Seminoma overview: Difference between revisions
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==Diagnosis== | ==Diagnosis== | ||
===Staging=== | ===Staging=== | ||
Seminoma grows slower than non-seminomatous germ cell tumors.<ref name=seminomas1>Cancerous tumours of the testicle. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/testicular/testicular-cancer/cancerous-tumours/?region=on. Accessed on February 26, 2016</ref> Common complications of seminoma include recurrence, lymph node metastasis, distant metastasis, and secondary malignancies.<ref name=Testicularseminomaradiopaediafhg>Testicular seminoma. Dr Marcin Czarniecki and Dr Andrew Dixon et al. Radiopaedia 2016. http://radiopaedia.org/articles/testicular-seminoma-1. Accessed on March 3, 2016</ref> Prognosis of seminoma is good for all stages with greater than 90% cure rate.<ref name=progseminomabjhk>Treatment and prognosis of testicular seminoma. Dr Marcin Czarniecki and Dr Andrew Dixon et al. Radiopaedia 2016. http://radiopaedia.org/articles/testicular-seminoma-1. Accessed on March 2, 2016</ref> The International Germ Cell Cancer Consensus Group divides seminoma into two prognosis groups: good and intermediate.<ref name=survivalkandprognosisoftesticularcancer>Prognosis and survival for testicular cancer. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/testicular/prognosis-and-survival/?region=on. Accessed on February 29, 2016</ref> | |||
===Symptoms=== | ===Symptoms=== | ||
Symptoms of seminoma include painless testicular mass with discomfort, [[back pain]], [[abdominal discomfort]], or [[abdominal mass]].<ref name=clinicslpresntatioontesticularseminoma1>Clinical presentation of testicular seminoma. Dr Marcin Czarniecki and Dr Andrew Dixon et al. Radiopaedia 2016. http://radiopaedia.org/articles/testicular-seminoma-1. Accessed on February 25, 2016</ref> | |||
===Physical Examination=== | ===Physical Examination=== | ||
Common physical examination findings of seminoma include unilateral, nontender mass with or without retroperitoneal or inguinal lymphadenopathy.<ref name="BoujelbeneCosinschi2011">{{cite journal|last1=Boujelbene|first1=Noureddine|last2=Cosinschi|first2=Adrien|last3=Boujelbene|first3=Nadia|last4=Khanfir|first4=Kaouthar|last5=Bhagwati|first5=Shushila|last6=Herrmann|first6=Eveleyn|last7=Mirimanoff|first7=Rene-Olivier|last8=Ozsahin|first8=Mahmut|last9=Zouhair|first9=Abderrahim|title=Pure seminoma: A review and update|journal=Radiation Oncology|volume=6|issue=1|year=2011|pages=90|issn=1748-717X|doi=10.1186/1748-717X-6-90}}</ref> | |||
===Laboratory Findings=== | ===Laboratory Findings=== | ||
Common laboratory tests performed in seminoma include complete blood count and blood chemistry tests.<ref name=Diagnosisoftesticularcancer1>Diagnosis of testicular cancer. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/testicular/diagnosis/?region=on. Accessed on March 2, 2016</ref> Laboratory findings consistent with the diagnosis of seminoma include abnormal serum tumor marker levels ([[LDH]], [[HCG]]).<ref name=Diagnosisoftesticularcancer1>Diagnosis of testicular cancer. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/testicular/diagnosis/?region=on. Accessed on March 2, 2016</ref><ref name=diagnosisoftesticularseminomawiki1>Diagnosis of seminoma. Wikipedia 2016. https://en.wikipedia.org/wiki/Seminoma. Accessed on March 3, 2016</ref> | |||
===CT=== | ===CT=== | ||
Abdominal and pelvic CT scans may be diagnostic of seminoma.<ref name=radiographicfeaturesofptesticularseminoma1>Radiographic features of testicular seminoma. Dr Marcin Czarniecki and Dr Andrew Dixon et al. Radiopaedia 2016. http://radiopaedia.org/articles/testicular-seminoma-1. Accessed on February 29, 2016</ref> CT scan may detect metastases of seminoma to the para-aortic, inguinal, or iliac lymph nodes. Visceral metastasis may also be seen.<ref name=radiographicfeaturesofptesticularseminoma1>Radiographic features of testicular seminoma. Dr Marcin Czarniecki and Dr Andrew Dixon et al. Radiopaedia 2016. http://radiopaedia.org/articles/testicular-seminoma-1. Accessed on February 29, 2016</ref> | |||
===MRI=== | ===MRI=== | ||
Pelvic MRI may be diagnostic of testicular seminoma. On MRI, seminoma is characterized by multinodular tumors of uniform signal intensity. Findings on MRI suggestive of seminoma include hypo- to isointense on T2-weighted images and inhomogenous enhancement on contrast enhanced T1-weighted images.<ref name=radiographicimagesofseminoma1>Radiographic features of testicular seminoma. Dr Marcin Czarniecki and Dr Andrew Dixon et al. Radiopaedia 2016. http://radiopaedia.org/articles/testicular-seminoma-1. Accessed on March 7, 2016</ref> | |||
===Other Imaging Findings=== | ===Other Imaging Findings=== | ||
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===Other Diagnostic Studies=== | ===Other Diagnostic Studies=== | ||
Other diagnostic studies for seminoma include [[biopsy]], [[PET|FDG-PET scan]], and [[bone scan]].<ref name=pathologyofseminoma1>Microscopic pathology of seminoma. Libre pathology 2016. http://librepathology.org/wiki/Seminoma. Accessed on March 3, 2016</ref> | |||
