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Surgical Pathology Clinics

Testicular Tumors

New Developments in Germ Cell and Sex Cord Stromal Tumors
Published:October 12, 2022DOI:https://doi.org/10.1016/j.path.2022.07.007

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      References

        • Park J.S.
        • Kim J.
        • Elghiaty A.
        • et al.
        Recent global trends in testicular cancer incidence and mortality.
        Medicine (Baltimore). 2018; 97: e12390
        • Oldenburg J.
        • Berney D.M.
        • Bokemeyer C.
        • et al.
        Testicular seminoma and non-seminoma: ESMO-EURACAN Clinical Practice Guideline for diagnosis, treatment and follow-up.
        Ann Oncol Off J Eur Soc Med Oncol. 2022; S0923-7534: 00007-00012
        • WHO Classification of Tumours Editorial Board
        Urinary and male genital tumours [Internet].
        ([cited YYYY Mmm D])5th edition. WHO classification of tumours series. 8. International Agency for Research on Cancer, Lyon (France)2022 (Available from:)
        • Ulbright T.M.
        • Amin M.B.
        • Balzer B.
        • et al.
        Tumors of the testis and paratesticular tissue.
        in: Moch H. Humphrey P.A. Ulbright T.M. World Health Organization classification of tumours of the urinary system and male genital organs. 4th edition. IARC Press, Lyon (France)2016: 185-258
        • Berney D.M.
        • Looijenga L.H.J.
        • Idrees M.
        • et al.
        Germ cell neoplasia in situ (GCNIS): evolution of the current nomenclature for testicular pre-invasive germ cell malignancy.
        Histopathology. 2016; 69: 7-10
        • Cheng L.
        • Albers P.
        • Berney D.M.
        • et al.
        Testicular cancer.
        Nat Rev Dis Primer. 2018; 4: 29
        • Oosterhuis J.W.
        • Looijenga L.H.J.
        Human germ cell tumours from a developmental perspective.
        Nat Rev Cancer. 2019; 19: 522-537
        • Fichtner A.
        • Richter A.
        • Filmar S.
        • et al.
        The detection of isochromosome i(12p) in malignant germ cell tumours and tumours with somatic malignant transformation by the use of quantitative real-time polymerase chain reaction.
        Histopathology. 2021; 78: 593-606
        • Howitt B.E.
        • Berney D.M.
        Tumors of the Testis: Morphologic Features and Molecular Alterations.
        Surg Pathol Clin. 2015; 8: 687-716
        • Berney D.M.
        • Stoneham S.
        • Arora R.
        • et al.
        Ovarian germ cell tumour classification: views from the testis.
        Histopathology. 2020; 76: 25-36
        • Ulbright T.M.
        • Young R.H.
        Seminoma with conspicuous signet ring cells: a rare, previously uncharacterized morphologic variant.
        Am J Surg Pathol. 2008; 32: 1175-1181
        • Ulbright T.M.
        Pitfalls in the interpretation of specimens from patients with testicular tumours, with an emphasis on variant morphologies.
        Pathology (Phila). 2018; 50: 88-99
        • Williamson S.R.
        • Delahunt B.
        • Magi-Galluzzi C.
        • et al.
        The world health organization 2016 classification of testicular germ cell tumours: a review and update from the international society of urological pathology testis consultation panel.
        Histopathology. 2017; 70: 335-346
        • Daugaard G.
        • Gundgaard M.G.
        • Mortensen M.S.
        • et al.
        Surveillance for stage I nonseminoma testicular cancer: outcomes and long-term follow-up in a population-based cohort.
        J Clin Oncol Off J Am Soc Clin Oncol. 2014; 32: 3817-3823
        • Nayan M.
        • Jewett M.A.S.
        • Hosni A.
        • et al.
        Conditional Risk of relapse in surveillance for clinical stage i testicular cancer.
        Eur Urol. 2017; 71: 120-127
        • Berney D.M.
        • Comperat E.
        • Feldman D.R.
        • et al.
        Datasets for the reporting of neoplasia of the testis: recommendations from the International Collaboration on Cancer Reporting.
        Histopathology. 2019; 74: 171-183
        • Blok J.M.
        • Pluim I.
        • Daugaard G.
        • et al.
