[Clinical presentation of testicular germinal cancer].
OBJECTIVE
To review the clinical features in our series of patients of germ-cell testicular cancer.


METHODS
The charts of 73 patients with diagnosis of germ-cell testicular tumours were reviewed. Age, history of cryptorchism, time to diagnosis, main symptoms, and serum markers values (alpha- fetoprotein and beta-HCG) were analysed. All cases underwent orchiectomy and extension study with abdominal CT-scan and either chest X-ray or Thoracic CT-scan. We follow the AJCC-UICC 1997 stage classification. Histological cell line, size, and clinical stage at presentation (local, regional and distance) have been analysed also.


RESULTS
Among 73 germ-cell testicular tumours 34 were seminomas (46.6%) and 39 were non-seminomatous (54.4%). Clinically, 58.9% of the patients had localised stage I tumours. On presentation 85.7% seminomas were stage I compared to 35.9% non-seminomatous tumours. The remaining tumours were diagnosed in advanced phases (stages II and III). Inguinal orchiectomy was performed in all patients except 5 in whom tumours were incidentally diagnosed (atrophic testis orchiectomy, hydrocoelectomy, trauma) and needed a second operation including ipsilateral scrotal excision. When size, cell line and primary tumour T category were reviewed we found that 32.3% seminomas and 20.5% non seminomas were smaller than 4 cm. 50% seminomas and 49.7% non seminomas were pT1; 41.2% seminomas and 28.2 non seminomas were pT2; finally 8.8% seminomas were pT3 compared to 23.1% non seminomas. Vascular infiltration, also evaluated in this chapter, was present in 38.2% seminomas compared to 38.5% non seminomas. Elements of embryonal carcinoma were found in 37 non seminomatous tumours, either isolated (14) or associated with other components. Teratoma appeared in 18 non seminomatous tumours, 16 of them associated to embryonal carcinoma alone or together with other components. Elements of choriocarcinoma and endodermal sinus were evident in 5 and 4 cases respectively, always associated with other elements.


CONCLUSIONS
Seminomas clinical presentation substantially differs from that of non seminomatous testicular tumours in age, clinical features, stage and histological aggressiveness.
Fernández Gómez
Jesús María
JM
Servicio de Urología I, Hospital Covadonga, Hospital Central de Asturias, Facultad de Medicina, Universidad de Oviedo, Oviedo, España.
Guate Ortiz
José Luis
JL
Martín Huescar
Agustín
A
Fresno Forcelledo
Florentino
F
Escaf Barmadah
Safwan
S
García Rodríguez
Javier
J
Pérez García
Francisco Javier
FJ
Rodríguez Faba
Oscar
O
Jalón Monzón
Antonio
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase; D014408:Biomarkers, Tumor / Q000097:blood; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D003456:Cryptorchidism / Q000453:epidemiology; D058851:GPI-Linked Proteins; D006801:Humans; D007527:Isoenzymes / Q000097:blood; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D009373:Neoplasms, Germ Cell and Embryonal / Q000097:blood / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D009919:Orchiectomy; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013736:Testicular Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D000509:alpha-Fetoproteins / Q000032:analysis
D014408:Biomarkers, Tumor; D018997:Chorionic Gonadotropin, beta Subunit, Human; D058851:GPI-Linked Proteins; D007527:Isoenzymes; D000509:alpha-Fetoproteins; D007770:L-Lactate Dehydrogenase; D000469:Alkaline Phosphatase; C019839:alkaline phosphatase, placental