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Abramson Cancer CenterNCI CANCERLIT® Search: Testicular Cancer - October 2001
National Cancer Institute®
Last Modified: November 21, 2001
Table of Contents
1
UI - 20416603
AU - Anonymous
TI -
[Epididymal tumor of adrenal remains]
SO - Arch Esp Urol 2000 Jun;53(5):481-3
2
UI - 21336428
AU - Gurbuz YS; Muezzinoglu B; Cimen K; Dillioglugil O
TI -
Synchronous occurrence of bladder carcinosarcoma and testicular
seminoma.
SO - Int J Urol 2001 Jul;8(7):404-7
AD - Department of Pathology, Kocaeli University Medical School, Kocaeli,
Turkey.
We report a case of urinary bladder carcinosarcoma with simultaneous
testicular seminoma. A 60-year-old male presented with painless gross
hematuria and a left testicular mass. The bladder tumor was deeply
infiltrating muscular tissue and had histologic features of both
carcinoma and sarcoma. Testicular tumor was diagnosed as classical
seminoma. Radical cystectomy, pelvic and left-modified retroperitoneal
lymphadenectomy were performed. The lymph nodes did not show metastasis.
At the 26 months follow-up, the patient is free of disease.
3
UI - 21340683
AU - Schrader M; Heicappell R; Muller M; Krause H; Straub B; Goessl C; Miller
TI -
K
Molecular markers in testicular germ cell tumors--objects of clinical
research or close to becoming clinical tools?
SO - Onkologie 2001 Apr;24(2):144-8
AD - Klinik und Poliklinik fur Urologie, Universitatsklinikum Benjamin
Franklin, Berlin. schrader@medizin.fu-berlin.de
The aim of this short review is to critically evaluate hitherto
investigated molecular markers for testicular germ cell tumors.
Molecular parameters have been clinically established as diagnostic and
prognostic markers for a number of tumors; this has not yet been
achieved for germ cell tumors. There are interesting prospects, however.
Studies on the ribonucleoprotein telomerase, for example, have
demonstrated a correlation between enzyme activity and chemotherapeutic
drug sensitivity. Moreover, innovative treatment approaches target this
reverse transcriptase via telomerase antisense RNA. Another potential
diagnostic marker is the detection of circulating tumor cells, which
correlated with an increased relapse rate in initial studies. There are
also interesting possibilities for the germ-cell-tumor-specific
isochromosome [i(12)p], which is helpful in the differential diagnosis
of mediastinal masses. Here initial studies demonstrated a correlation
between the copy number and resistance against chemotherapeutic drugs.
Without prospective studies to validate data obtained thus far, neither
these nor other parameters can be assessed as diagnostic and prognostic
factors. Irrespective of their immediate clinical applicability,
however, investigations on molecular alterations in testicular germ cell
tumors will become the basis for a molecular-diagnostically oriented
subclassification of tumors as well as for novel therapeutic approaches.
Copyright 2001 S. Karger GmbH, Freiburg
4
UI - 21340689
AU - Kormann KU
TI -
Treatment of testicular cancer--is quality management possible?
SO - Onkologie 2001 Apr;24(2):177-9
AD - Urologische Klinik, Universitatsklinikum Mannheim.
The incidence of testicular cancer has continuously increased during the
last decades, especially in the developed countries. The prognosis for a
great number of young patients with this terminal illness was
dramatically improved to a cure rate of 95% through the introduction of
Cisplatin chemotherapy in the late seventies. Einhorn demonstrated the
excellent efficacy of Cisplatin in 1977 [see 1]. At that time, germ cell
tumors were the cause of death in 400 males per year in Germany. The
propagation of chemotherapy could have reduced the number of deaths to
100 per year, but in 1996 there were still 200 deaths from this type of
cancer [2]. This fact demonstrates, firstly, that in general practice,
the excellent results gained on the efficacy of new agents only asserted
themselves slowly, and secondly, that even after 20 years, the success
rates derived from study evaluations on testicular cancer have still not
been achieved in practice. Although it is accepted that the results of
study evaluation are not representative for the general population,
improved treatment strategies that were confirmed as a result of study
evaluation have to be implemented more rapidly into general therapy.
Quality management will ensure the introduction of results from study
evaluation into general practice. It will also ensure continuous
progress. Copyright 2001 S. Karger GmbH, Freiburg
5
UI - 21388453
AU - Tomomasa H; Shimizu H; Sato S; Adachi Y; Ashizawa Y; Kamiyama Y; Okano
TI -
Y; Sato M; Yoshii T; Iizumi T; Umeda T; Yazaki T
Clinical study of testicular germ cell tumors.
SO - Hinyokika Kiyo 2001 Jun;47(6):389-95
AD - Department of Urology, Teikyo University School of Medicine.
A clinical statistical analysis on 65 patients with 68 testicular germ
cell tumors was performed. Thirty-six testes (53.7%) had seminomas and
the remainder non-seminomatous germ cell testicular tumors (NSGCTTs). Of
the seminomas, 31 (88.6%) were in stage I and the others showed distant
metastases at presentation. Of the 32 NSGCTTs, 22 (68.8%) were in stage
I. The average ages of the patients with seminomas and NSGCTTs were 40.4
and 29.9 years, respectively. Thirty-nine patients (60.0%) had tumors on
the right side, 23 (35.4%) on the left and 3 (4.6%) in both testes. Five
patients had a past history of cryptorchidism. Chief complaints in 49
patients (73.1%) were a painless scrotal mass. The interval from
clinical onset to presentation was longer in seminoma patients than in
NSGCTT patients (10.9 months on average versus 3.4 months).