        Lymphovascular invasion and presence of embryonal carcinoma as risk factors for occult metastatic disease in clinical stage I nonseminomatous germ cell tumour: a systematic review and meta-analysis.
        BJU Int. 2020; 125: 355-368
        • Kao C.S.
        • Ulbright T.M.
        • Young R.H.
        • et al.
        Testicular embryonal carcinoma: a morphologic study of 180 cases highlighting unusual and unemphasized aspects.
        Am J Surg Pathol. 2014; 38: 689-697
        • Berney D.M.
        • Shamash J.
        • Pieroni K.
        • et al.
        Loss of CD30 expression in metastatic embryonal carcinoma: the effects of chemotherapy?.
        Histopathology. 2001; 39: 382-385
        • Berney D.M.
        • Lu Y.J.
        • Shamash J.
        • et al.
        Postchemotherapy changes in testicular germ cell tumours: biology and morphology.
        Histopathology. 2017; 70: 26-39
        • Michael H.
        • Hull M.T.
        • Ulbright T.M.
        • et al.
        Primitive neuroectodermal tumors arising in testicular germ cell neoplasms.
        Am J Surg Pathol. 1997; 21: 896-904
        • Ulbright T.M.
        • Hattab E.M.
        • Zhang S.
        • et al.
        Primitive neuroectodermal tumors in patients with testicular germ cell tumors usually resemble pediatric-type central nervous system embryonal neoplasms and lack chromosome 22 rearrangements.
        Mod Pathol Off J U S Can Acad Pathol Inc. 2010; 23: 972-980
        • Matoso A.
        • Idrees M.T.
        • Rodriguez F.J.
        • et al.
        Neuroglial differentiation and neoplasms in testicular germ cell tumors lack immunohistochemical evidence of alterations characteristic of their cns counterparts: a study of 13 cases.
        Am J Surg Pathol. 2019; 43: 422-431
        • Kilpatrick S.E.
        • Reith J.D.
        • Rubin B.
        Ewing sarcoma and the history of similar and possibly related small round cell tumors: from whence have we come and where are we going?.
        Adv Anat Pathol. 2018; 25: 314-326
        • Louis D.N.
        • Perry A.
        • Reifenberger G.
        • et al.
        The 2016 world health organization classification of tumors of the central nervous system: a summary.
        Acta Neuropathol (Berl). 2016; 131: 803-820
        • Flood T.A.
        • Ulbright T.M.
        • Hirsch M.S.
        Embryonic-type Neuroectodermal Tumor” should replace “primitive neuroectodermal tumor” of the testis and gynecologic tract: a rationale for new nomenclature.
        Am J Surg Pathol. 2021; 45: 1299-1302
        • Necchi A.
        • Colecchia M.
        • Nicolai N.
        • et al.
        Towards the definition of the best management and prognostic factors of teratoma with malignant transformation: a single-institution case series and new proposal.
        BJU Int. 2011; 107: 1088-1094
        • Scheckel C.J.
        • Kosiorek H.E.
        • Butterfield R.
        • et al.
        Germ cell tumors with malignant somatic transformation: a mayo clinic experience.
        Oncol Res Treat. 2019; 42: 95-100
        • Motzer R.J.
        • Amsterdam A.
        • Prieto V.
        • et al.
        Teratoma with malignant transformation: diverse malignant histologies arising in men with germ cell tumors.
        J Urol. 1998; 159: 133-138
        • Kao C.S.
        • Idrees M.T.
        • Young R.H.
        • et al.
        Solid pattern yolk sac tumor: a morphologic and immunohistochemical study of 52 cases.
        Am J Surg Pathol. 2012; 36: 360-367
        • Howitt B.E.
        • Magers M.J.
        • Rice K.R.
        • et al.
        Many postchemotherapy sarcomatous tumors in patients with testicular germ cell tumors are sarcomatoid yolk sac tumors: a study of 33 cases.
        Am J Surg Pathol. 2015; 39: 251-259
        • Michael H.
        • Lucia J.
        • Foster R.S.
        • et al.
        The pathology of late recurrence of testicular germ cell tumors.
        Am J Surg Pathol. 2000; 24: 257-273
        • Al-Obaidy K.I.
        • Williamson S.R.
        • Shelman N.
        • et al.
