Testicular Germ Cell Tumors A Histopathologic Overview

Abstract

ABSTRACT
Background: Germ cell tumors are the most common primary tumor of the testis. They
are histologically very diverse; seminoma is the most common type, with a high
percentage of mixed and combined forms.
Objectives: To assess the cases histologically, with clinical correlation where available.
Methods: This is a retrospective study of total number of 384 cases of testicular germ cell
tumors collected over 12-year period (Jan 1985 - Dec 1996). Slides were collected from all
public and private laboratories in Baghdad city. All cases were revised and diagnosis
microscopically confirmed, then classified according to the WHO classification.
Results: Pure germ cell tumors comprised 82.5% and mixed tumors 17.5%. Of pure
forms, seminoma was the most common histological type (53.9%), classical seminoma
143 cases, seminoma variants 58 cases and sperrmatocytic seminoma 6 cases. Nonseminomatous
germ cell tumors were 110 cases or 28.6%, embryonal carcinoma 47
cases, teratomas 40 cases, yolk sac tumor 16 cases and choriocarcinomas 7 cases.
Mixed tumors comprised 17.5%, the most common combination was ‘teratoma +
embryonal carcinoma’ or teratocarcinoma. Age incidence relates to tumor type, so
seminoma peaked in the 4th decade and non-seminomas in the 3rd decade, except for yolk
sac tumors which were seen mostly in the first 3 years of life.
Conclusion: Germ cell tumors are histologically diverse, with a unique age incidence
pattern. They can be in pure form, of which seminoma is the most common type, or in
mixed form, of which teratocarcinoma is the most common combination.