title: Malignant germ cell tumours in the elderly: a histopathological review of 50 cases in men aged 60 years or over.
abstract: Malignant testicular germ cell tumours in the elderly are extremely rare with anecdotal accounts of their aggressive behaviour. Fifty cases of germ cell tumour, diagnosed at the age of 60 years or above, were pathologically reviewed. The oldest patient was 86 years of age, with 78% of cases presenting in men in their 60s. Forty-one (82%) of the tumours were seminomas with only nine cases (18%) of mixed or non-seminomatous germ cell tumour. However, all non-seminomatous types of tumour were represented in the series. The macroscopic tumour size was significantly larger (median=6 cm, range=2-11 cm) than comparable series in younger men. They were also of higher stage with more frequent vascular invasion and rete testis invasion than is typically seen in a younger population. The tumours were less associated with intratubular germ cell neoplasia than in younger men as it was present in only 47% of assessable cases. We conclude that germ cell tumours, in man aged 60 years or above, present at a later stage than in younger men, and although most are seminomas, non-seminomatous tumours may occur with a wide spectrum of morphology.
authors.affiliation: Department of Histopathology, Barts, The London School of Medicine and Dentistry, St Bartholomew's Hospital, West Smithfield, London, UK. danberney@hotmail.com
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Berney
authors.forename: Anne Y
authors.initials: AY
authors.lastname: Warren
authors.forename: Monika
authors.initials: M
authors.lastname: Verma
authors.forename: Sak
authors.initials: S
authors.lastname: Kudahetti
authors.forename: Jane M
authors.initials: JM
authors.lastname: Robson
authors.forename: Michael W
authors.initials: MW
authors.lastname: Williams
authors.forename: David E
authors.initials: DE
authors.lastname: Neal
authors.forename: Thomas
authors.initials: T
authors.lastname: Powles
authors.forename: J
authors.initials: J
authors.lastname: Shamash
authors.forename: R Timothy D
authors.initials: RT
authors.lastname: Oliver
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D018236:Carcinoma, Embryonal / Q000473:pathology; D002822:Choriocarcinoma / Q000473:pathology; D018240:Endodermal Sinus Tumor / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D018198:Mixed Tumor, Malignant / Q000473:pathology*; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009373:Neoplasms, Germ Cell and Embryonal / Q000473:pathology*; D018239:Seminoma / Q000473:pathology; D013724:Teratoma / Q000473:pathology; D013736:Testicular Neoplasms / Q000473:pathology*; D006113:United Kingdom