Immunosuppressive acidic protein (IAP) was a useful diagnostic tumor
marker as well as alpha-feto protein (AFP), beta-human chorionic
gonadotropin (beta-hCG) and lactic dehydrogenase (LDH). We adopted a
surveillance policy in more than half of the stage I patients and
obtained acceptable results. In the remaining cases, therapies including
combination chemotherapy, radiation and salvage operation were performed
after orchiectomy. The three-year survival rate was 98.0, 100.0 and
26.7%, for stage I, II and III patients respectively.
6
UI - 21388454
AU - Okamura K; Mizutani K; Hattori R; Gotoh M; Ono Y; Ohshima S
TI -
[Peripheral blood stem cell harvest for patients with germ cell tumors]
SO - Hinyokika Kiyo 2001 Jun;47(6):397-403
AD - Department of Urology, Nagoya University School of Medicine.
tumors underwent peripheral blood stem cell harvest during 15 courses of
bleomycin, etoposide, cisplatin (BEP), 4 courses of etoposide,
ifosfamide, cisplatin (VIP) and 3 courses of high-dose etoposide
mobilization at Nagoya University Hospital. We performed 29 aphereses
during BEP, eight during VIP, and six during high-dose etoposide.
Although we were able to harvest 4.4 x 10(6)/kg of median CD34 positive
cells per apheresis during BEP, the number of stem cells (more than 4 x
10(6)/kg of CD34 positive cells), which are needed for tandem high-dose
chemotherapy, could not be obtained during four courses of BEP. For
three patients in whom white blood cell counts at nadir were
2,000/microL or more, however, the required number of CD34 positive
cells were harvested. VIP provided only 1.7 x 10(6)/kg of median CD34
positive cells per apheresis, while, 7.3 x 10(6)/kg of CD34 positive
cells were harvested during high-dose etoposide mobilization. The dose
of G-CSF was a significant factor for the number of CD34 positive cells
harvested during BEP (p = 0.02); however, there might be some
relationship between the harvest and the number of the peripheral white
blood cells on the day of apheresis (p = 0.08), the day to start G-CSF
(p = 0.13), or the day to initiate apheresis (p = 0.27). Based on our
experience, it is recommended that 5 micrograms/kg of G-CSF should be
started from the 14th or 15th day of BEP until the last apheresis and
that aphereses should be performed between the 19th and 21st day,
especially at the days when the peripheral white blood cell count
increases beyond 10,000/microL.
7
UI - 21388462
AU - Uemura M; Nishimura K; Hirai T; Inoue H; Mizutani S; Miyoshi S;
TI -
Tsujihata M
[Undescended testicular tumor found by torsion of the testis: a case
report]
SO - Hinyokika Kiyo 2001 Jun;47(6):437-9
AD - Department of Urology, Osaka Rosai Hospital.
A 37-year-old man was admitted with a painful mass in his left inguinal
region. He had an undescended testis on the left side. Six months
earlier, he had noted that his left inguinal testis was larger, and he
had suddenly developed pain in the left inguinal region. The levels of
AFP, hCG beta and LDH were normal. We diagnosed a left undescended
testicular tumor and torsion of the left testis. Left inguinal high
orchiectomy showed a torsion of the left testis and histopathological
examination of the specimen revealed seminoma.
8
UI - 21377750
AU - Schrey A; Reiter WJ; Kratzik C
TI -
[Value of ultrasound in microlithiasis of the testis in andrological
patients]
SO - Ultraschall Med 2001 Jun;22(3):143-5
AD - Urologische Abteilung, Universitat Wien.
PURPOSE: The objective of this retrospective study is to show the
importance of sonography in andrological patients with testicular
microlithiasis (TM). PATIENTS AND METHODS: 1314 male patients were seen
to our andrological clinic in the course of one year. The age range of
these patients was 25 to 39 years (mean age 32 years). All patients
underwent testicular sonography as well as a sperm-analysis. RESULTS:
284 patients showed normozoospermia without any evidence of TM. Of the
remaining 1030 patients with a pathological spermiogram, 8 were shown to
display more than 10 echogenic foci per transducer field in both tests.
1 patient suffering from an already palpable testicular tumor only
showed, unilateral, unifocal calcification. Another patient who had
suffered from a maldescensus testicle in his early childhood discharged
only one unifocal calcification. Tumor markers including AFP and
beta-HCG were normal in 9 patients, but elevated in 1 patient suffering
from a testicular tumor (AFP: 73 kU/l; beta-HCG: 10.6 U/l). The hormonal
status was normal in 6 patients and pathological 4 patients with the
diagnosis of OAT-syndrome. CONCLUSION: TM is a rare condition even in
andrological patients. Nevertheless, a thorough scrotal sonography is
mandatory in order to rule out testicular malignancy.
9
UI - 21369650
AU - Khadra A; Oakeshott P
TI -
General practice perspective on cancer services.
SO - Fam Pract 2001 Aug;18(4):463-4
10
UI - 21385661
AU - Skotheim RI; Kraggerud SM; Fossa SD; Stenwig AE; Gedde-Dahl T Jr;
TI -
Danielsen HE; Jakobsen KS; Lothe RA
Familial/bilateral and sporadic testicular germ cell tumors show
frequent genetic changes at loci with suggestive linkage evidence.
SO - Neoplasia 2001 May-Jun;3(3):196-203
AD - Department of Genetics, Institute for Cancer Research, The Norwegian
Radium Hospital, Montebello, Oslo N-0310, Norway.
