Testicular Cancer

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TESTICULAR CANCER GO-TEAM-The James Buchanan Brady Urological Institute - Urology at Hopkins

Types of Testis Cancer

As stated above, the most common type of testis cancer is a germ cell tumor (GCT).  There are two main types of GCT: Seminoma and Non-Seminomatous Germ Cell Tumors (NSGCT).  Both seminoma and NSGCT occur at about the same rate and men can have seminoma, NSGCT or a combination of both.  There are several differences between seminomas and NSGCT, but the initial distinction is based on how the tumor looks under the microscope. 

Seminoma
Tend to grow and spread more slowly than NSGCT, although some seminomas can grow very rapidly.  Subtypes of seminoma include:

  • classic seminoma – 95% of seminomas are “classic”
  • spermatocytic seminoma – tend to occur in older men and has an excellent prognosis 

Seminomas can secrete human chorionic gonadotropin (HCG) but do not secrete other tumor markers (see the section on Tumor Markers for more details).  If seminoma spreads from the testicle, it is most often and best treated with chemotherapy and/or radiation.  Surgery can be performed in some cases.

Non-Seminomatous Germ Cell Tumors (NSGCT)
NSGCT are very variable in appearance and prognosis.  There are four main types of NSGCT that can appear alone, but most often appear as a “mixed” NSGCT with more than one type present:

  • Embryonal carcinoma – present in about 40% of tumors, among the most rapidly growing and potentially aggressive tumor types.  Embryonal carcinoma can secrete HCG or alpha-fetoprotein (AFP).
  • Yolk Sac carcinoma – most common type of tumor in children, respond well to chemotherapy in children and adults.  Yolk sac tumors almost always secrete (AFP).
  • Choriocarcinoma – very rare and very aggressive form of testis cancer.  Can secrete HCG.
  • Teratoma – most often appear as a “mixed” NSGCT, usually grow locally but can appear in retroperitoneal lymph nodes.  Teratoma is chemotherapy and radiation resistant and best treated with surgical removal.

Stromal Tumors
Tumors can also develop from the supportive tissues around the germ cells in the testicle.  These tumors are rare, less than 5% of testis cancers, and have an excellent prognosis if surgically resected.  There are two types of stromal tumors:

  • Leydig cell tumors – Leydig cells make the male-hormone, testosterone, and are most often cured with surgery.
  • Sertoli cell tumors – the Sertoli cells support and nourish the developing sperm and are usually benign tumors.
testicular cancer

 

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