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Testicular cancer: Difference between revisions
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== Pathology == | == Pathology == | ||
95% of testicular tumors originate from germ cells. The remaining 5% originate from the testicular stroma (which is derived from the sex cords), including Sertoli cells, Leydig cells or granulosa cells. | 95% of testicular tumors originate from germ cells. The remaining 5% originate from the testicular stroma (which is derived from the sex cords), including Sertoli cells, Leydig cells or granulosa cells.<section end="oncology" /> | ||
The classification can be visualised like this: | The classification can be visualised like this: | ||
[[File:Classification of testicular tumours.png|center|thumb|Classification of testicular tumours]] | [[File:Classification of testicular tumours.png|center|thumb|Classification of testicular tumours]] | ||
<section begin="oncology" /> | |||
=== Germ cell tumours === | === Germ cell tumours === | ||
Germ cell tumors develop from totipotent germ cells. During embryonal development these totipotent cells can travel down normal differentiation pathways and become spermatocytes. However, if they instead travel down abnormal developmental pathways, they can become seminomas or embryonal carcinomas. Embryonal carcinoma cells can then take one or more of these courses: They can undergo (intra)embryonic differentiation and form a (postpubertal) teratoma (which is comprised of embryonic tissues). They can undergo extraembryonic differentiation and form (postpubertal) yolk sac tumors or choriocarcinomas (which are extraembryonic tissues). Lastly the totipotent germ cells can remain undifferentiated and remain embryonal carcinoma. This is better illustrated on the figure below: | Germ cell tumors develop from totipotent germ cells. During embryonal development these totipotent cells can travel down normal differentiation pathways and become spermatocytes. However, if they instead travel down abnormal developmental pathways, they can become seminomas or embryonal carcinomas. <section end="oncology" />Embryonal carcinoma cells can then take one or more of these courses: They can undergo (intra)embryonic differentiation and form a (postpubertal) teratoma (which is comprised of embryonic tissues). They can undergo extraembryonic differentiation and form (postpubertal) yolk sac tumors or choriocarcinomas (which are extraembryonic tissues). Lastly the totipotent germ cells can remain undifferentiated and remain embryonal carcinoma. This is better illustrated on the figure below: | ||
[[File:Classification of testicular germ cell tumours.png|center|thumb|Classification of testicular germ cell tumours. From https://www.nature.com/articles/s41572-018-0029-0. I don’t think this is very important to know but it might impress the examiners.]] | [[File:Classification of testicular germ cell tumours.png|center|thumb|Classification of testicular germ cell tumours. From https://www.nature.com/articles/s41572-018-0029-0. I don’t think this is very important to know but it might impress the examiners.]] | ||
<section begin="oncology" /> | |||
Germ cell tumors account for 95% of all testicular tumors. It’s very common (in 60% of cases) for germ cell tumors to contain more than one histological subtype. These are called ''mixed germ cell tumors''. The remaining 40% of cases are ''pure germ cell tumors'' and contain only one histological subtype. | Germ cell tumors account for 95% of all testicular tumors. It’s very common (in 60% of cases) for germ cell tumors to contain more than one histological subtype. These are called ''mixed germ cell tumors''. The remaining 40% of cases are ''pure germ cell tumors'' and contain only one histological subtype. | ||