Choriogonadotropin positive seminoma-a clinicopathological and molecular genetic study of 15 cases.
The presence of human chorionic gonadotropin (hCG) positive syncytiotrophoblastic cells (STC) in classic seminoma (CS) is well documented. CS with extensive hCG positive, non-syncytiotrophoblastic tumour cells (without STC) is exceptionally rare. In this study, we present 15 such cases. 168 CSs were retrieved from the Plzen Tumor registry. Cases of mixed germ cell tumors (with CS) and CSs with typical STC were excluded. Cases with completely embedded tumor mass were selected for further study and immunohistochemically examined with anti-hCG. Positive cases were further analyzed by reverse transcriptase polymerase chain reaction. Two groups of hCG-positive CSs were identified. Group 1 comprised 10 patients with a mean patient age of 37.7 years and mean tumor size of 4.96 cm. Eight cases were pT1 (TMN 2009) and 2 cases pT3a. Blood levels of hCG were elevated in 6 of the 10 patients preoperatively. In 2 patients the blood level of hCG was not tested. Mean follow-up period was 6.1 years. No metastatic behavior was noted. All tumors were extensively immunoreactive for hCG in more than 60% of tumor cells. The expression of hCG beta subunit (CGB)-mRNA in tumor tissue was documented. Group 2: Comprised 5 patients with a mean age was 34 years. Mean tumor size was 4.7 cm. Four cases were stage pT1 and 1 case was pT2. The mean follow-up period was 3.1 years. No metastatic behavior was noted. Preoperative blood levels of hCG were elevated in 1/5 of the patient. Strong hCG positivity was limited to scattered single tumor cells distributed throughout the entire tumor. Only weak expression of CGB mRNA was detected. We can conclude that immunohistochemical detection of expression of hCG in CS is not limited to syncytiotrophoblastic cells. In this study, we report two immunohistochemical patterns of hCG expression in classic seminomas: diffuse hCG staining in the majority of tumor cells and scattered hCG-positive cells within the tumor.
Department of Pathology, Charles University, Medical Faculty and Charles University Hospital Plzen, Czech Republic; Biomedical Centre, Faculty of Medicine in Plzen, Charles University in Prague, Plzen, Czech Republic. Electronic address: hes@medima.cz.
Ondrej
O
Hes
Department of Pathology, Charles University, Medical Faculty and Charles University Hospital Plzen, Czech Republic.
Kristyna
K
Pivovarcikova
Department of Pathology, Charles University, Medical Faculty and Charles University Hospital Plzen, Czech Republic.
Jan
J
Stehlik
Department of Pathology, Charles University, Medical Faculty and Charles University Hospital Plzen, Czech Republic.
Petr
P
Martinek
Department of Pathology, Charles University, Medical Faculty and Charles University Hospital Plzen, Czech Republic.
Tomas
T
Vanecek
Department of Pathology, Charles University, Medical Faculty and Charles University Hospital Plzen, Czech Republic.
Kevin
K
Bauleth
Department of Urology, Charles University, Medical Faculty and Charles University Hospital Plzen, Czech Republic.
Olga
O
Dolejsova
Department of Pathology, Charles University, Medical Faculty and Charles University Hospital Plzen, Czech Republic; Department of Pathology, National University Health System, Singapore.
Fredrik
F
Petersson
Department of Urology, Charles University, Medical Faculty and Charles University Hospital Plzen, Czech Republic.
Milan
M
Hora
Department of Pathology, Institute Nacional de Cancerologia, Mexico City, Mexico.
Delia
D
Perez Montiel
Department of Pathology, Charles University, Medical Faculty and Charles University Hospital Plzen, Czech Republic.
Kvetoslava
K
Peckova
Department of Pathology, Charles University, Medical Faculty and Charles University Hospital Plzen, Czech Republic.
Jindrich
J
Branzovsky
Department of Otorhinolaryngology, Charles University, Medical Faculty and Charles University Hospital Plzen, Czech Republic.
David
D
Slouka
Department of Surgery, Charles University, Medical Faculty and Charles University Hospital Plzen, Czech Republic.
Josef
J
Vodicka
Department of Pathology, Charles University, Medical Faculty and Charles University Hospital Plzen, Czech Republic.
Bohuslava
B
Kokoskova
Department of Pathology and Molecular Medicine, Thomayer's Hospital, Prague, Czech Republic.
Radoslav
R
Matej
Department of Pathology, Charles University, Medical Faculty and Charles University Hospital Plzen, Czech Republic.
Michal
M
Michal
D000328:Adult; D014408:Biomarkers, Tumor / Q000097:blood*; D006063:Chorionic Gonadotropin / Q000097:blood*; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009373:Neoplasms, Germ Cell and Embryonal / Q000235:genetics / Q000473:pathology*; D012333:RNA, Messenger / Q000235:genetics; D012334:RNA, Neoplasm / Q000235:genetics; D018239:Seminoma / Q000235:genetics / Q000473:pathology*; D013736:Testicular Neoplasms / Q000235:genetics / Q000473:pathology*; D055815:Young Adult
D014408:Biomarkers, Tumor; D006063:Chorionic Gonadotropin; D018997:Chorionic Gonadotropin, beta Subunit, Human; D012333:RNA, Messenger; D012334:RNA, Neoplasm
Human chorionic gonadotropin; Immunohistochemistry; RT-PCR; Seminoma; Testis