Skip to main content

Advertisement

Log in

Teratoma with somatic-type malignant components of the testis. A review and an update

  • Review and Perspectives
  • Published:
Virchows Archiv Aims and scope Submit manuscript

Abstract

Malignant transformation of germ cell tumors into somatic malignancy is uncommon. Its presentation differs from series to series, with 43 % of adult cases identified within the primary tumors and the remainder at the time of relapse or in the metastasis. Patients with stage I disease enjoy an excellent prognosis; whereas in metastatic sites when not completely resectable, the somatic type malignancies suffer a dismal prognosis. Radical surgery is significant for the prospects of cure and is standard chemotherapy for germ cell tumors; a transformation-oriented treatment can be effective for these patients. A deeper understanding of the biology of this phenomenon is essential for clinicians involved in such malignancies in order to permit a better control of the disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Ulbright TM, Amin MB, Young RH (1997) Tumors of the testis, adnexa, spermatic cord, and scrotum. In: Rosai J, Sobin LH (eds) Atlas of Tumor Pathology, third series fascicle 25. Armed Force Institute of Pathology, Washington, DC

    Google Scholar 

  2. Ahmed T, Bosl GJ, Hajdu SI (1985) Teratoma with malignant transformation in germ cell tumors in men. Cancer 56:860–863

    Article  PubMed  CAS  Google Scholar 

  3. Ulbright TM, Loehrer PJ, Roth LM et al (1984) The development of non-germ cell malignancies within germ cell tumors. A clinicopathologic study of 11 cases. Cancer 54:1824–1833

    Article  PubMed  CAS  Google Scholar 

  4. Donadio AC, Motzer RJ, Bajorin DF et al (2003) Chemotherapy for teratoma with malignant transformation. J Clin Oncol 21:4285–4291

    Article  PubMed  CAS  Google Scholar 

  5. Guo CC, Punar M, Contreras AL et al (2009) Testicular germ cell tumors with sarcomatous components: an analysis of 33 cases. Am J Surg Pathol 33:1173–1788

    Article  PubMed  Google Scholar 

  6. Little JS Jr, Foster RS, Ulbright TM et al (1994) Unusual neoplasms detected in testis cancer patients undergoing post-chemotherapy retroperitoneal lymphadenectomy. J Urol 152:1144–1149

    PubMed  Google Scholar 

  7. Malagón HD, Valdez AM, Moran CA et al (2007) Germ cell tumors with sarcomatous components: a clinicopathologic and immunohistochemical study of 46 cases. Am J Surg Pathol 31:1356–1362

    Article  PubMed  Google Scholar 

  8. Comiter CV, Kibel AS, Richie JP et al (1998) Prognostic features of teratomas with malignant transformation: a clinicopathological study of 21 cases. J Urol 159:859–863

    Article  PubMed  CAS  Google Scholar 

  9. Motzer RJ, Amsterdam A, Prieto V et al (1998) Teratoma with malignant transformation: diverse malignant histologies arising in men with germ cell tumors. J Urol 159(1):133–138

    Article  PubMed  CAS  Google Scholar 

  10. Colecchia M, Necchi A, Paolini B et al (2011) Teratoma with somatic-type malignant components in germ cell tumors of the testis: a clinicopathologic analysis of 40 cases with outcome correlation. Int J Surg Pathol 19:321–327

    Article  PubMed  Google Scholar 

  11. Ewing J (1911) Teratoma testis and its derivates. Surg Gynecol Obstet 12:230–261

    Google Scholar 

  12. Kaufmann E. (1903) Malattie degli organi genitali maschili. In: Trattato di anatomia patologica speciale per medici e studenti (2nd German edition), Vallardi, Milano, pp 782–783

  13. Friedman NB, Moore RA (1946) Tumors of the testis: a report of 922 cases. Mil Surg 99:573–593

    PubMed  CAS  Google Scholar 

  14. Mostofi FK, Price EP (1973) Tumors of the genital system. In: Atlas of Tumor Pathology, fascicle 8. Washington, DC, Armed Forces Institute of Pathology, pp 59–65

  15. Eble JN, Sauter G, Epstein JI et al (eds) (2004) World Health Organization classification of tumors. Pathology and genetics tumors of the urinary system and male genital organs. IARC Press, Lyon

    Google Scholar 

  16. Terenziani M, D'Angelo P, Bisogno G et al (2010) Teratoma with a malignant somatic component in pediatric patients: the Associazione Italiana Ematologia Oncologia Pediatrica (AIEOP) experience. Pediatr Blood Cancer 54:532–537

    PubMed  Google Scholar 

  17. Davey DD, Ulbright TM, Loehrer PJ et al (1987) The significance of atypia within teratomatous metastases after chemotherapy for malignant germ cell tumors. Cancer 59:533–539

    Article  PubMed  CAS  Google Scholar 

  18. Ulbright TM, Roth LM (1999) Testicular and paratesticular tumors. In: Sternberg SS (ed) Diagnostic surgical pathology, 3rd edn. Lippincott, Philadelphia, p 2000

