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Seminoma


Presentation

  • This is a rare presentation of seminoma and emphasises the importance of scrotal examination in young men presenting with acute abdomen.[ncbi.nlm.nih.gov]
  • Even more rare is a synchronous bilateral presentation. Only eight cases of bilateral SS have been reported in the literature, of which three cases were present with synchronous testis enlargement, and five were sequential.[ncbi.nlm.nih.gov]
  • We report a case of extragonadal seminoma presenting as a polypoid mass in the urinary bladder. The patient presented with two months history of hematuria.[ncbi.nlm.nih.gov]
  • Both components appeared to be present in almost equal proportions in the tumor.[ncbi.nlm.nih.gov]
  • A review of literature pertaining to clinical presentation, diagnosis, and management is also presented.[ncbi.nlm.nih.gov]
Cervical Lymphadenopathy
  • Abstract A 52-year-old man was presented with a huge left testicular mass and palpable cervical lymphadenopathy with retroperitoneal lymph node enlargement on an abdominal computed tomography.[ncbi.nlm.nih.gov]
Soft Tissue Mass
  • Thorax computerized tomography demonstrated a soft tissue mass in the anterior mediastinum with stippled calcifications compressing the superior vena cava and other major vessels.[ncbi.nlm.nih.gov]
  • He was evaluated at an outside hospital where a non-contrasted CT scan revealed a 20 cm well-circumscribed soft tissue mass within the pelvis.He was referred and further imaging revealed a 12 cm heterogeneous mass with foci of air that appeared to be[ncbi.nlm.nih.gov]
Respiratory Insufficiency
  • Bleomycin-induced lung injury, a major complication of chemotherapy for germ cell tumors, occasionally fails to respond to the standard treatment with corticosteroids and develops into severe respiratory insufficiency.[ncbi.nlm.nih.gov]
Dry Cough
  • At the end of second cycle, he developed a dry cough and fever that was accompanied by newly-identified bilateral infiltrates on chest X-ray.[ncbi.nlm.nih.gov]
Hoarseness
  • Abstract Primary mediastinal seminoma is a rare tumor usually with nonspecific symptoms such as chest pain, dyspnea and hoarseness, but superior vena cava syndrome (SVCS) is an extremely uncommon syndrome.[ncbi.nlm.nih.gov]
Constipation
  • A 39-year-old man presented with a 2-day history of worsening constant, dull diffuse lower abdominal pain with associated constipation and known history of left undescended testicle.[ncbi.nlm.nih.gov]
Polydipsia
  • Nausea, polyuria, polydipsia, lethargy and confusion led him to the emergency department. An abdominal and pelvic enhanced CT confirmed a calcified pelvic mass, along with multiple retroperitoneal lymphadenopathy.[ncbi.nlm.nih.gov]
Retrosternal Chest Pain
  • We report a 25-year-old man who presented with superior vena cava syndrome for 1 month and a 1-week history of retrosternal chest pain.[ncbi.nlm.nih.gov]
Ulcer
  • The tumor had invaded the pericardium and an ulcerative surface with hemorrhagic necrosis on the cut surfaces of the intrapericardial tumor was revealed. All cardiac chambers and intrathoracic great vessels were intact and both testes were normal.[ncbi.nlm.nih.gov]
Collar of Stokes
  • Physical examination showed collar of Stokes and extensive collateral circulation in the neck and anterosuperior thoracic region, as well as a large testicular mass.[ncbi.nlm.nih.gov]
Urinary Retention
  • Pelvic mass was caused due to seminoma is a rare cause of urinary retention.[ncbi.nlm.nih.gov]
  • A 58-year-old man with urinary retention and abdominal distension was admitted to our hospital. Computed tomography and magnetic resonance imaging demonstrated a large mass in the pelvic cavity.[ncbi.nlm.nih.gov]

Workup

  • Metastatic workup showed no nodal or distant spread, T1N0M0 stage I. After orchiectomy, the patient underwent adjuvant external beam radiotherapy to the para-aortic nodes.[emedicine.com]
Anterior Mediastinal Mass
  • A very large anterior mediastinal mass was identified and demonstrated to be an extragonadal seminoma. Extragonadal germ cell tumours are rare tumours with a high potential for cardiovascular, pulmonary and vascular sequelae.[ncbi.nlm.nih.gov]
  • Ours was an interesting case where a 17-year-old adolescent male presented with anterior mediastinal mass. Fine needle aspiration and trucut biopsy of the mass favored tuberculosis; however, he did not respond to antituberculosis treatment regime.[ncbi.nlm.nih.gov]
  • Diagnostic imaging revealed the presence of large anterior mediastinal masses. Both patients underwent thoracotomy with complete resection of their tumors.[ncbi.nlm.nih.gov]

