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Spectrum of Germ Cell Tumor (GCT): 5 Years’ Experience in a Tertiary Care Center and Utility of OCT4 as a Diagnostic Adjunct

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Abstract

Germ cell tumors (GCT) are an intriguing group of neoplasm having myriad clinical and morphological presentation. More and more transcription factors are being evaluated for identification of same. To study the spectrum of GCTs in a tertiary care center and the use of a stem cell marker OCT4 as a diagnostic adjunct, a retrospective 5-year (2008–2013) study was carried out. Immunohistochemistry (IHC) with OCT4 was performed on all cases and IHC for α feto protein (AFP), CD30, and epithelial membrane antigen (EMA) as per requirement. Cohort included 73 cases (23 males and 50 females). Testicular and ovarian GCTs accounted for 95.83% and 35.71% respectively. In males, seminoma was the commonest (34.78%) followed by mixed GCT (26%). 17.85% of ovarian GCTs were malignant mostly constituted by dysgerminoma (18%). Benign mature cystic teratoma (MCT) constituted 50% of ovarian GCTs. OCT4 immunoexpression was seen in all cases of seminoma/dysgerminoma, embryonal carcinoma, immature teratoma, and seminomatous/embryomatous component of mixed GCTs. Pure yolk sac tumor (YST) and MCT were consistently negative. OCT4 was especially helpful in identification of mixed GCT. A panel of immunohistochemical markers would be a more ideal way to identify and clarify the components because correct identification of the components is important for therapeutic intervention and prognostication. OCT4 being a primordial germ cell marker predicts aggressive behavior and targeted therapy against this should be investigated.

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Acknowledgements

Authors are thankful to King Georges Medical University, Lucknow, for providing necessary resources. We would like to acknowledge Prof Raj Mehrotra, former Professor, dept of Pathology and Dean, KGMU, who had guided us in our study and is no longer with us. We want to thank our technical team members especially Mr. Kamlesh Sharma and Miss Nidhi Varma for their support. The authors have no other relevant affiliations or financial involvements.

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Authors and Affiliations

  1. Department of Pathology, IMS-BHU, Varanasi, 221005, UP, India

    Paul Paramita

  2. Department of Pathology, KGMU, Lucknow, 226003, UP, India

    Agarwal Preeti, Jain Mili, Jaiswal Ridhi, Sagar Mala & Goel MM

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  1. Paul Paramita
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Correspondence to Paul Paramita.

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This is a retrospective study on the paraffin blocks stored in the Department of Pathology, KGMU, Lucknow, and consent for use of the stored tissue is taken from the patients at the time of surgery. Institute ethics committee has a waiver for these retrospective studies on paraffin blocks.

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The authors affirm that this manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned have been explained.

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Paramita, P., Preeti, A., Mili, J. et al. Spectrum of Germ Cell Tumor (GCT): 5 Years’ Experience in a Tertiary Care Center and Utility of OCT4 as a Diagnostic Adjunct. Indian J Surg Oncol 13, 533–541 (2022). https://doi.org/10.1007/s13193-022-01522-w

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