        Hepatoid teratoma, hepatoid yolk sac tumor, and hepatocellular carcinoma: a morphologic and immunohistochemical study of 30 cases.
        Am J Surg Pathol. 2021; 45: 127-136
        • Magers M.J.
        • Kao C.S.
        • Cole C.D.
        • et al.
        Somatic-type” malignancies arising from testicular germ cell tumors: a clinicopathologic study of 124 cases with emphasis on glandular tumors supporting frequent yolk sac tumor origin.
        Am J Surg Pathol. 2014; 38: 1396-1409
      1. Segura SE, Young RH, Oliva E, et al. Malignant Gonadal Germ Cell Tumors (Other Than Pure Germinoma) in Patients With Disorders of Sex Development: A Report of 21 Cases Based Largely on the Collection of Dr Robert E. Scully, Illustrating a High Frequency of Yolk Sac Tumor With Prominent Hepatoid and Glandular Features. Am J Surg Pathol Published online September 23, 2021. doi:10.1097/PAS.0000000000001815.

        • Petersson F.
        • Grossmann P.
        • Vanecek T.
        • et al.
        Testicular germ cell tumor composed of placental site trophoblastic tumor and teratoma.
        Hum Pathol. 2010; 41: 1046-1050
        • Ulbright T.M.
        • Henley J.D.
        • Cummings O.W.
        • et al.
        Cystic trophoblastic tumor: a nonaggressive lesion in postchemotherapy resections of patients with testicular germ cell tumors.
        Am J Surg Pathol. 2004; 28: 1212-1216
        • Idrees M.T.
        • Kao C.S.
        • Epstein J.I.
        • et al.
        Nonchoriocarcinomatous trophoblastic tumors of the testis: the widening spectrum of trophoblastic neoplasia.
        Am J Surg Pathol. 2015; 39: 1468-1478
        • Kao C.S.
        • Zhang C.
        • Ulbright T.M.
        Testicular hemorrhage, necrosis, and vasculopathy: likely manifestations of intermittent torsion that clinically mimic a neoplasm.
        Am J Surg Pathol. 2014; 38: 34-44https://doi.org/10.1097/PAS.0b013e31829c0206
        • Miller J.S.
        • Lee T.K.
        • Epstein J.I.
        • et al.
        The utility of microscopic findings and immunohistochemistry in the classification of necrotic testicular tumors: a study of 11 cases.
        Am J Surg Pathol. 2009; 33: 1293-1298
        • Balzer B.L.
        • Ulbright T.M.
        Spontaneous regression of testicular germ cell tumors: an analysis of 42 cases.
        Am J Surg Pathol. 2006; 30: 858-865
        • Lombardi M.
        • Valli M.
        • Brisigotti M.
        • et al.
        Spermatocytic seminoma: review of the literature and description of a new case of the anaplastic variant.
        Int J Surg Pathol. 2011; 19: 5-10
        • Moch H.
        • Cubilla A.L.
        • Humphrey P.A.
        • et al.
        The 2016 WHO classification of tumours of the urinary system and male genital organs-part a: renal, penile, and testicular tumours.
        Eur Urol. 2016; 70: 93-105
        • Hu R.
        • Ulbright T.M.
        • Young R.H.
        Spermatocytic seminoma: a report of 85 cases emphasizing its morphologic spectrum including some aspects not widely known.
        Am J Surg Pathol. 2019; 43: 1-11
        • Anderson W.J.
        • Maclean F.M.
        • Acosta A.M.
        • et al.
        Expression of the C-terminal region of the SSX protein is a useful diagnostic biomarker for spermatocytic tumour.
        Histopathology. 2021; 79: 700-707
        • Horn T.
        • Schulz S.
        • Maurer T.
        • et al.
        Poor efficacy of BEP polychemotherapy in metastatic spermatocytic seminoma.
        Med Oncol Northwood Lond Engl. 2011; 28: S423-S425
        • Mikuz G.
        • Böhm G.W.
        • Behrend M.
        • et al.
        Therapy-resistant metastasizing anaplastic spermatocytic seminoma: a cytogenetic hybrid: a case report.
        Anal Quant Cytopathol Histopathol. 2014; 36: 177-182
        • Steiner H.
        • Gozzi C.