Testicular germ cell tumor (TGCT) is the most common tumor type among
adolescent and young adult males. Familial clustering and bilateral
disease are suggestive of a genetic predisposition among a subgroup of
these patients, but susceptibility genes for testicular cancer have not
yet been identified. However, suggestive linkage between disease and
genetic markers has been reported at loci on chromosome arms 3q, 5q,
12q, 18q, and Xq. We have analyzed primary familial/bilateral (n=20) and
sporadic (n=27) TGCTs, including 28 seminomas and 19 nonseminomas, for
allelic imbalance (AI) within the autosomal regions. DNA from all tumors
were analyzed by fluorescent polymerase chain reaction of 22 polymorphic
loci at 3q27-ter, 5q13-35.1, 12q21-ter, and 18q12--ter. All tumor
genotypes were evaluated against their corresponding constitutional
genotypes. The percentages of TGCTs with genetic changes at 3q, 5q, 12q,
and 18q, were 79%, 36%, 53% and 43%, respectively. The frequencies at 3q
and 12q in nonseminomas were significantly higher than in seminomas
(P=.003 and P=.004). In order to evaluate changes at hemizygous Xq loci,
five loci were analyzed by co-amplification with an autosomal reference
marker known to reveal retained heterozygosity in the tumor DNA. Gain of
Xq sequences was seen in more than 50% of the tumors. The degree of
amplification varied among the loci in each of five tumors, and based on
these breakpoints, a common region of overlapping gains was found at
Xq28. No significant differences were found between the frequencies of
genetic changes in familial/bilateral versus sporadic tumors, an
observation speaking in disfavor of the existence of a single
susceptibility gene for TGCT in any of the analyzed regions. Our data
suggest that gain of genetic material at distal Xq and losses at 5q and
18q contribute to establishment of seminomas, whereas imbalances at 3q
as well as gain at distal part of 12q are associated with further
progression into nonseminomas.
11
UI - 21414852
AU - Suzuki K; Tokue A
TI -
[Serum CA19-9 levels in testicular germ cell tumor patients]
SO - Hinyokika Kiyo 2001 Jul;47(7):467-72
AD - Department of Urology, Jichi Medical School.
This study was designed to examine whether measurement of serum CA19-9
was useful in testicular germ cell tumor patients. We analyzed the
clinical courses of 55 testicular germ cell tumor cases diagnosed after
high orchiectomy. The patients in this study consisted of 33 seminomas
and 22 non-seminomatous germ cell tumors (NSGCT), and their mean age was
32.7 +/- 12.7 years (mean +/- SD). The mean follow-up period after the
operation was 33.7 months. The positive rate of the pre-treatment serum
CA19-9 level was 16.4% (3.0% in seminomas versus 36.4% in NSGCT, p =
0.0017). The pre-treatment serum CA19-9 levels in NSGCT patients were
significantly higher than those in seminoma patients (46.6 +/- 50.0 U/ml
versus 10.6 +/- 9.6 U/ml, p = 0.0008). We divided the patients into two
groups according to the detailed histological types, and found that the
serum CA19-9 levels in the patients with embryonal carcinoma (EC) were
significantly higher than in those without EC (p = 0.0160), and the
levels in those with yolk sac tumor (YS) were higher than in those
without YS (p = 0.0099). Moreover, the levels in those with either EC or
YS were significantly higher than in those with neither EC nor YS (p =
0.0004). In 9 patients with a high serum pre-treatment CA19-9 level, the
serum CA19-9 level was useful as a monitoring marker through the
treatment or tumor progression. On the other hand, the pre-treatment
serum CA19-9 level did not correlate with the clinical stage or
prognosis. In conclusion, the phenomenon that the serum levels of CA19-9
increase in testicular germ cell tumor patients is not extremely rare,
and in NSGCT, especially in EC or YS, the serum CA19-9 can be a useful
tumor marker.
12
UI - 21439128
AU - Moroni M; Veronese S; Schiavo R; Carminati O; Sorensen BS; Gambacorta M;
TI -
Siena S
Epidermal growth factor receptor expression and activation in
nonseminomatous germ cell tumors.
SO - Clin Cancer Res 2001 Sep;7(9):2770-5
AD - The Falck Division of Medical Oncology, Department of Oncology and
Hematology, Ospedale Niguarda Ca' Granda, I-20162 Milan, Italy.
oncologia@ospedale-niguarda.it
PURPOSE: The goal of this work was to study the expression of epidermal
growth factor receptor (by use of monoclonal antibody EGFR 1) and
HER-2/neu (by use of monoclonal antibody EGFR 2), as well as EGFR
activation [phosphorylated EGFR (P-EGFR)] and autocrine stimulation
[ligand transforming growth factor-alpha (TGF-alpha)] markers in a
series of 24 testicular tumors [18 nonseminomatous germ cell tumors
(GCTs), 1 Leydig cell tumor, and 5 seminomatous GCTs]. EXPERIMENTAL
DESIGN: Paraffin-embedded sections of tumors were studied
immunohistochemically for beta-human chorionic gonadotropin (beta-HCG),
EGFR 1, HER-2/neu, TGF-alpha, and P-EGFR expression. In one case of pure
choriocarcinoma, fresh-frozen tumor sections were also evaluated. The
presence of EGFR mRNA was studied in the Jar choriocarcinoma cell line
using reverse transcription-PCR. RESULTS: Staining for cell membrane
EGFR was detected immunohistochemically in the 16 beta-HCG-positive
components of 18 nonseminomatous GCTs as well as in the control Jar
choriocarcinoma cell line and normal placenta. In contrast, 1 Leydig
cell tumor, 5 seminomatous GCTs, and beta-HCG-negative components of 18
GCTs, as well as control B and T lymphoma cell lines, did not express
EGFR. Expression of HER-2/neu, TGF-alpha, and P-EGFR was detected in 25,
36, and 27% of EGFR-positive, nonseminomatous GCTs, respectively. EGFR
mRNA was detected in the Jar choriocarcinoma cells. CONCLUSIONS: We
report data, for the first time, that document EGFR and HER-2/neu
expression and indicate EGFR activation and autocrine stimulation in
beta-HCG-positive, nonseminomatous GCTs. These findings may be
clinically relevant in relation to the recent availability of active
EGFR- and HER-2/neu-targeted pharmaceutical agents and to the
extensively described negative prognostic significance of beta-HCG
expression in mixed GCTs.
