Tumours of the Testis

Chapter 1 - Anatomy of the GU Tract and Histology of GU Tumours

More than 95% of all testicular neoplasias are germ cell tumours. Germ cell tumours mostly occur at young age (highest frequency at the age of 30 years).

More than 90% of these develop through intratubular germ cell neoplasia (IGCNU), which is commonly found in the vicinity of these cancers.

50% of IGCNU progress into invasive germ cell tumours within 5 years.

Tumours of the Testis Figure 2

Bostwick DG & Cheng L. Urologic Surgical Pathology, 3rd edition. New York: Elsevier, 2014

Seminoma is the least differentiated (earliest) development stage of invasive germ cell carcinoma.

About 50% of all testicular germ cell tumours halt at that stage of development and are diagnosed as pure seminomas.

Teratoma in the adult is a “differentiated type” of germ cell tumour having evolved from IGCNU and seminoma. Teratoma in the adult is thus considered malignant.

Tumour stage (PT) is critical for subsequent therapy of testicular tumours.

Most pT2 stages are diagnosed because of vascular invasion.

Regional lymph nodes include the abdominal, paraaortic, preaortic, interaortocaval, precaval, paracaval, retrocaval, and retroaortic nodes.

Revision Questions

  1. What is the precursor lesion of most germ cell tumours?
  2. What is the typical age of patients with germ cell tumours?
  3. Why is a testicular teratoma in an adult considered malignant?

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Last update: 08 September 2015