    Google Scholar 

  19. Moran CA, Suster S (1997) Primary germ cell tumors of the mediastinum. Cancer 80:681–690

    Article  PubMed  CAS  Google Scholar 

  20. Pressing J, Smith H (1979) Rhabdomyosarcoma arising in pineal teratoma. Cancer 44:281–284

    Article  Google Scholar 

  21. Ahlgren AD, Simrell CR, Triche TJ et al (1984) Sarcoma arising in a residual testicular teratoma after cytoreductive chemotherapy. Cancer 54:2015–2018

    Article  PubMed  CAS  Google Scholar 

  22. Klein FA, Herr HW, Vugrin D (1983) Fibrosarcoma associated with intensive chemotherapy for advanced germ cell testicular tumor. J Surg Oncol 23:5–7

    Article  PubMed  CAS  Google Scholar 

  23. Michael H (1998) Nongerm cell tumors arising in patients with testicular germ cell tumors. J Urol Pathol 9:39–60

    Article  Google Scholar 

  24. Ritchey ML, Bagnall JW, McDonald EC et al (1985) Development of nongerm cell malignancies in nonseminomatous germ cell tumors. J Urol 134:146–149

    PubMed  CAS  Google Scholar 

  25. Terrier-Lacombe MJ, Martinez-Madrigal F et al (1990) Embryonal rhabdomyosarcoma arising in a mature teratoma of the testis: a case report. J Urol 143:1232–1234

    PubMed  CAS  Google Scholar 

  26. Ulbright TM, Michael H, Loehrer PJ et al (1990) Spindle cell tumors resected from male patients with germ cell tumors. A clinicopathologic study of 14 cases. Cancer 65:148–156

    Article  PubMed  CAS  Google Scholar 

  27. Kasai T, Moriyama K, Tsuji M et al (2003) Adenocarcinoma arising from a mature cystic teratoma of the testis. Int J Urol 10:505–509

    Article  PubMed  Google Scholar 

  28. Emerson RE, Ulbright TM, Zhang S et al (2004) Nephroblastoma arising in a germ cell tumor of testicular origin. Am J Surg Pathol 28:687–692

    Article  PubMed  Google Scholar 

  29. El Mesbahi O, Terrier-Lacombe MJ, Rebischung C et al (2007) Chemotherapy in patients with teratoma with malignant transformation. Eur Urol 51:1306–1311

    Article  PubMed  Google Scholar 

  30. Reyes A, Moran CA, Suster S et al (2003) Neuroendocrine carcinomas (carcinoid tumor) of the testis. A clinicopathologic and immunohistochemical study of ten cases. Am J Clin Pathol 120:182–187

    Article  PubMed  CAS  Google Scholar 

  31. Ulbright TM, Clark SA, Einhorn LH (1985) Angiosarcoma associated with germ cell tumors. Hum Pathol 16:268–272

    Article  PubMed  CAS  Google Scholar 

  32. Ganjoo KN, Foster RS, Michael H et al (2001) Germ cell tumor associated primitive neuroectodermal tumors. J Urol 165:1514–1516

    Article  PubMed  CAS  Google Scholar 

  33. Kato K, Ijiri R, Tanaka Y et al (2000) Testicular immature teratoma with primitive neuroectodermal tumor in early childhood. J Urol 164:2068–2069

    Article  PubMed  CAS  Google Scholar 

  34. Michael H, Hull MT, Ulbright TM et al (1997) Primitive neuroectodermal tumors arising in testicular germ cell neoplasms. Am J Surg Pathol 21:896–904

    Article  PubMed  CAS  Google Scholar 

  35. Aguirre P, Scully RE (1983) Primitiveneuroectodermal tumor of the testis. Report of a case. Arch Pathol Lab Med 107:643–645

    PubMed  CAS  Google Scholar 

  36. Molenaar WM, Oosterhuis JW, Meiring A et al (1986) Histology and DNA contents of a secondary malignancy arising in a mature residual lesion six years after chemotherapy for a disseminated nonseminomatous testicular tumor. Cancer 58:264–268

    Article  PubMed  CAS  Google Scholar 

  37. Serrano-Olmo J, Tang CK, Seidmon EJ et al (1993) Neuroblastoma as a prominent component of a mixed germ cell tumor of testis. Cancer 72:3271–3276

    Article  PubMed  CAS  Google Scholar 

  38. Nocks BN, Dann JA (1983) Primitive neuroectodermal tumor (immature teratoma) of testis. Urology 22:543–544

    Article  PubMed  CAS  Google Scholar 

  39. Carney JA (1975) Wilms’ tumor and renal cell carcinoma in retroperitoneal teratoma. Cancer 35:1179–1183

    Article  PubMed  CAS  Google Scholar 

  40. Michael H, Hull MT, Foster RS et al (1998) Nephroblastoma-like tumors in patients with testicular germ cell tumors. Am J Surg Pathol 22:1107–1114

