A 25 year old man undergoes orchiectomy for a testicular tumor. Microscopically, the tumor shows a variety of patterns, including lobules containing large cells with watery cytoplasm, structures resembling primitive glomeruli, syncytiotrophoblast, and shafts of undifferentiated cells with focal glandular differentiation. Which of the following terms most accurately describes this tumor?
This is a mixed testicular tumor. Mixed patterns occur in 60% of testicular tumors, with the most common pattern being teratoma (not present in this patient), embryonal carcinoma, yolk sack tumor, and hCG-containing syncytiotrophoblast. This patient's tumor also contains elements of seminoma. The prognosis of these tumors is determined by the presence or absence of more aggressive elements, notably choriocarcinoma. Choriocarcinoma contains both syncytiotrophoblast and cytotrophoblast. Embryonal carcinoma is characterized by sheets of undifferentiated cells with focal glandular differentiation. Seminoma shows lobules containing large cells with watery cytoplasm. Ref: Wyatt C., Butterwoh IV J.F., Moos P.J., Mackey D.C., Brown T.G. (2008). Chapter 17. Pathology of the Male and Female Reproductive Tract and Breast. In C. Wyatt, J.F. Butterwoh IV, P.J. Moos, D.C. Mackey, T.G. Brown (Eds),Pathology: The Big Picture.
Choriocarcinoma
Embryonal carcinoma
Mixed tumor
Seminoma