13
UI - 21454116
AU - Oliver RT
TI -
Trends in testicular cancer.
SO - Lancet 2001 Sep 8;358(9284):841
14
UI - 21268707
AU - Kollmannsberger C; Mayer F; Kuczyk M; Kanz L; Bokemeyer C
TI -
Treatment of patients with metastatic germ cell tumors relapsing after
high-dose chemotherapy.
SO - World J Urol 2001 Apr;19(2):120-5
AD - Department of Medicine II, University of Tuebingen, Otfried-Mueller-Str.
10, 72076 Tuebingen, Germany.
With the use of cisplatin-based combination chemotherapy, metastatic
testicular germ cell tumors can be cured in 70-80% of patients. Patients
refractory to cisplatin-based chemotherapy have a very poor prognosis.
Several mechanisms have been discussed for the development of platinum
resistance such as a decreased intracellular concentration of the drug,
increased repair of the drug induced damage, or an altered apoptotic
response to this damage. Various chemotherapeutic agents have been
evaluated in intensively pretreated or cisplatin-refractory patients.
Neither the antracyclines nor vinorelbine, bendamustine, topotecan, nor
biological agents such as suramin and retinoic acid have demonstrated
clinical activity. Paclitaxel has been evaluated at different doses and
schedules and yielded a response rate of 21% (range 11-30%) with
individual patients achieving complete remissions. This has led to the
inclusion of paclitaxel in salvage regimens in combination with
cisplatin and/or ifosfamide. Two recent studies have evaluated
gemcitabine in refractory germ cell tumors, demonstrating a response
rate of 17% (95% CI: 7-28%) in 52 intensively pretreated patients,
two-thirds of whom had relapsed after previous high-dose chemotherapy
plus autologous stem cell transplantation. The nonhematologic toxicity
of weekly gemcitabine at doses of 1000-1250 mg/m2 was tolerable and
hematologic side effects included thrombocytopenia in approximately 20%
of patients. Ongoing studies in refractory germ cell tumors performed by
the German Testicular Cancer Study Group (GTCSG) are evaluating
oxaliplatin, a platinum derivative with incomplete cross-resistance to
cisplatin. Future trials combining new active agents may make it
possible to test the use of alternating treatment strategies in patients
with "poor prognostic" disease or as salvage treatment. It is hoped that
the increase in knowledge of the molecular mechanism of testicular
cancer may lead to the development of new therapeutic options.
15
UI - 21268701
AU - Albers P; Perabo FG; Melchior D; Siener R
TI -
Adjuvant chemotherapy in stage I and stage II testicular cancer.
SO - World J Urol 2001 Apr;19(2):76-81
AD - Department of Urology, Bonn University, 53105 Bonn, Germany.
albers@mailer.meb.uni-bonn.de
Adjuvant chemotherapy in low-stage testis cancer is an accepted
treatment option for two clinical situations: (1) chemotherapy after
complete removal of the primary tumor by orchidectomy without clinical
evidence of metastasis (clinical stage I), and (2) chemotherapy after
complete surgical removal of non-seminomatous retroperitoneal metastases
up to 5 cm in greatest transverse diameter by retroperitoneal lymph node
dissection in clinical stage II. Aim of treatment is the prevention of
tumor recurrences. The risk of recurrence depends on the type and stage
of disease and ranges from 16% (clinical stage I seminoma) to 50%
(pathological stage II B non-seminoma). Thus, 50-84% of patients receive
adjuvant treatment unnecessarily. Prognostic factors have been developed
in each tumor entity to tailor treatment to patients with high risk of
recurrence.
16
UI - 21268702
AU - Nichols CR
TI -
Chemotherapy of disseminated germ cell tumors.
SO - World J Urol 2001 Apr;19(2):82-9
AD - Oregon Health Sciences University, 3181 SW Sam Jackson Park Road, OP-28,
Portland, Oregon, USA, 97201.
The fact that germ cell tumors can be successfully managed puts an
extraordinary burden on the physician and health care system to ensure
that the promise of cure is achieved in all patients except the small
proportion that present with advanced refractory disease. Good risk
disseminated disease should be treated with three cycles of bleomycin,
etoposide and cisplatin (BEP) whereas those with more advanced disease
should receive four cycles. Postchemotherapy resection of residual
disease is commonly required. In patients in whom disease recurs after
primary chemotherapy, salvage treatments can result in cure in 30-40% of
patients. Physicians managing these patients should be aware of some of
the pitfalls encountered when determining relapse and should be versed
in the indications for salvage conventional dose chemotherapy, high dose
chemotherapy, and the role of aggressive desperation surgery.
17
UI - 21268703
AU - Beyer J; Rick O; Siegert W; Bokemeyer C
TI -
Salvage chemotherapy in relapsed germ cell tumors.
SO - World J Urol 2001 Apr;19(2):90-3
AD - Department of Hematology and Oncology, Philipps Universitat Marburg,
Baldinger Strasse, 35033 Marburg, Germany.
joerg.beyer@mailer.uni-marburg.de
Issues concerning the optimal salvage treatment in patients with germ
cell tumors are for the most part controversial. As the majority of
patients will suffer systemic relapses, chemotherapy will remain the
mainstay of any salvage treatment. However, the question of whether to
use conventional-dose or high-dose chemotherapy (HDCT) immediately
arises. Prognostic factors have recently been recognized as an aid in
this decision. However, as reliable data are lacking for many clinical
scenarios, the salvage treatment of germ-cell tumors continues to be a
therapeutic challenge.
