What Are The Main Pathological Types Of Testicular Cancer De

Testicular cancer primarily arises from the germ cells within the testes, which are responsible for producing sperm. The two main pathological types of testicular cancer are germ cell tumors (GCTs) and sex cord-stromal tumors. Germ cell tumors are by far the most common, accounting for about 95% of all testicular cancers, while sex cord-stromal tumors are much rarer.

1. Germ Cell Tumors (GCTs)

Germ cell tumors are categorized into two main subtypes:

A. Seminomas

- Origin: Seminomas originate from the germ cells in the seminiferous tubules, which are the structures within the testes where sperm is produced. These tumors retain some characteristics of primitive germ cells.
- Characteristics: Seminomas are generally slow-growing and tend to remain localized within the testes for a longer period before metastasizing. They are typically more sensitive to radiation therapy compared to non-seminomas, which contributes to a better prognosis.
- Histology: Histologically, seminomas are composed of uniform cells with clear cytoplasm, central nuclei, and distinct cell borders. The tumors often contain lymphocytic infiltrates and may sometimes have areas of necrosis or granulomatous inflammation.

B. Non-Seminomatous Germ Cell Tumors (NSGCTs)

- Origin: NSGCTs also arise from the germ cells but exhibit more differentiation than seminomas. These tumors are generally more aggressive and can spread rapidly to other parts of the body, including the lymph nodes, lungs, and liver.
- Subtypes:

- Embryonal Carcinoma: A highly malignant tumor that resembles early embryonic tissue. It is often a component of mixed germ cell tumors and is more likely to spread outside the testes.
- Yolk Sac Tumor (Endodermal Sinus Tumor): The most common testicular cancer in children, characterized by the presence of Schiller-Duval bodies on histology. It resembles the yolk sac of early embryonic development.
- Choriocarcinoma: A rare but highly aggressive form that is characterized by early hematogenous spread. It mimics placental tissue and is often associated with high levels of human chorionic gonadotropin (hCG).
- Teratoma: Contains a mixture of various tissue types (e.g., bone, muscle, hair) derived from all three germ layers (ectoderm, mesoderm, and endoderm). Teratomas can be mature (benign) or immature (malignant), with the latter being more common in adults and having the potential to metastasize.

2. Sex Cord-Stromal Tumors

Sex cord-stromal tumors arise from the supportive and hormone-producing tissues within the testes, including the Leydig cells and Sertoli cells. These tumors are rare and generally less aggressive than germ cell tumors.
- Leydig Cell Tumors: Derived from Leydig cells, which are responsible for producing testosterone. These tumors can produce androgens or estrogens, sometimes leading to hormonal symptoms such as gynecomastia or precocious puberty.
- Sertoli Cell Tumors: Arise from Sertoli cells, which support germ cell development in the seminiferous tubules. These tumors are often hormonally inactive and are usually benign.

3. Mixed Germ Cell Tumors

Mixed germ cell tumors contain elements of both seminomatous and non-seminomatous components, representing a combination of different histological types. The treatment and prognosis depend on the most aggressive component within the tumor.

In conclusion, testicular cancer is predominantly composed of germ cell tumors, with seminomas and non-seminomas being the primary subtypes. Understanding the origin and characteristics of these tumors is crucial for determining appropriate treatment and prognosis.

Unless otherwise stated, the content of this page is licensed under Creative Commons Attribution-NonCommercial-NoDerivs 3.0 License