==Treatment== | ==Treatment== | ||
Revision as of 15:54, 7 March 2016
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Seminoma Microchapters |
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Case Studies |
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Seminoma overview On the Web |
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American Roentgen Ray Society Images of Seminoma overview |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]
Overview
Seminoma is the most common testicular tumor and accounts for approximately 45% of all primary testicular tumors. However, seminoma can arise outside of the testicle, most often within the anterior mediastinum, e.g. anterior mediastinal germ cell tumor.[1] Seminoma is the most common germ cell tumor of the testis. It is the male counterpart of the dysgerminoma, which arise in the ovary. It should not be confused with the unrelated tumor called spermatocytic seminoma.[2]
Classification
Based on the histology, testicular seminoma may be classified into three subtypes: classic, anaplastic, and spermatocytic.[3]
Pathophysiology
On gross pathology, seminoma is characterized by pale gray to yellow nodules that are uniform or slightly lobulated and often bulge from the cut surface.[3] On microscopic pathology, seminoma is characterized by the cells with fried egg appearance with clear cytoplasm and central nucleus with prominent nucleolus, with interspersed lymphocytes and syncytiotrophoblasts.[4] Approximately 24% of Stage I seminomas have lymphovascular invasion for stage I (Tx, N0, M0). Intertubular seminoma may not form a discrete mass and mimic a benign testis.[4] Seminoma is demonstrated by positivity to tumor markers, such as OCT4, CD117, D2-40, and CD117.[5]
Causes
There are no known direct causes for seminoma.[6] To view a comprehensive list of risk factors that increase the risk of seminoma, click here.[7][8]
Differentiating Primary Central Nervous System Lymphoma from other Diseases
Seminoma must be differentiated from other diseases that cause testicular mass, such as non seminomatous germ cell tumor, sex cord tumors, focal orchitis, focal intratesticular hemorrhage, testicular torsion, tuberculosis, and polyorchidism.[9][10]
Epidemiology and Demographics
Testicular germ cell tumor accounts for around 1-2% of all malignancies in males up to the age of 65, but they are the most common nonhematologic malignancy in males 15-49 years old. Approximately 50% of germ cell tumours are seminomas.[11] The mean age at diagnosis of testicular seminoma is between 15 and 35 years. This is about 5 to 10 years older than men with other germ cell tumors of the testis.[12] Testicular seminoma usually affects individuals of the Caucasian race. African american individuals are less likely to develop testicular seminoma.[11]
Risk Factors
Common risk factors for testicular seminoma include undescended testis, caucasian race, previous tumor in the contralateral testis, and family history of testicular germ cell tumor.[7][8][6]
Screening
There is insufficient evidence to recommend routine screening for seminoma.[13]
Natural History, Complications and Prognosis
Seminoma grows slower than non-seminomatous germ cell tumors.[14] Common complications of seminoma include recurrence, lymph node metastasis, distant metastasis, and secondary malignancies.[15] Prognosis of seminoma is good for all stages with greater than 90% cure rate.[16] The International Germ Cell Cancer Consensus Group divides seminoma into two prognosis groups: good and intermediate.[17]
Diagnosis
Staging
Seminoma grows slower than non-seminomatous germ cell tumors.[14] Common complications of seminoma include recurrence, lymph node metastasis, distant metastasis, and secondary malignancies.[15] Prognosis of seminoma is good for all stages with greater than 90% cure rate.[16] The International Germ Cell Cancer Consensus Group divides seminoma into two prognosis groups: good and intermediate.[17]
Symptoms
Symptoms of seminoma include painless testicular mass with discomfort, back pain, abdominal discomfort, or abdominal mass.[9]
Physical Examination
Common physical examination findings of seminoma include unilateral, nontender mass with or without retroperitoneal or inguinal lymphadenopathy.[18]
Laboratory Findings
Common laboratory tests performed in seminoma include complete blood count and blood chemistry tests.[19] Laboratory findings consistent with the diagnosis of seminoma include abnormal serum tumor marker levels (LDH, HCG).[19][20]
CT
Abdominal and pelvic CT scans may be diagnostic of seminoma.[21] CT scan may detect metastases of seminoma to the para-aortic, inguinal, or iliac lymph nodes. Visceral metastasis may also be seen.[21]
MRI
Pelvic MRI may be diagnostic of testicular seminoma. On MRI, seminoma is characterized by multinodular tumors of uniform signal intensity. Findings on MRI suggestive of seminoma include hypo- to isointense on T2-weighted images and inhomogenous enhancement on contrast enhanced T1-weighted images.[22]
Other Imaging Findings
There are no other imaging findings associated with seminoma.
