46. Mixed germ cell tumor with seminoma and teratoma

Last updated on April 22, 2019 at 19:57

Organ: Testis

Description:

There are two different cancers on this preparation. On the superior half there is an embryonal carcinoma, which is brownish and has a focus of greyish necrosis.

On the inferior half there is a seminoma, which is bright greyish, lobulated and almost homogenous. There is no necrosis in the seminoma.

Diagnosis: Mixed germ cell tumor with seminoma and embryonal carcinoma

Risk factors:

  • 20-30 years old males

Theory:

Seminomas develop from germ cell neoplasia in situ (GCNIS), which again develops from a primitive germ cell.

Testicular germ cell tumors are mixed in approx. 60% of cases, meaning that multiple histological types are present, like in this case.

Isochromosome 12p, which means that the long arm (q) of the chromosome is replaced with another copy of the short arm (p), is found in virtually all germ cell tumors, including this one.

The title of the topic states that there is a teratoma in this prep, but there isn’t. It’s a mistake. Embryonal carcinoma is not a type of teratoma.

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5 thoughts on “46. Mixed germ cell tumor with seminoma and teratoma”

  1. Hi!

    “The title of the topic states that there is a teratoma in this prep, but there isn’t. It’s a mistake. Embryonal carcinoma is not a type of teratoma”

    But, can’t a Teratoma be a type of Embryonal Carcinoma?

  2. Seminoma is the upper part, and the embryonal cc is the lower part. Its a very rare prep, since there is normalt no necrosis in a seminoma.

    1. There’s an ongoing disagreement as to which tumor is the seminoma and which is the embryonal carcinoma. According to my teacher the bottom tumor is the seminoma, while other teachers say it’s the opposite. I don’t understand why it’s more likely that this prep is a very rare condition where the seminoma is necrotic, rather than that the necrotic tumor is the embryonal carcinoma. That doesn’t really make sense to me.

      According to pathologyoutlines seminomas are grey-white masses, while testicular embryonal carcinoma is “Soft, tan white, poorly circumscribed, with hemorrhage and necrosis”. Also, google seminoma and testicular embryonal carcinoma. Which of them look most similar to the bottom tumor? In my opinion the answer is seminoma.

      I’m not saying that I’m 100% correct here, but in my eyes the current status seems the most correct for me.

  3. Szia, Nik

    Just want to mention that David said during the lectures that seminomas usually don’t contain any scar or necrosis, but that our prep is an exception to this rule.

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