Seminoma overview
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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
Symptoms
Physical Examination
Laboratory Findings
CT
MRI
Other Imaging Findings
There are no other imaging findings associated with seminoma.
Other Diagnostic Studies
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 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
- ↑ 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
- ↑ 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
- ↑ 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
- ↑ 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
- ↑ 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