18
UI - 21268020
AU - Slowikowska-Hilczer J; Walczak-Jedrzejowska R; Kula K
TI -
Immunohistochemical diagnosis of preinvasive germ cell cancer of the
testis.
SO - Folia Histochem Cytobiol 2001;39(2):67-72
AD - Department of Andrology and Reproductive Endocrinology, Institute of
Endocrinology, Medical University, Lodz, Poland.
The aim of the study was to identify testicular carcinoma in situ (CIS),
a precursor of germ cell tumours (GCT), in patients from the high risk
groups, using classic and alternative immunohistochemical methods. 70
patients with 46,XY karyotype were examined. Whole gonads or biopsy
specimens were fixed in Bouin's fluid. In cases with dysgenetic male
pseudohermaphroditism (DMP), gross histopathology revealed sex cord
tumour gonadoblastoma in 4 and malignant dysgerminoma in 1 out of 23
patients. In all patients, paraffin sections were treated with
antibodies against placental-like alkaline phosphatase (PLAP), a classic
immunohistochemical marker of GCT and CIS. CIS was detected
immunohistochemically in 10 out of 23 cases with DMP (43.5%), in 1 out
of 10 cases with androgen insensitivity syndrome (10%), in 3 out of 18
cases operated previously because of already developed GCT in
contralateral testis (16.6%) and in 1 out of 3 patients with
cryptorchidism in anamnesis (33.3%). CIS was not found in 16 examined
adult infertile men with azoospermia. In addition to PLAP investigation,
12 cases with DMP and 6 cases with GCT were examined using M2A and
TRA-1-60 antibodies, the alternative immunohistochemical markers of CIS.
While in DMP positive reactions for M2A and TRA-1-60 accompanied PLAP
reaction in 1/3 of cases, M2A accompanied PLAP in all cases with GCT.
The positive reaction for TRA-1-60 accompanied PLAP and M2A in 1 case
with GCT. The results indicate that among different risk groups the
highest incidence of CIS occurs in DMP. Screening for CIS is of
importance also in cryptorchidism, androgen insensitivity syndrome and
in men who underwent gonadectomy because of unilateral GCT. The
immunostaining for PLAP seems to be more discriminative procedure. The
positive staining of CIS cells with M2A and TRA-1-60 antibodies may be
indicative for more advanced neoplastic transformation.
19
UI - 21384903
AU - Witjes JA; Spermon JR
TI -
Prognostic factors in clinical stage 1 non-seminomatous testicular
tumours.
SO - Curr Opin Urol 2001 Sep;11(5):531-4
AD - Department of Urology, University Medical Center St Radboud, Nijmegen,
The Netherlands. f.witjes@uro.azn.nl
For patients with a clinical stage 1 non-seminomatous germ cell tumour
of the testis cure rates should be close to 100%, whether surveillance,
primary surgery, primary chemotherapy or a combination is chosen. The
identification of patients with microscopic metastases is difficult.
Even with the best predictive factors currently available (vascular
invasion and percentage embryonal cell carcinoma in the primary tumour),
the identification of micro-metastases is no better than the flip of a
coin. Several additional prognostic factors have been studied, but none
is yet applicable in daily practice.
20
UI - 21425466
AU - Anonymous
TI -
Current world literature. Oncology: bladder and testis.
SO - Curr Opin Urol 2001 Sep;11(5):553-61
21
UI - 21455681
AU - Ono Y; De-Meyts ER; Guellaen G; Bulle F
TI -
Sporadic testicular germ cell cancers do not exhibit specific alteration
in CAG/CTG repeats containing genes expressed in human testis.
SO - Oncogene 2001 Sep 6;20(39):5548-53
AD - Unite 99 INSERM, Hopital Henri Mondor, 94010 Creteil, France.
CAG/CTG repeat expansions in genomic DNA of testicular tumour cell
lines, and germline DNA from members of families predisposed to this
malignancy, have been previously described. In order to identify genes
possibly concerned by this alteration, we attempted to clone all
possible human testis cDNA containing at least five CAG/CTG repeats.
Thirty-four different transcripts were identified. By using PCR and non
denaturing gel electrophoresis, we determined the size of their repeats,
as well as their polymorphisms in a collection of human testicular germ
cell tumours and the normal surrounding tissues. For all tested genes,
we detected the presence of several species of the same mRNA for each
person. Nine genes exhibited specific patterns of expression among
different groups of individuals, indicative of polymorphism. None of
these polymorphisms was related to human testicular tumours.
22
UI - 20253605
AU - Tekin A; Aygun YC; Aki FT; Ozen H
TI -
Bilateral germ cell cancer of the testis: a report of 11 patients with a
long-term follow-up.
SO - BJU Int 2000 May;85(7):864-8
AD - Department of Urology, School of Medicine, Hacettepe University, Ankara,
Turkey.
OBJECTIVE: To describe the incidence, clinical characteristics,
treatment methods and long-term follow-up of bilateral germ cell tumours
of the testis (GCTT) in patients treated at one institution. PATIENTS
AND METHODS: Of 552 patients with GCTT, 11 (2%, mean age 26. 9 years)
developed bilateral disease; all 11 underwent radical orchidectomy.
