Seminoma

Seminoma 

Updated: 02/03/2022

© Jun Wang, MD, PhD

General features
  • Counterpart of ovarian dysgerminoma
  • Mean age 40 years vs. 25 years for nonseminomatous germ cell tumors (NSGCT)
  • Rare in infants
  • Also present in mediastinum, pineal gland (germinoma), retroperitoneum 
Pathological findings
  • Homogenous well demarcated gray-white with lobulated and bulging cut surface
  • Uniform tumor cells with clear cytoplasm (glycogen contents), prominent cell border, and large nuclei with prominent nucleoli
Marker
  • Serum: PLAP, LDH (Less specific), hCG (probably)
  • Tumor cells positive: KIT, OCT3/4, PLAP
  • Tumor cells negative: cytokeratin
Genetic abnormalities
  • KRAS
  • KIT
  • OCT ¾
  • Others: CCND2, NANOG, etc
Diagnosis
  • Diagnosed if only seminomatous elements upon radical orchiectomy (Otherwise, mixed germ cell tumor)
  • Normal AFP
Management
  • Orchiectomy
  • Post operative radiation therapy if mets in regional lymph nodes (very radiosensitive)
  • Cisplatin based chemotherapy, if distant metastasis 
  • Usually excellent prognosis



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