Pure Testicular Seminoma Relapsing Late with Somatic Type Malignancy
Background. Somatic type malignancy (STM) occurs in 2% of all germ cell tumours (GCTs). The prognosis is unfavourable and the origin is poorly understood. Pathogenetic hypotheses involve direct transformation of teratoma, origin from totipotent cancer cells, or derivation from yolk sac tumour elemen...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Case Reports in Oncological Medicine |
| Online Access: | http://dx.doi.org/10.1155/2017/2457023 |
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| author | Klaus-Peter Dieckmann Petra Anheuser Ralf Gehrckens Waldemar Wilczak Guido Sauter Doris Höflmayer |
| author_facet | Klaus-Peter Dieckmann Petra Anheuser Ralf Gehrckens Waldemar Wilczak Guido Sauter Doris Höflmayer |
| author_sort | Klaus-Peter Dieckmann |
| collection | DOAJ |
| description | Background. Somatic type malignancy (STM) occurs in 2% of all germ cell tumours (GCTs). The prognosis is unfavourable and the origin is poorly understood. Pathogenetic hypotheses involve direct transformation of teratoma, origin from totipotent cancer cells, or derivation from yolk sac tumour elements. Case Presentation. A 31-year-old patient was cured from testicular seminoma clinical stage IIc by orchiectomy and cisplatin-based chemotherapy. Nine years later, he experienced a late relapse with a mass sized 5×6 cm located at the former metastatic site. As no remission occurred after chemotherapy with three cycles of cisplatin, ifosfamide and etoposide, the mass was surgically resected. Histologically, the specimen consisted of neurofibroma with areas of malignant peripheral nerve sheath tumour and spots with mature bone formation. FISH analysis disclosed isochromosome 12p in the majority of evaluated cells suggesting somatic type malignancy (STM) of GCT. The patient is well 1 year after surgery. Conclusion. The pathogenesis of this STM remains enigmatic. The origin from GCT was evidenced by documentation of isochromosome 12p. Unrecognized teratomatous elements in the primary and totipotent cancer cells surviving the first chemotherapy could be hypothesized to represent the origin. STM developing from seminoma cells would be another novel hypothesis. |
| format | Article |
| id | doaj-art-34501efd7439452d810ad78707b57cec |
| institution | Kabale University |
| issn | 2090-6706 2090-6714 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Oncological Medicine |
| spelling | doaj-art-34501efd7439452d810ad78707b57cec2025-02-03T01:01:04ZengWileyCase Reports in Oncological Medicine2090-67062090-67142017-01-01201710.1155/2017/24570232457023Pure Testicular Seminoma Relapsing Late with Somatic Type MalignancyKlaus-Peter Dieckmann0Petra Anheuser1Ralf Gehrckens2Waldemar Wilczak3Guido Sauter4Doris Höflmayer5Department of Urology, Albertinen-Krankenhaus Hamburg, Süntelstrasse 11a, 22457 Hamburg, GermanyDepartment of Urology, Albertinen-Krankenhaus Hamburg, Süntelstrasse 11a, 22457 Hamburg, GermanyDepartment of Diagnostic Radiology, Albertinen-Krankenhaus Hamburg, Süntelstrasse 11a, 22457 Hamburg, GermanyInstitute of Pathology, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, GermanyInstitute of Pathology, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, GermanyInstitute of Pathology, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, GermanyBackground. Somatic type malignancy (STM) occurs in 2% of all germ cell tumours (GCTs). The prognosis is unfavourable and the origin is poorly understood. Pathogenetic hypotheses involve direct transformation of teratoma, origin from totipotent cancer cells, or derivation from yolk sac tumour elements. Case Presentation. A 31-year-old patient was cured from testicular seminoma clinical stage IIc by orchiectomy and cisplatin-based chemotherapy. Nine years later, he experienced a late relapse with a mass sized 5×6 cm located at the former metastatic site. As no remission occurred after chemotherapy with three cycles of cisplatin, ifosfamide and etoposide, the mass was surgically resected. Histologically, the specimen consisted of neurofibroma with areas of malignant peripheral nerve sheath tumour and spots with mature bone formation. FISH analysis disclosed isochromosome 12p in the majority of evaluated cells suggesting somatic type malignancy (STM) of GCT. The patient is well 1 year after surgery. Conclusion. The pathogenesis of this STM remains enigmatic. The origin from GCT was evidenced by documentation of isochromosome 12p. Unrecognized teratomatous elements in the primary and totipotent cancer cells surviving the first chemotherapy could be hypothesized to represent the origin. STM developing from seminoma cells would be another novel hypothesis.http://dx.doi.org/10.1155/2017/2457023 |
| spellingShingle | Klaus-Peter Dieckmann Petra Anheuser Ralf Gehrckens Waldemar Wilczak Guido Sauter Doris Höflmayer Pure Testicular Seminoma Relapsing Late with Somatic Type Malignancy Case Reports in Oncological Medicine |
| title | Pure Testicular Seminoma Relapsing Late with Somatic Type Malignancy |
| title_full | Pure Testicular Seminoma Relapsing Late with Somatic Type Malignancy |
| title_fullStr | Pure Testicular Seminoma Relapsing Late with Somatic Type Malignancy |
| title_full_unstemmed | Pure Testicular Seminoma Relapsing Late with Somatic Type Malignancy |
| title_short | Pure Testicular Seminoma Relapsing Late with Somatic Type Malignancy |
| title_sort | pure testicular seminoma relapsing late with somatic type malignancy |
| url | http://dx.doi.org/10.1155/2017/2457023 |
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