Additional treatment was planned according to the histological type and
clinical stage of the tumour, and previous treatments. Intramuscular
testosterone was administered periodically after total castration. The
data on survival, sexual status and treatment complications were
reviewed. RESULTS: Of the 11 patients, seven developed a second tumour
metachronously (median interval 87 months) and four had synchronous
bilateral GCTT. Cryptorchidism, infertility or atrophic testis was
associated with the development of bilateral GCTT in seven of the 11
patients. All synchronous tumours and most of the sequential tumours had
identical histology on both sides. Although all sequential tumours
presented at an early clinical stage, three of four synchronous
bilateral GCTTs presented at an advanced stage. Five patients received
platinum-based chemotherapy; three patients underwent post- chemotherapy
resection of the retroperitoneal residual mass. Sexual libido and
potency were conserved in all patients. No significant morbidity was
recorded as being caused by any of these treatments. At a median
follow-up of 11. 6 years, all patients were alive with no evidence of
cancer. CONCLUSIONS: All patients with unilateral GCTT have an increased
risk of developing a contralateral testicular tumour, even decades after
diagnosis. Management should be adapted to each patient. As all patients
in this series survived in the long-term, developing a second germ cell
cancer does not necessarily predict a poor prognosis.
23
UI - 21119554
AU - Heidenreich A; Weissbach L; German Testicular Cancer Intergroup
TI -
Bilateral germ cell cancer of the testis: a report of 11 patients with a
long-term follow-up.
SO - BJU Int 2001 Feb;87(3):278-80
24
UI - 21287672
AU - Janetschek G; Peschel R; Hobisch A; Bartsch G
TI -
Laparoscopic retroperitoneal lymph node dissection.
SO - J Endourol 2001 May;15(4):449-53; discussion 453-5
AD - Department of Urology, University of Innsbruck, Austria.
PURPOSE: Retroperitoneal lymph node dissection is the most sensitive and
specific diagnostic modality for detecting occult lymph node metastases
in clinical stage I testicular tumor. In stage II disease, residual
tumors after chemotherapy have to be removed surgically. To reduce the
morbidity of these procedures we have replaced open surgery by
125 patients underwent laparoscopic RPLND (stage I: 76 pts., stage II:
49 pts.) RESULTS: Laparoscopic RPLND could be completed as planned in
all but two patients in whom bleeding required conversion to open
surgery. Once the learning curve had been overcome, mean operative time
decreased significantly from 476 to 219 min for stage I and averaged 226
min in stage IIB disease. Only minor postoperative complications
occurred such as asymptomatic lymphoceles (7 pts.) and chylous ascites
(6 pts.). Mean post-op hospital stay was 3.3 and 3.5 days, respectively
(stages I and II). Mean followup is currently 46 months for stage I and
35 months for stage II tumors. Over this period a single retroperitoneal
recurrence was observed (stage I), which, however, was not due to
surgical failure, but to false negative histologic findings. All other
patients have remained free of relapse. CONCLUSIONS: Laparoscopic RPLND
is a demanding procedure with a long and steep learning curve. It has
proved feasible also after chemotherapy. The diagnostic accuracy of
laparoscopic RPLND was as good as that of the open procedure, while the
morbidity is significantly lower. Tumor control was not compromised by
the laparoscopic approach.
25
UI - 21318320
AU - Incarbone GP; Poletti F; Salsi P; Sebastio N; Cortellini P; Gabrielli M;
TI -
Crafa P
[Report of 2 cases extragonadal germ cell neoplasia with primary burnt
out tumor of the testis]
SO - Acta Biomed Ateneo Parmense 2000;71(1-2):53-7
AD - Divisione di Urologia, Azienda Ospedaliera di Parma.
If the histogenesis of the extragonadal germ cell tumor is a still
debatable subject, its clinical diagnosis remains a question of no
immediate solution. In fact, only the keen histologic evaluation of
microfocuses and/or scar tissue in the testis, possibly on the guide of
US finding, could give the answer about the primitiveness or not of the
extragonadal neoplasia. Which implies, of course, some problems of
compliance on the part of young locally symptomless men, especially on
the ground of possibly bilateral involvement.
26
UI - 21456675
AU - Wittekind C; Loy V
TI -
[Pathology and pathomorphologic diagnosis of germ cell tumors of the
testis]
SO - Pathologe 2001 Sep;22(5):316-25
AD - Institut fur Pathologie, Universitatsklinikum Leipzig, Liebigstrasse 26,
04103 Leipzig. wittc@medizin.uni-leipzig.de
Testicular germ cell tumors are rare and comprise about 90% of all
testis tumors. Genetic factors may play a role in the pathogenesis as
can be deduced by a higher family-linked incidence and the p53 gene
seems to be important in the development of these tumors which derive
from a malignant transformed germ cell. Testicular intraepithelial
neoplasia (TIN) may differentiate in two directions, namely into
seminomas which comprise nearly 50% of all testicular germ cell tumors
and non-seminomas. Since the term "differentiated teratoma" may be
misleading, we propose the use of the term "teratoma" only. A
preoperative diagnosis by biopsy is not indicated. An exact
postoperative diagnosis including all necessary classifications,
particularly the WHO and the TNM classifications, requires a very
careful preparation of the resected specimen. The histological diagnosis
should list all the different types of the WHO classification and the
percentage of the tumor should be indicated, at least for embryonal
carcinomas. For T categorisation in the TNM classification, the presence
of invasion of veins or lymph vessels is important. Documentation,
preferably in the form of a standard checklist, is strongly recommended.
27
UI - 21467940
AU - Danikas D; Sachs R; Dressner RM; Arvanitis ML
TI -
Testicular metastasis from ileal carcinoid: report of a case.
SO - Dis Colon Rectum 2001 Sep;44(9):1365-6
AD - Department of Surgery, Monmouth Medical Center, Long Branch, New Jersey,
USA.