Treatment

  • Adjuvant treatment after orchiectomy was classified into 3 groups: surveillance, radiotherapy, and chemotherapy. Yearly trends in management are described.[ncbi.nlm.nih.gov]
  • Factors affecting treatment selection (active surveillance [AS] vs adjuvant treatment [AT]) were identified using a parsimonious multivariate logistic regression model.[ncbi.nlm.nih.gov]
  • Patients undergoing adjuvant RT received more treatments per patient than patients followed with surveillance, but there was no significant difference noted with regard to the risk of receiving 1 line of treatment.[ncbi.nlm.nih.gov]
  • Little is known about salvage treatment for refractory cases.[ncbi.nlm.nih.gov]
  • BACKGROUND: The purpose of the protocol was to reduce the treatment burden in clinical stage I (CSI) seminoma by offering risk-adapted treatment.[ncbi.nlm.nih.gov]

Prognosis

  • It is associated with good prognosis. Testicular tumours as such are uncommon in Asia as compared to western countries. In the literature only five cases of bilateral synchronous Spermatocytic Seminoma have been reported.[ncbi.nlm.nih.gov]
  • Abstract Spermatocytic seminoma is an extremely rare clinically and pathologically distinct subtype of testicular cancer that infrequently metastasizes and typically yields a good prognosis.[ncbi.nlm.nih.gov]
  • Diagnostic delays are unfortunately common and may lead to metastatic spread and worse prognosis.[ncbi.nlm.nih.gov]
  • Elevation of the serum markers HCG and LDH were of prognostic significance, while an extragonadal primary tumor site was not associated with an adverse prognosis.[ncbi.nlm.nih.gov]

Etiology

  • It should be considered especially in young patients who have findings of liver disease with unexplained etiology.[ncbi.nlm.nih.gov]
  • We describe an unusual case of mediastinal seminoma in a 21-year-old male on chronic peritoneal dialysis for renal failure of uncertain etiology.[ncbi.nlm.nih.gov]
  • A 43-year-old patient without any additional pathology was admitted for anemia of unknown etiology. The clinical examination revealed through deep abdominal palpation a mass in the left flank, and normal testes.[ncbi.nlm.nih.gov]
  • Etiology The etiology of SS is unknown. It is thought to originate from a premeiotic germ cell.[orpha.net]
  • Etiology Etiology is unknown but tumors are thought to arise from an embryonic germ cell leading to testicular intraepithelial neoplasia (the precursor to classical seminoma).[rarediseases.info.nih.gov]

Epidemiology

  • Links: epidemiology of testicular cancer clinical features/presenting features of testicular cancer investigations in testicular cancer treatment of testicular cancer prognosis of testicular cancer testicular cancer testicular microlithiasis urgent referral[gpnotebook.co.uk]
  • Summary Epidemiology SS accounts for around 1- 2% of all cases of testicular germ cell tumors (see this term). Annual incidence in Europe is 1/3,300,000. Clinical description SS presents in males in their fifth to sixth decade of life.[orpha.net]
  • Epidemiology Annual incidence in Europe is 1/62,000 people. It accounts for 40% of testicular cancer cases. Clinical description Seminoma usually presents in males between the ages of 30-40. A painless mass in the scrotum is indicative of disease.[rarediseases.info.nih.gov]
  • McGlynn et al (2005) published an analysis of 9 registries of the Surveillance, Epidemiology, and End Results (SEER) database from 1973-2001. They found an increasing incidence among African Americans starting in the 1990s.[emedicine.medscape.com]
Sex distribution
Age distribution

Pathophysiology

  • The relationship with PTHrP has not been determined or studied.The aim of this study is to describe and discuss the case and the pathophysiological mechanisms involved in a malignant hypercalcemia mediated by 1,25-dihydroxyvitamin D and PTHrP cosecretion[ncbi.nlm.nih.gov]
  • Pathophysiology Testicular seminoma is a pathologic diagnosis in which only seminomatous elements are observed upon histopathologic review after a radical orchiectomy and in which serum alpha-fetoprotein (AFP) is within the reference range.[emedicine.medscape.com]
  • Epidemiology : usually develop after the age of 4 Pathophysiology : produces amounts of testosterone and a small amount of estrogen , progesterone , and corticosteroids testosterone excess causes precocious puberty in males (and masculinization in females[amboss.com]

Prevention

  • A wide excision of the left hemiscrotum including the testis was performed in order to prevent severe local and systemic infectious complications. Histological examination revealed an AS.[ncbi.nlm.nih.gov]
  • PURPOSE: The cure rate of stage I seminoma patients is close to 100% and so the recent focus of clinical research has shifted onto the prevention of treatment-related complications.[ncbi.nlm.nih.gov]
  • These findings identify spindle-associated RHAMM as an intrinsic regulator of male germ cell fate and as a gatekeeper preventing initiation of TGCTs. Cancer Res; 76(21); 6382-95. 2016 AACR. [Indexed for MEDLINE] Free full text[ncbi.nlm.nih.gov]
  • […] and early detection of cervical cancer: American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer.[nccn.org]
  • Carboplatin does not prevent contralateral testicular tumors in patients with seminoma. J Clin Oncol 2011;29:2944-5. 17. Ruf CG, Gnoss A, Hartmann M, Matthies C, Anheuser P, Loy V, et al.[cancerjournal.net]

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