        • Verdorfer I.
        • et al.
        Metastatic spermatocytic seminoma--an extremely rare disease.
        Eur Urol. 2006; 49: 183-186
        • Wagner T.
        • Grantham M.
        • Berney D.
        Metastatic spermatocytic tumour with hybrid genetics: breaking the rules in germ cell tumours.
        Pathology (Phila). 2018; 50: 562-565
        • Grogg J.B.
        • Schneider K.
        • Bode P.K.
        • et al.
        A systematic review of treatment outcomes in localised and metastatic spermatocytic tumors of the testis.
        J Cancer Res Clin Oncol. 2019; 145: 3037-3045
        • Wagner T.
        • Scandura G.
        • Roe A.
        • et al.
        Prospective molecular and morphological assessment of testicular prepubertal-type teratomas in postpubertal men.
        Mod Pathol Off J U S Can Acad Pathol Inc. 2020; 33: 713-721
        • Zhang C.
        • Berney D.M.
        • Hirsch M.S.
        • et al.
        Evidence supporting the existence of benign teratomas of the postpubertal testis: a clinical, histopathologic, and molecular genetic analysis of 25 cases.
        Am J Surg Pathol. 2013; 37: 827-835
        • Rindi G.
        • Klimstra D.S.
        • Abedi-Ardekani B.
        • et al.
        A common classification framework for neuroendocrine neoplasms: an International Agency for Research on Cancer (IARC) and World Health Organization (WHO) expert consensus proposal.
        Mod Pathol Off J U S Can Acad Pathol Inc. 2018; 31: 1770-1786
        • Wang W.P.
        • Guo C.
        • Berney D.M.
        • et al.
        Primary carcinoid tumors of the testis: a clinicopathologic study of 29 cases.
        Am J Surg Pathol. 2010; 34: 519-524
        • Amine M.M.
        • Mohamed B.
        • Mourad H.
        • et al.
        Neuroendocrine Testicular Tumors: A Systematic Review and Meta-Analysis.
        Curr Urol. 2017; 10: 15-25
        • Dilworth J.P.
        • Farrow G.M.
        • Oesterling J.E.
        Non-germ cell tumors of testis.
        Urology. 1991; 37: 399-417
        • Lau H.D.
        • Kao C.S.
        • Williamson S.R.
        • et al.
        Immunohistochemical characterization of 120 testicular sex cord-stromal tumors with an emphasis on the diagnostic utility of SOX9, FOXL2, and SF-1.
        Am J Surg Pathol. 2021; 45: 1303-1313
        • Young R.H.
        Sex cord-stromal tumors of the ovary and testis: their similarities and differences with consideration of selected problems.
        Mod Pathol Off J U S Can Acad Pathol Inc. 2005; 18: S81-S98
        • Idrees M.T.
        • Ulbright T.M.
        • Oliva E.
        • et al.
        The World Health Organization 2016 classification of testicular non-germ cell tumours: a review and update from the International Society of Urological Pathology Testis Consultation Panel.
        Histopathology. 2017; 70: 513-521
        • Mosharafa A.A.
        • Foster R.S.
        • Bihrle R.
        • et al.
        Does retroperitoneal lymph node dissection have a curative role for patients with sex cord-stromal testicular tumors?.
        Cancer. 2003; 98: 753-757
        • Scandura G.
        • Verrill C.
        • Protheroe A.
        • et al.
        Incidentally detected testicular lesions <10 mm in diameter: can orchidectomy be avoided?.
        BJU Int. 2018; 121: 575-582
        • Fankhauser C.D.
        • Grogg J.B.
        • Rothermundt C.
        • et al.
        Treatment and follow-up of rare testis tumours.
        J Cancer Res Clin Oncol. 2022; 20https://doi.org/10.1007/s00432-021-03890-2
        • Grogg J.B.
        • Schneider K.
        • Bode P.K.
        • et al.
        Risk factors and treatment outcomes of 239 patients with testicular granulosa cell tumors: a systematic review of published case series data.
        J Cancer Res Clin Oncol. 2020; 146: 2829-2841
        • Grogg J.
        • Schneider K.
        • Bode P.K.
        • et al.
        Sertoli cell tumors of the testes: systematic literature review and meta-analysis of outcomes in 435 patients.