PURPOSE: This report presents a patient with testicular metastasis from
an ileal carcinoid. METHODS: This was a retrospective case review with
literature review. RESULTS: The patient underwent right orchiectomy for
a solid mass. Pathology revealed carcinoid tumor. Octreotide scan showed
increased concentration in the right lower quadrant of the abdomen.
Computerized tomography results were negative. Colonoscopy with biopsy
revealed carcinoid of the terminal ileum. The patient underwent an
elective resection of the terminal ileum and the right colon. Pathology
revealed carcinoid tumor with vascular and lymphatic invasion present,
and eight lymph nodes were positive. The patient had adjuvant treatment
with octreotide. CONCLUSION: Carcinoid tumors have been reported to
metastasize to numerous areas. This is the first report of testicular
metastasis from ileal carcinoid. Primary carcinoids of the testicle have
been reported also. The clinician should be aware of this rare
metastatic event. When pathology reveals carcinoid of the testicle,
metastatic disease should be excluded before the tumor is identified as
primary.
28
UI - 21473607
AU - Molto Marhuenda J; Mora Rufete A; Gonzalvez Gasch A; Sanchez Sevillano
TI -
A; Lopez Menendez V; Martin Hidalgo A
[Leydig cell tumor, gynecomastia, and inferior vena cava thrombosis]
SO - An Med Interna 2001 Aug;18(8):432-4
AD - Servicios de Medicina Interna, Hospital General Universitario de Elche,
Alicante.
Leydig cell tumor is a testicular tumor with a low incidence
characterized by a high estrogens secretion from the tumoral cells. Its
more frequent clinical presentation is a testicular nodule with or
without other endocrine manifestations due to estrogenic hypersecretion.
We're reporting a case of a Leydig cell tumor with high plasmatic levels
of estradiol, gynecomastia and inferior cava vein thrombosis, which
hasn't been described among its clinical features up to now. Vascular
thrombotic phenomenons have already been reported in other clinical
situations with hiperestrogesism and they could also be associated with
these tumors. Patients with Leydig cell tumors could be at a higher risk
of developing thromboembolic phenomenons because of tumoral
hyperestrogenism and could present thrombotic complications among the
clinical findings.
29
UI - 21426708
AU - Jain M; Aiyer HM; Bajaj P; Dhar S
TI -
Intracytoplasmic and intranuclear Reinke's crystals in a testicular
Leydig-cell tumor diagnosed by fine-needle aspiration cytology: a case
report with review of the literature.
SO - Diagn Cytopathol 2001 Sep;25(3):162-4
AD - Department of Pathology, Lady Hardinge Medical College and S.K.
Hospital, New Delhi, India.
We report on the cytopathologic findings of a Leydig-cell tumor of the
testis in a young adult male with no evidence of endocrine dysfunction.
The preoperative diagnosis was based on fine-needle aspiration cytology
(FNAC) alone, which was subsequently confirmed on histopathology. The
present case was of interest on account of the paucity of literature
regarding the cytodiagnosis of this lesion. In addition, the finding of
intracytoplasmic lipofuscin pigment and several intracytoplasmic as well
as intranuclear Reinke's crystals served to clinch the diagnosis on FNA.
Therefore, the use of FNAC, especially in the presence of diagnostic
Reinke's crystals, may vitiate the need for more invasive biopsy
procedures in the preoperative diagnosis of testicular Leydig-cell
tumors. Copyright 2001 Wiley-Liss, Inc.
30
UI - 99398922
AU - Lane TM; Wilde M; Schofield J; Trotter GA
TI -
Benign cystic mesothelioma of the tunica vaginalis.
SO - BJU Int 1999 Sep;84(4):533-4
AD - Departments of Surgery and Cellular Pathology, The Maidstone Hospital,
Kent, UK.
31
UI - 96223436
AU - Narasimhan P; Kalra J
TI -
Ethical questions on the testicular seminoma study.
SO - J Clin Oncol 1996 Feb;14(2):684
32
UI - 97054309
AU - Foley SJ; De Winter P; McFarlane JP; Shah PJ; Bahadur G
TI -
Storage of sperm and embryos. Cryopreservation of sperm should be
offered to men with testicular cancer.
SO - BMJ 1996 Oct 26;313(7064):1078
33
UI - 21269963
AU - Bajdik CD; Phillips N; Huchcroft S; Hill GB; Gallagher RP
TI -
Cancer in the mothers and siblings of testicular cancer patients.
SO - Can J Urol 2001 Apr;8(2):1229-33
AD - Cancer Control Research, British Columbia Cancer Agency, Vancouver, BC,
Canada.
Some families seem to have an increased risk of several different
cancers and a reduced risk of others. Either genetic predisposition or a
shared environment may explain this familial clustering, and the type of
cause can affect how family members should be advised. We used data from
a case-control study to examine the risk of cancer in the mother,
sisters and brothers of men with testicular cancer. Our results show a
significant relative risk (RR=1.7; 95% confidence interval (CI):
1.05-2.6) of cancer for sisters of testicular cancer patients in
comparison with the sisters of controls. When data were combined for
brothers and sisters, the RR for all cancers was 1.53 (CI: 1.1-2.3).
Despite the limitations of our data, there is evidence for cancer
clustering in the families of testicular cancer patients. Unfortunately,
the evidence is consistent with either a genetic or environmental
etiology.
34
UI - 21269964
AU - Lo KC; Wong C; Emond J; Aprikian AG
TI -
Scrotal orchiectomy for a large testicular seminoma.
SO - Can J Urol 2001 Apr;8(2):1234-6
AD - Department of Urology, Montreal General Hospital, McGill University
Health Centre, Montreal, Quebec, Canada.
