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CC BY 4.0 · Indian J Med Paediatr Oncol
DOI: 10.1055/s-0044-1788307
Original Article

Spectrum of Somatic Malignancy in Testicular Germ Cell Tumors—A Histopathological Review of 25 Cases with Clinical Outcome

Priyadarsani Subramanian 
1   Department of Pathology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
,
Amandeep Arora
2   Department of Urology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
,
Mahendra Pal
2   Department of Urology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
,
Gagan Prakash
2   Department of Urology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
,
Priyamvada Maitre
3   Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
,
Vedang Murthy
3   Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
,
Amit Joshi
4   Department of Medical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
,
Swapnil Rane
1   Department of Pathology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
,
Sangeeta Desai
1   Department of Pathology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
,
Santosh Menon
1   Department of Pathology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
› Author Affiliations Funding None.
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Abstract

Introduction Germ cell tumors (GCTs) are the commonest testicular malignancy in young males. These tumors are highly chemoresponsive, however become resistant to conventional therapy when a somatic-type malignancy (SM) develops, which happens in ∼3 to 6% of the cases.

Methods We reviewed the histologic profile of all cases of testicular/retroperitoneal GCT with SM, diagnosed over a period of 12 years in our institute. Correlation of histologic profile with clinical outcome was done wherever feasible.

Results A total of 25 cases of testicular/retroperitoneal GCT with SM were identified for review. The histological spectrum of SMs included carcinoma (n = 9), sarcoma (n = 9), embryonic-type neuroectodermal tumor (ENET) (n = 4), and other rare histological types (n = 3). SMs were frequently seen at the resected metastatic sites (n = 13) and in postchemotherapy setting (n = 12); 14 cases had concurrent GCT and SM at the time of diagnosis/initial resection and 9 cases presented as late relapses (more than 2 years after initial presentation). Four patients were treated with metastasectomy and lymph node dissection, six patients were treated with combined resection and chemotherapy, and nine patients were treated with only adjuvant chemotherapy. The patients with SM confined to testis and those treated with multimodality approach had relatively better outcome.

Conclusion GCTs with SM are a highly heterogeneous group of tumors with varying histologic types and management strategies. Strict adherence to histological diagnostic criteria, differentiating these tumors from close mimics such as glandular and sarcomatoid yolk sac tumors, teratomatous overgrowth, and a new second primary somatic tumor are important due to implications in management and prognosis.

Keywords

germ cell tumors - somatic malignancy - embryonic-type neuroectodermal tumors - rhabdomyosarcoma - teratomatous overgrowth

Ethics

Ethical clearance was obtained from the institutional ethics committee (IEC-II Tata Memorial Center—IEC project number 4294/06.12.2023) and the study was performed in accordance with the ethical standards of our IEC and1964 Declaration of Helsinki and its later amendments. Waiver of consent was obtained from the IEC.


Institutional Ethics Committee Approval Status of the Study

Approved.




Publication History

Article published online:
14 August 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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