        Oncologist. 2020; 25: 585-590
        • Sangoi A.R.
        • McKenney J.K.
        • Brooks J.D.
        • et al.
        Evaluation of SF-1 expression in testicular germ cell tumors: a tissue microarray study of 127 cases.
        Appl Immunohistochem Mol Morphol AIMM. 2013; 21: 318-321
        • Zhang C.
        • Ulbright T.M.
        Nuclear localization of β-catenin in sertoli cell tumors and other sex cord-stromal tumors of the testis: an immunohistochemical study of 87 cases.
        Am J Surg Pathol. 2015; 39: 1390-1394
        • Henley J.D.
        • Young R.H.
        • Ulbright T.M.
        Malignant Sertoli cell tumors of the testis: a study of 13 examples of a neoplasm frequently misinterpreted as seminoma.
        Am J Surg Pathol. 2002; 26: 541-550
        • Fankhauser C.D.
        • Grogg J.B.
        • Hayoz S.
        • et al.
        Risk factors and treatment outcomes of 1,375 patients with testicular leydig cell tumors: analysis of published case series data.
        J Urol. 2020; 203: 949-956
        • Necchi A.
        • Bratslavsky G.
        • Shapiro O.
        • et al.
        Genomic features of metastatic testicular sex cord stromal tumors.
        Eur Urol Focus. 2019; 5: 748-755
        • Kao C.S.
        • Ulbright T.M.
        A morphologic and immunohistochemical comparison of nuclear β-catenin expressing testicular sertoli cell tumors and pancreatic solid pseudopapillary neoplasms supporting their continued separate classification.
        Am J Surg Pathol. 2020; 44: 1082-1091
        • Michalova K.
        • Michal M.
        • Kazakov D.V.
        • et al.
        Primary signet ring stromal tumor of the testis: a study of 13 cases indicating their phenotypic and genotypic analogy to pancreatic solid pseudopapillary neoplasm.
        Hum Pathol. 2017; 67: 85-93
        • Ulbright T.M.
        • Young R.H.
        Pseudo-"solid pseudopapillary neoplasms" of the testis: in reality Sertoli cell tumors.
        Hum Pathol. 2019; 83: 228-230
        • Renne S.L.
        • Valeri M.
        • Tosoni A.
        • et al.
        Myoid gonadal tumor. case series, systematic review, and Bayesian analysis.
        Virchows Arch Int J Pathol. 2021; 478: 727-734
      2. Anderson WJ, Gordetsky JB, Idrees MT, et al. Large cell calcifying sertoli cell tumour: a contemporary multi-institutional case series highlighting the diagnostic utility of PRKAR1A immunohistochemistry. Histopathology. Published online November 15, 2021. doi:10.1111/his.14599.

        • Ulbright T.M.
        • Amin M.B.
        • Young R.H.
        Intratubular large cell hyalinizing sertoli cell neoplasia of the testis: a report of 8 cases of a distinctive lesion of the Peutz-Jeghers syndrome.
        Am J Surg Pathol. 2007; 31: 827-835
        • Carvajal-Carmona L.G.
        • Alam N.A.
        • Pollard P.J.
        • et al.
        Adult leydig cell tumors of the testis caused by germline fumarate hydratase mutations.
        J Clin Endocrinol Metab. 2006; 91: 3071-3075
        • Mooney K.L.
        • Kao C.S.
        A contemporary review of common adult non-germ cell tumors of the testis and paratestis.
        Surg Pathol Clin. 2018; 11: 739-758
        • Roth L.M.
        • Cheng L.
        Gonadoblastoma: origin and outcome.
        Hum Pathol. 2020; 100: 47-53
        • Kao C.S.
        • Idrees M.T.
        • Young R.H.
        • et al.
        Dissecting Gonadoblastoma” of scully: a morphologic variant that often mimics germinoma.
        Am J Surg Pathol. 2016; 40: 1417-1423
        • Michalova K.
        • McKenney J.K.
        • Kristiansen G.
        • et al.
        Novel insights into the mixed germ cell-sex cord stromal tumor of the testis: detection of chromosomal aneuploidy and further morphological evidence supporting the neoplastic nature of the germ cell component.
        Virchows Arch Int J Pathol. 2020; 477: 615-623