 was able to pick up small foci of yolk sac tumor intermixed/embedded in other germ cell tumor subtype elements. Diffuse ZBTB16 immunoreactivity was also observed in 2/2 metastatic yolk sac tumors, 1/1 mediastinal yolk sac tumor, 2/2 ovarian yolk sac tumors, 2/2 spermatocytic tumors, 1/1 carcinoid, and the spermatogonial cells. All the other non-yolk sac germ cell tumors were nonreactive, including seminoma (n=27), embryonal carcinoma (n=21), teratoma (n=17), choriocarcinoma (n=4), and germ cell neoplasia in situ (n=35). The sensitivity and specificity of ZBTB16 in detecting yolk sac tumor among the germ cell tumors was 100% (20/20) and 96% (66/69), respectively. In conclusion, ZBTB16 is a highly sensitive and specific marker for yolk sac tumor.
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Yoon YM, Kang DY, Kim DY, Seo JW, Lim HJ, Lee HJ, Park SG. Extremely elevated alpha-fetoprotein due to acute exacerbation of chronic hepatitis B without malignancy: a case report. J Med Case Rep 2016; 10:140. [PMID: 27246404 PMCID: PMC4888519 DOI: 10.1186/s13256-016-0915-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Accepted: 04/26/2016] [Indexed: 12/27/2022] Open
Abstract
Background Alpha-fetoprotein is produced by a variety of tumors such as hepatocellular carcinoma, hepatoblastoma, and germ cell tumors of the ovary and testes. However, we present a case of significantly elevated serum alpha-fetoprotein without evidence of malignant disease in a patient who is a carrier of chronic hepatitis B. Case presentation A 60-year-old Korean man presented with markedly increased alpha-fetoprotein (2350 ng/mL; normal <5 ng/mL). Various diagnostic evaluations, including computed tomography of the abdomen and thorax and ultrasonography of the abdomen and testes, showed liver cirrhosis and mild splenomegaly; however, no mass was detected in the liver, testes, or other organs scanned. The laboratory findings showed elevated liver function, positivity for hepatitis B e antigen, and a marked increase in hepatitis B virus deoxyribonucleic acid copy number (>7 × 105 IU/mL). Our patient was diagnosed with acute exacerbation of chronic hepatitis B, and we presumed that this condition might be related to extremely elevated alpha-fetoprotein. When our patient was treated with entecavir, the serum alpha-fetoprotein level immediately decreased, in parallel with the hepatitis B virus deoxyribonucleic acid copy number. Conclusions We report a rare case of extremely elevated alpha-fetoprotein due to acute exacerbation of chronic hepatitis B without any malignancy, and a decrease in this tumor marker simultaneous with a decrease in hepatitis B virus deoxyribonucleic acid copy number on entecavir treatment. This case report is important due to the rarity of the case; furthermore, it provides details of a diagnostic process for a variety of benign diseases and malignant tumors that should be considered in patients with elevated alpha-fetoprotein. Thus, we present a case report, along with a review, that will be helpful for diagnosis and treatment of patients with elevated alpha-fetoprotein.
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Affiliation(s)
- Young-Min Yoon
- Department of Internal Medicine, Chosun University Hospital, 365 Pilmun-daero, Dong-gu, Gwangju, 501-717, Republic of Korea
| | - Da-Yeong Kang
- Department of Internal Medicine, Chosun University Hospital, 365 Pilmun-daero, Dong-gu, Gwangju, 501-717, Republic of Korea
| | - Da-Young Kim
- Department of Internal Medicine, Chosun University Hospital, 365 Pilmun-daero, Dong-gu, Gwangju, 501-717, Republic of Korea
| | - Jun-Won Seo
- Department of Medicine, Graduate School of Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju, 501-717, Republic of Korea
| | - Hyun-Jong Lim
- Department of Medicine, Graduate School of Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju, 501-717, Republic of Korea
| | - Hee-Jeong Lee
- Department of Internal Medicine, Hemato-oncology, Chosun University Hospital, 365 Pilmun-daero, Dong-gu, Gwangju, 501-717, Republic of Korea
| | - Sang-Gon Park
- Department of Internal Medicine, Hemato-oncology, Chosun University Hospital, 365 Pilmun-daero, Dong-gu, Gwangju, 501-717, Republic of Korea.
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