Other Diagnostic Studies
Other diagnostic studies for seminoma include biopsy, FDG-PET scan, and bone scan.[4]
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
References
- ↑ Testicular seminoma. Dr Marcin Czarniecki and Dr Andrew Dixon et al. Radiopaedia 2016. http://radiopaedia.org/articles/testicular-seminoma-1. Accessed on February 25, 2016
- ↑ Overview of seminoma. Libre pathology 2016. http://librepathology.org/wiki/Seminoma. Accessed on March 3, 2016
- ↑ 3.0 3.1 Pathology of testicular seminoma. Dr Marcin Czarniecki and Dr Andrew Dixon et al. Radiopaedia 2016. http://radiopaedia.org/articles/testicular-seminoma-1. Accessed on February 25, 2016
- ↑ 4.0 4.1 4.2 Microscopic pathology of seminoma. Libre pathology 2016. http://librepathology.org/wiki/Seminoma. Accessed on March 3, 2016
- ↑ IHC for seminoma. Libre pathology 2016. http://librepathology.org/wiki/Seminoma. Accessed on March 3, 2016
- ↑ 6.0 6.1 Causes of seminoma. US National Library of Medicine 2016. https://www.nlm.nih.gov/medlineplus/ency/article/001288.htm. Accessed on February 29, 2016
- ↑ 7.0 7.1 Risk factors for testicular seminoma. Dr Marcin Czarniecki and Dr Andrew Dixon et al. Radiopaedia 2016. http://radiopaedia.org/articles/testicular-seminoma-1. Accessed on February 25, 2016>
- ↑ 8.0 8.1 Risk factors for testicular germ cell tumors. Dr Matt A. Morgan and Dr Andrew Dixon et al. Radiopaedia 2016. Accessed on February 25, 2016
- ↑ 9.0 9.1 Clinical presentation of testicular seminoma. Dr Marcin Czarniecki and Dr Andrew Dixon et al. Radiopaedia 2016. http://radiopaedia.org/articles/testicular-seminoma-1. Accessed on February 25, 2016
- ↑ Differential diagnosis of testicular seminoma. Dr Marcin Czarniecki and Dr Andrew Dixon et al. Radiopaedia 2016. http://radiopaedia.org/articles/testicular-seminoma-1. Accessed on February 25, 2016
- ↑ 11.0 11.1 Epidemiology of testicular seminoma. Dr Marcin Czarniecki and Dr Andrew Dixon et al. Radiopaedia 2016. http://radiopaedia.org/articles/testicular-seminoma-1. Accessed on February 25, 2016
- ↑ Presentation of seminoma. Wikipedia 2016. https://en.wikipedia.org/wiki/Seminoma. Accessed on February 25, 2016
- ↑ Screening of seminoma. U.S. preventive services task force 2016. http://www.uspreventiveservicestaskforce.org/BrowseRec/Search?s=seminoma. Accessed on March 3, 2016
- ↑ 14.0 14.1 Cancerous tumours of the testicle. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/testicular/testicular-cancer/cancerous-tumours/?region=on. Accessed on February 26, 2016
- ↑ 15.0 15.1 Testicular seminoma. Dr Marcin Czarniecki and Dr Andrew Dixon et al. Radiopaedia 2016. http://radiopaedia.org/articles/testicular-seminoma-1. Accessed on March 3, 2016
- ↑ 16.0 16.1 Treatment and prognosis of testicular seminoma. Dr Marcin Czarniecki and Dr Andrew Dixon et al. Radiopaedia 2016. http://radiopaedia.org/articles/testicular-seminoma-1. Accessed on March 2, 2016
- ↑ 17.0 17.1 Prognosis and survival for testicular cancer. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/testicular/prognosis-and-survival/?region=on. Accessed on February 29, 2016
- ↑ Boujelbene, Noureddine; Cosinschi, Adrien; Boujelbene, Nadia; Khanfir, Kaouthar; Bhagwati, Shushila; Herrmann, Eveleyn; Mirimanoff, Rene-Olivier; Ozsahin, Mahmut; Zouhair, Abderrahim (2011). "Pure seminoma: A review and update". Radiation Oncology. 6 (1): 90. doi:10.1186/1748-717X-6-90. ISSN 1748-717X.
- ↑ 19.0 19.1 Diagnosis of testicular cancer. Canadian cancer society 2016. http://www.cancer.ca/en/cancer-information/cancer-type/testicular/diagnosis/?region=on. Accessed on March 2, 2016
- ↑ Diagnosis of seminoma. Wikipedia 2016. https://en.wikipedia.org/wiki/Seminoma. Accessed on March 3, 2016
- ↑ 21.0 21.1 Radiographic features of testicular seminoma. Dr Marcin Czarniecki and Dr Andrew Dixon et al. Radiopaedia 2016. http://radiopaedia.org/articles/testicular-seminoma-1. Accessed on February 29, 2016
- ↑ Radiographic features of testicular seminoma. Dr Marcin Czarniecki and Dr Andrew Dixon et al. Radiopaedia 2016. http://radiopaedia.org/articles/testicular-seminoma-1. Accessed on March 7, 2016