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Solid Tumour Section
Mini Review
Testis: Spermatocytic seminoma
Ewa Rajpert-De Meyts
Dept. of Growth & Reproduction, Copenhagen University Hospital, Rigshospitalet, Section GR-5064, 9
Blegdamsvej, DK-2100 Copenhagen, Denmark (ERDM)
Published in Atlas Database: November 2003
Online updated version : http://AtlasGeneticsOncology.org/Tumors/SpermatSeminID5119.html
DOI: 10.4267/2042/38059
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 2.0 France Licence.
© 2004 Atlas of Genetics and Cytogenetics in Oncology and Haematology
Identity
Clinics and pathology
Alias: Spermatocytoma
Note: Spermatocytic seminoma is a rare testicular
neoplasm derived from germ cells. It was first
described by Masson in 1946. This tumour occurs
exclusively in the testes, in relatively older men. There
is no female (ovarian) equivalent.
Disease
Spermatocytic seminoma has a relatively mild clinical
course. Most patients present with a painless swelling
of one testis, but in some cases tenderness was
reported. Metastases are very rare and have been
basically reported only in cases with sarcomatous
transformation.
Classification
Phenotype / cell stem origin
Note
Classification of germ cell tumours has not been
adapted uniformly in the world. Two classifications
most commonly used are the modified WHO
classification and the British Testicular Panel (BTTP)
classification. In addition Grigor proposed in 1993 a
new classification based on biological features, and it
was suggested in the AFIP Atlas of Tumor Pathology a
modified classification of testicular and paratesticular
tumours and tumour-like lesions. Spermatocytic
seminoma is classified in these four systems as follows:
Atlas Genet Cytogenet Oncol Haematol. 2004; 8(1)
The origin of spermatocytic seminoma from the germ
cell lineage has been clearly demonstrated by a number
of studies, however the cell of origin have been a
matter of debate. The initial hypothesis suggested that
the spermatocyte was the progenitor cell and the
tumour might contain post-meiotic haploid cells.
Subsequent studies failed to find haploid DNA values,
thus arguing against a true meiotic-phase tumour.
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Testis: Spermatocytic seminoma
Rajpert-De Meyts E
En example of spermatocytic seminoma, HE-stained.
A high power image showing characteristic polymorphism of the cell nucleus size of spermatocytic seminoma.
Other hypotheses stipulated that spermatocytic
seminoma might be a better differentiated variant of
classical seminoma (composed of cells differentiating
in the direction of spermatocytes but which have not
yet reached this stage) or may originate from type B
(dark) spermatogonia, which are committed to enter
meiosis.
Finally, some researchers suggested that spermatocytic
seminoma might be derived from primordial germ cells
or gonocytes. The current consensus, based on
comparative studies of the phenotypes of spermatocytic
seminoma, normal germ cells and other germ cell
derived tumours, is that spermatocytic seminoma is
derived from spermatogonia that are committed to enter
meiosis but have not yet done so.
Importantly, spermatocytic seminoma is not derived
from carcinoma in situ (CIS), the gonocytes-like
Atlas Genet Cytogenet Oncol Haematol. 2004; 8(1)
intratubular precursor lesion for germ cell tumours of
adolescents and young adults (classical seminoma and
non-seminoma).
Etiology
Aetiology of spermatocytic seminoma is unknown.
Epidemiology
Spermatocytic seminoma is rare and represents around
2-5% of seminomas. It occurs in patients at 45-80 years
of age, and is extremely rare in young men under than
35. This is in contrast to the classical seminoma, which
demonstrates the peak of age-specific incidence around
35 years of age.
Cytology
A characteristic feature of spermatocytic seminoma is
the presence of three types of cells with different
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Testis: Spermatocytic seminoma
Rajpert-De Meyts E
nuclear size: large, small and intermediate. Some nuclei
may exhibit a presence of nuclear thread-like
chromatin.
Evolution
Some cases of spermatocytic seminoma may
undergo sarcomatous transformation and spread outside
the testis. An anaplastic variant was also described.
Pathology
There is no specific marker for spermatocytic
seminoma. Proteins/antigens that are highly expressed
in spermatogonia (most of them also present in
gonocytes and primary spermatocytes), such as SSX
(synovial sarcoma on X chromosome), NSE (neuronspecific enolase), CHK2, MAGE-A4, NY-ESO-1,
VASA are present in spermatocytic seminoma.
Antigens expressed in embryonic germ cells but not in
the normal adult testis, e.g. PLAP (placental-like
alkaline phosphatase), TRA-1-60, or KIT are usually
undetectable in spermatocytic seminoma. High
expression of p53 protein in a subset of cells was
demonstrated in approximately 80% of cases. Proteins
highly abundant in post-meiotic spermatids, e.g.
p19INK4d, are usually not present in spermatocytic
seminoma. The expression of telomerase (the RNA
component) in spermatocytic seminoma was found to
be moderate: lower than in classical seminomas but
higher than in mature teratomas.
Genetics
Note
No specific germ-line chromosomal aberration or gene
mutations were reported in patients with spermatocytic
seminoma.
Cytogenetics
Note
Cytogenetic studies demonstrated variable ploidy of the
different cell populations in spermatocytic seminoma,
with prevalence of diploid and polyploid cells. No
haploid values were found.
Cytogenetics Molecular
Only one molecular study of 4 spermatocytic
seminomas was performed to date. A uniform gain of
chromosome 9, and less consistent gains of
chromosomes 1 and 20, and loss of chromosome 22
material were found by comparative genomic
hybridisation.
Treatment
Spermatocytic seminoma
(orchiectomy).
is
treated
by
surgery
MAGE-A4 antigen is abundant is spermatocytic seminoma (visible in a lower part of the picture). Note that MAGE-A4 is also present in
spermatogonia (visible in the upper part) (from Rajpert-De Meyts et al. Histopathology 2003).
Atlas Genet Cytogenet Oncol Haematol. 2004; 8(1)
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Testis: Spermatocytic seminoma
Rajpert-De Meyts E
Delgado R, Rathi A, Albores-Saavedra J, Gazdar AF.
Expression of the RNA component of human telomerase in
adult testicular germ cell neoplasia. Cancer. 1999 Nov
1;86(9):1802-11
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This article should be referenced as such:
Rosenberg C, Mostert MC, Schut TB, van de Pol M, van
Echten J, de Jong B, Raap AK, Tanke H, Oosterhuis JW,
Looijenga LH. Chromosomal constitution of human
spermatocytic seminomas: comparative genomic hybridization
supported by conventional and interphase cytogenetics. Genes
Chromosomes Cancer. 1998 Dec;23(4):286-91
Atlas Genet Cytogenet Oncol Haematol. 2004; 8(1)
Rajpert-De Meyts E. Testis: Spermatocytic seminoma. Atlas
Genet Cytogenet Oncol Haematol. 2004; 8(1):57-60.
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