    Article  PubMed  CAS  Google Scholar 

  41. Ho J, Ma L, Wong KC (1981) An extrarenal Wilms’ tumor arising from an undescended testis. Pathology (Phila) 13:619–624

    CAS  Google Scholar 

  42. Idrees MT, Kuhar M, Ulbright TM et al (2010) Clonal evidence for the progression of a testicular germ cell tumor to angiosarcoma. Hum Pathol 41:139–144

    Article  PubMed  CAS  Google Scholar 

  43. Marusić Z, Zovak M, Hagenkord JM et al (2010) Papillary renal cell-like carcinoma in a retroperitoneal teratoma. Pathol Int 60:581–586

    Article  PubMed  Google Scholar 

  44. Pichman S, Mikuz G, Schmid KW (1993) Chromogranins A and B in non-seminomatous testicular tumors. J Urol Pathol 1:43–45

    Google Scholar 

  45. Mikuz G, Colecchia M (2007) Miscellaneous tumors of the testis. In: Mikuz G (ed) Clinical pathology of urologic tumor. Informa Healthcare, London, p 198

    Google Scholar 

  46. Comerci JT Jr, Licciardi F, Bergh PA et al (1994) Mature cystic teratoma: a clinicopathologic evaluation of 517 cases and review of the literature. Obstet Gynecol 84:22–28

    PubMed  Google Scholar 

  47. Damjanov I (1997) Tumors of the testis and epididymis. In: Murphy WM (ed) Urological pathology, 2nd edn. Saunders, London, pp 271–341

    Google Scholar 

  48. Sakuma M, Otsuki T, Yoshinaga K et al (2010) Malignant transformation arising from mature cystic teratoma of the ovary: a retrospective study of 20 cases. Int J Gynecol Cancer 20:766–771

    Article  PubMed  Google Scholar 

  49. Dos Santos L, Mok E, Iasonos A et al (2007) Squamous cell carcinoma arising in mature cystic teratoma of the ovary: a case series and review of the literature. Gynecol Oncol 105:321–324

    Article  PubMed  Google Scholar 

  50. Marcy PY, Thariat J, Benisvy D et al (2010) Lethal, malignant, metastatic struma ovarii. Thyroid 20:1037–1340

    Article  PubMed  Google Scholar 

  51. Robboy SY, Scully RE (1980) Strumal carcinoid of the ovary: an analysis of 50 cases of a distinctive tumor composed of thyroid tissue and carcinoid. Cancer 46:2019–2034

    Article  PubMed  CAS  Google Scholar 

  52. Borup K, Leisgård Rasmussen K, Schierup L et al (1992) Amelanotic melanoma arising in an ovarian dermoid cyst. Acta Obstet Gynecol Scand 71:242–244

    Article  PubMed  CAS  Google Scholar 

  53. La Heras F, Pritzke KP, Colgan TJ (2007) Chordoma arising in a mature cystic teratoma of the ovary: acase report. Pathol Res Pract 203:467–471

    Article  PubMed  Google Scholar 

  54. Den Boon J, van Djik CM, Helfferich et al (1999) Glioblastoma multiforme in a dermoid cyst of the ovary. A case report. Eur J Gynaecol Oncol 20:187–188

    Google Scholar 

  55. Korski K, Breborowicz D, Filas V et al (2007) A case of primary testicular germ cell tumor with rhabdomyosarcoma metastases as an example of applying the FISH method to diagnostic pathology. APMIS 115:1296–1301

    Article  PubMed  Google Scholar 

  56. Almstrup K, Sonne SB, Hoei-Hansen CE et al (2006) From embryonic stem cells to testicular germ cell cancer—should we be concerned? Int J Androl 29:211–218

    Article  PubMed  CAS  Google Scholar 

  57. Mego M (2006) Cancer stem cell in relapsed testicular germ cell cancer: embryonic or somatic? Int J Androl 29:627

    Article  PubMed  Google Scholar 

  58. Necchi A, Colecchia M, Nicolai N et al (2010) Towards the definition of the best management and prognostic factors of teratoma with malignant transformation: a single-institution case series and new proposal. BJU Int 107:1088–1094

    Article  PubMed  Google Scholar 

  59. Biskup W, Calaminus G, Schneider DT et al (2006) Teratoma with malignant transformation: experiences of the cooperative GPOH protocols MAKEI 83/86/89/96. Klin Padiatr 218:303–308

    Article  PubMed  CAS  Google Scholar 

  60. Kernel KM, Ulbright TM, Zhang S et al (2003) Identical allelic losses in mature teratoma and other histologic components of malignant mixed germ cell tumors of the testis. Am J Pathol 163:2477–2484

    Article  Google Scholar 

Download references

Conflict of interest statement

We declare that we have no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Maurizio Colecchia.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mikuz, G., Colecchia, M. Teratoma with somatic-type malignant components of the testis. A review and an update. Virchows Arch 461, 27–32 (2012). https://doi.org/10.1007/s00428-012-1251-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00428-012-1251-x

Keywords

Navigation