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- W4210530714 abstract "Introduction: Mixed germ cell tumours (GCTs) are malignant neoplasms comprising of more than one type of GCT. There is a range of morphological variation in non-seminomatous forms, especially in embryonal carcinoma (EC) and yolk sac tumours (YST). We discuss potential diagnostic pitfalls in mixed tumours and possible clinical implications. Case report: A 27-year-old male presented with a painful left testicular mass. Blood test showed elevated alpha fetoprotein (AFP) and a minimal increase in human chorionic gonadotrophin (hCG). Ultrasound scan of the testis revealed a heterogeneous mass showing areas haemorrhage and calcification. Microscopy showed a mixed germ cell tumour, including components of EC, YST, seminoma and immature teratoma with foci amounting to primitive neuroectodermal tumour (PNET). Interestingly, there were embryo-like bodies incorporating core of EC, wrapping a component of YST. Non-specific loose stroma-like neural tissue was also seen. Discussion and recommendations: Accurate recognition of different components in mixed GCTs can be challenging and use of immunohistochemistry is inevitable in certain situations. Presence of 80% or more of the EC component is known to be a predictor of the occurrence of metastasis for clinical stage 1 mixed GCTs. More aggressive management is performed in cases of early carcinomatous differentiation. References 1. Moch H, Humphrey PA, Ulbright TM, et al. WHO Classification of Tumours of the Urinary System and Male Genital Organs. 4th ed. Lyon: IARC, 2016. 2. Bahrami A, Ro JY, Ayala AG. An overview of testicular germ cell tumours. Arch Pathol Lab Med 2007; 131: 1267–80. 3. Tickoo SK, Hutchinson B, Bacik J, et al. Testicular seminoma: a clinicopathologic and immunohistochemical study of 105 cases with special reference to seminomas with atypical features. Int J Surg Pathol 2002; 10: 23–32." @default.
- W4210530714 created "2022-02-08" @default.
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- W4210530714 date "2022-03-01" @default.
- W4210530714 modified "2023-09-24" @default.
- W4210530714 title "Potential diagnostic pitfalls in testicular mixed germ cell tumours" @default.
- W4210530714 doi "https://doi.org/10.1016/j.pathol.2021.12.157" @default.
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