Primary mature teratoma of the testis: clinical, morphological, and immnohistochemical predictors

• Main Authors: K. Olman, A. Keinderreich
• Format: Article
• Language: Russian
• Published: ABV-press 2020-02-01
• Series: Onkourologiâ
• Online Access: https://oncourology.abvpress.ru/oncur/article/view/1139
• ISSN: 1726-9776; 1996-1812

The clinical, pathomorphological, and immunohistochemical (p53, MIB-1, bcl-2, and cathepsin D) parameters were retrospectively analyzed to determine the molecular markers associated with the progression of a mature teratoma (MT) of the testis is presented.Subjects and methods. Sixty-nine patients with pure primary MT of the testis were retrospectively selected. In all 69 cases, archival tumor blocks were accessible to histological re-evaluation. Fifty 55 (80%) patients with an early-stage tumorous process, including 44 patients with Stages I and 11 with IIA/B stage, had undergone radical orchiectomy, followed by retroperitoneal lymphadenectomy (RPLAE). Fourteen (20%) patients with a disseminated tumor received induction multidrug therapy (MDT), followed by residual tumor resection.Results. The detection rates of metastases to the retroperitoneal lymph nodes were 14 and 73% in Stages I and IIA/B, retrospectively. The morphological diagnosis of pure MT was verified in all cases. However, 22 (79%) out of 28 patients with testicular metastases were found to have scars and calcification of the parenchyma; 6 patients had microscopic foci of a germ-cell tumor. In all, metastases were detected in 41% of patients. The mean follow-up was 92 (range 8—252) months. No recurrence developed in patients with Stage I; 5 patients with disseminated tumor had recurrences after RPLAE and 5 (7.3%) patients died from progressive cancer. The expression of p53, MIB-1, and cathepsin D in MT was low with an insignificant difference in different stages of the disease.Conclusion. The molecular markers are of no clinical value in estimating the metastatic potential of MT. Additional serial paraffin sections should be made in all cases of pure MT. RPLAE should be performed when scar tissue or germ-cell tumor elements are found in the testis; a follow-up is indicated in other cases. If it is impossible to make additional serial paraffin sections, nerve-sparing RPLAE is the method of choice.