Our patient had neglected a growing left testicular mass over a 5-year
period. Due to the large size of the tumor a scrotal delivery was
necessary. Pathology showed a 1.6 kg pure classic seminoma. Metastatic
work up revealed stage IIC disease and he was treated with primary
cisplatin-based chemotherapy and remains free of recurrence after 24
months. The potential risk of scrotal violation is discussed.
35
UI - 21279588
AU - Augustin H; Schips L; Vilits P; Zigeuner R; Petritsch HP; Uggowitzer M;
TI -
Hubmer G
Handicap of walking by a huge paratesticular liposarcoma.
SO - Urol Int 2001;66(4):229-30
AD - Department of Urology, Karl Franzens University, Graz, Austria.
herbert.augustin@klinikum-graz.at
We describe the case of a 71-year-old male with a huge left-sided
paratesticular tumour, whose walking was increasingly handicapped by
this vast mass. Two palliative excisions of tumour tissue were
performed. Histology revealed a poorly differentiated paratesticular
liposarcoma. The patient achieved satisfying mobility for several months
before he died of cachexia. Copyright 2001 S. Karger AG, Basel
36
UI - 21291612
AU - Arranz Arija JA; Garcia del Muro X; Guma J; Aparicio J; Salazar R; Saenz
TI -
A; Carles J; Sanchez M; Germa-Lluch JR
E400P in advanced seminoma of good prognosis according to the
international germ cell cancer collaborative group (IGCCCG)
classification: the Spanish Germ Cell Cancer Group experience.
SO - Ann Oncol 2001 Apr;12(4):487-91
AD - Hospital Gregorio Maranon, Madrid, Spain.
PURPOSE: To evaluate the efficacy and toxicity of primary chemotherapy
with the schedule E400P in the treatment of patients with early stage II
(IIa and IIb) and advanced seminoma of good prognosis according to the
international classification (IGCCCG). PATIENTS AND METHODS: Sixty-four
patients were included. E400P consisted of cisplatin 25 mg/m2/day and
etoposide 100 mg/m2/day for four days, every three weeks. Royal Marsden
stages were IIab: 53% and IIc-IV: 47%. Twenty-three percent had high
BHCG levels, twenty-seven percent had LDH > 2 x N. Sixty-two patients
were of good prognosis according to the Medical Research Council
classification. RESULTS: Response rate was 98% (69% complete remission,
29% residual disease). After a median follow-up of 34 months, treatment
failure was seen in 7 patients (11%). Neutropenia (32%) was the most
relevant grade 3-4 toxicity. Other important grade 3-4 side effects were
found in less than 5%. Three-year time to treatment failure (TTF) was
89% (95% confidence intervals (CI): 80%-97%) for all patients, 91% (95%
CI: 80%-99%) for stages IIa-b, and 87% (95% CI: 74%-99%) for stages
IIc-IV. Three-year overall survival (OS) was 97% (95% CI: 93%-99%) for
all patients and 95% (95% CI: 85%-99%) for stages IIa-b. CONCLUSIONS:
E400P was a very active and safe regimen in good-prognosis advanced
seminoma, with low toxicity rates. Definitive comparisons of this
regimen with radiotherapy in stages IIa-b or with the more standard
E500P or BEP, could be of interest.
37
UI - 21481156
AU - Bates MN; Fawcett J; Garrett N; Arnold R; Pearce N; Woodward A
TI -
Is testicular cancer an occupational disease of fire fighters?
SO - Am J Ind Med 2001 Sep;40(3):263-70
AD - Institute of Environmental Science and Research Ltd., Kenepuru Science
Centre, PO Box 50-348, Porirua, New Zealand. m_bates@uclink.berkeley.edu
BACKGROUND: A previous investigation showed an increased risk of
testicular cancer among fire fighters in Wellington City, New Zealand,
during the 1980s. Other studies of fire fighters had not identified
testicular cancer as an occupational disease. METHODS: This was an
historical cohort study of mortality and cancer incidence in all paid
New Zealand fire fighters, from 1977 to 1995. RESULTS: The only cancer
for which this study provided evidence of an increased risk was
testicular cancer, even after excluding cases from the previous
investigation. The standardized incidence ratio for 1990-96 was 3.0 (95%
confidence interval: 1.3-5.90). There was no evidence that fire fighters
were at increased risk from any particular cause of death. CONCLUSIONS:
This study confirmed that New Zealand fire fighters are at increased
risk of testicular cancer, although the reason is unknown. Other
incidence studies of cancer in fire fighters are needed to confirm this
finding. Copyright 2001 Wiley-Liss, Inc.
38
UI - 21477282
AU - Bartkova J; Falck J; Rajpert-De Meyts E; Skakkebaek NE; Lukas J; Bartek
TI -
J
Chk2 tumour suppressor protein in human spermatogenesis and testicular
germ-cell tumours.
SO - Oncogene 2001 Sep 13;20(41):5897-902
AD - Danish Cancer Society, Institute of Cancer Biology, Strandboulevarden
49, DK-2100 Copenhagen O, Denmark.
Chk2 is a transducer of DNA damage signals and a tumour suppressor whose
germ-line mutations predispose to diverse tumour types. Unlike its
downstream targets such as the p53 tumour suppressor, the expression
patterns of Chk2 in tissues and tumours remain unknown. As DNA breaks
occur commonly during gametogenesis, and p53 is wild-type and
overexpressed in testicular cancer, we examined abundance and
localisation of the Chk2 protein during normal development of human
testes, and at various stages of germ-cell tumour (GCT) pathogenesis.
Our results show that Chk2 is abundant in foetal germ cells and adult
spermatogonia, yet only weakly expressed or lacking during the meiotic
and later stages of spermatogenesis. High levels of Chk2 are detected in
the majority of GCTs including all pre-invasive carcinoma-in-situ
lesions, contrary to variable e
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