Neuroblastoma as a prominent component of a mixed germ cell tumor of testis.
BACKGROUND
Primitive neuroectodermal tissue in teratomas of testis has been reported in the literature. A mixed germ cell tumor of testis with a prominent neuroblastoma component dictating the clinical behavior was found to be unique.


METHODS
Tissue sections were stained with hematoxylin and eosin, and immunohistochemical, ultrastructural, cytogenetic, and flow cytometric analyses were performed on the primitive neuroectodermal component of the testicular mass. Follow-up results at 2.5 years are included.


RESULTS
The microscopic findings on hematoxylin and eosin slides showed cells composing the majority of the neoplasm to have features of neuroblastoma. The immunohistochemical stains showed positivity for neuron-specific enolase in the cells comprising the neuroblastoma, and transmission electron microscopic study corroborated these findings by demonstrating microtubules and rare membrane-limited, dense-core granules in the cytoplasm. Flow cytometry showed a hypertetraploid population with a large aneuploid DNA content. Cytogenetics revealed a hypertriploid modal number of 74 chromosomes. The clinical features were dictated by the neuroblastoma component in a fashion similar to that of adult neuroblastomas and responded to the chemotherapeutic regimen designed for treating neuroblastoma.


CONCLUSIONS
The neuroblastoma component proved to be more aggressive than the other elements of this neoplasm. This finding suggests that mixed germ cell tumors showing a large neuroblastoma component should be treated promptly and aggressively with chemotherapy.
Serrano-Olmo
J
J
Department of Pathology, Temple University Hospital, Philadelphia, Pennsylvania.
Tang
C K
CK
Seidmon
E J
EJ
Ellison
N E
NE
Elfenbein
I B
IB
Ming
P M
PM
D000328:Adult; D001859:Bone Neoplasms / Q000473:pathology / Q000556:secondary; D018236:Carcinoma, Embryonal / Q000473:pathology; D002467:Cell Nucleus / Q000648:ultrastructure; D002872:Chromosome Deletion; D003593:Cytoplasm / Q000648:ultrastructure; D004273:DNA, Neoplasm / Q000032:analysis; D018237:Germinoma / Q000235:genetics / Q000473:pathology*; D006801:Humans; D007085:Ilium / Q000473:pathology; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000235:genetics / Q000473:pathology*; D009447:Neuroblastoma / Q000235:genetics / Q000473:pathology* / Q000556:secondary; D015388:Organelles / Q000648:ultrastructure; D010751:Phosphopyruvate Hydratase / Q000032:analysis; D018239:Seminoma / Q000473:pathology; D013724:Teratoma / Q000473:pathology; D013736:Testicular Neoplasms / Q000235:genetics / Q000473:pathology*; D014178:Translocation, Genetic
D004273:DNA, Neoplasm; D010751:Phosphopyruvate Hydratase