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53. Testicular tumours, classification, tumour markers: Difference between revisions

53. Testicular tumours, classification, tumour markers (view source)

Revision as of 12:28, 7 June 2023

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(Created page with "== Introduction == Testicular cancer is most frequent in young males. It is the most common tumor in men in the 15 – 35 age group. There are 6 – 8 new cases per 100 000 every year in Hungary. There are three age peaks where testicular cancer is most common: * 15 – 35 years (the most common age group) * 0 – 10 years * > 60 years Common risk factors include: * Cryptorchidism * Previous testicular cancer * Positive family history * Gonadal dysgenesis ** Klinefelt...")
 
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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. 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.]]




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The postpubertal teratoma develops from GCNIS. It’s commonly found as a component of mixed germ cell tumors. It is malignant, unlike the prepubertal teratoma.
The postpubertal teratoma develops from GCNIS. It’s commonly found as a component of mixed germ cell tumors. It is malignant, unlike the prepubertal teratoma.


Mixed germ cell tumors account for 60% of all germ cell tumors. They frequently produce AFP and/or hCG. These are the most frequent combinations:
Mixed germ cell tumors account for 60% of all germ cell tumors, and as such most testicular tumours are mixed. They frequently produce AFP and/or hCG. These are the most frequent combinations:


* Embryonal carcinoma + seminoma
* Embryonal carcinoma + seminoma