Testicular cancer pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Gertrude Djouka, M.D.[2], Shanshan Cen, M.D. [3]

Overview

The pathophysiology of testicular cancer depends on the histological cell subtypes and findings. Most testicular cancers derived from the lack of differentiation of primordial germ cell into spermatogonia. Germ cells testicular tumor have some genetic component while most sex cord stromal testicular cancer are hormonal dependent. Most gross pathology of testicular tumors look similar on the physical appearance. On microscopic histopathological analysis of testicular cancer, fried-egg appearance is the characteristic finding of seminoma; marked nuclear atypia is the characteristic finding of embryonal carcinoma; hyaline-type globules, and Schiller-Duval bodies are characteristic findings of yolk sac tumor  ; syncytiotrophoblasts and cytotrophoblast cells are the characteristic findings of choriocarcinoma, Polymorphism with"spirene" chromatin for spermatocytic.

Pathogenesis

Normal process of testicular germ cells

Normal process of testicular sex cord stromal

Leydig cells

Germ cells tumors

Germ cell tumors derived from germ cell neoplasia in situ

Germ cell tumors unrelated to germ cell neoplasia in situ

Testicular sex cord stromal tumors

Leydig cells tumor

Sertoli cell tumor

Granulosa cell tumor

Gross and Microscopic Pathology

The gross and microscopic features of the most common tumors are described below:[16][17][18][19][20][21][22][19][23][24][25][26][27][3][28][29][15]

Types Gross pathology Microscopic pathology Images
Germ cell neoplasia in situ
Contributed by Nephron in wikimedia.commons
Seminoma
  • Solid, firm without cross section
Contributed by Nephron in wikimedia.commons
Embryonal carcinoma
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Yolk sac tumor
Contributed by EDDAOUALLINE Hanane in wikimedia.commons
Choriocarcinoma
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Teratoma, postpubertal-type
Contributed by Nephron in wikimedia.commons
Mixed germ cell tumors
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Spermatocytic tumor
  • Soft, gray, and gelatinous mass
  • Well circumscribed with small hemorrhagic and necrotic foci.
Contributed by Nephron in wikimedia.commons
Teratoma, prepubertal-type,

Desmoid cyst

Epidermoid cyst

Contributed by Nephron in wikimedia.commons
Testicular lymphoma
  • Soft, gray, and gelatinous mass
  • Well circumscribed with small hemorrhagic and necrotic foci.
Contributed by Nephron in wikimedia.commons
Leydig cells tumor
Contributed by Nephron in wikimedia.commons
Sertoli tumor
  • White to grey on cut surface
Contributed by Nephron in wikimedia.commons
Granulosa tumor

Adult type

  • No distint feature

Juvenile type

Adult type

  • Cells are arranged in elongated, microfollicular "call-Exner bodies"

Juvenile type

Contributed by Nephron in wikimedia.commons

Genetics

These are genes involved in the pathogenesis of testicular cancer:[30][31]

Immunohistochemical Markers

References

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