ABSTRACT
Embryonal cell carcinoma affects young males in the prime of their life with majority of tumours already having metastasised at the time of diagnosis. Subcutaneous metastasis from embryonal carcinoma is rare and is associated with widespread disease and poor prognosis. We report a case of 22-year-old male who presented with haemoptysis and skin nodules. Fine needle aspiration cytology of skin nodules and the lung lesion led to the diognosis of testicular embryonal cell carcinoma.
Subject(s)
Bone Neoplasms/secondary , Carcinoma, Embryonal/diagnosis , Carcinoma, Embryonal/pathology , Hemoptysis/etiology , Humans , Lung Neoplasms/secondary , Male , Testicular Neoplasms/diagnosis , Testicular Neoplasms/pathology , Young AdultSubject(s)
Humans , Child , Neoplasms/classification , Neoplasms/diagnosis , Carcinoma, Embryonal/diagnosis , Choriocarcinoma/diagnosis , Dysgerminoma/diagnosis , Gonadoblastoma/diagnosis , Hamartoma/diagnosis , Lymphoma/diagnosis , Rhabdomyosarcoma/diagnosis , Retinoblastoma/diagnosis , Wilms Tumor/diagnosisABSTRACT
Las lesiones del DNA que permiten las mutaciones son más frecuentemente las modificaciones, pérdidas o errores en la incorporación de nucleótidos, sin embargo, numerosas vías enzimáticas permiten la reparación de estos errores. La mejor vía de reparación descrita actualmente es a través de los genes de reparación del sistema del mismatch repair genes(MMR).Se seleccionó entre el material anatomopatológico del Departamento de Anatomía Patológica de la Universidad Católica de Chile, 118 casos de tumores testiculares, de los distintos tipos histológicos que tuvieran un seguimiento clínico completo. La fecha de la cirugía testicular fue realizada entre enero de 1995 y diciembre de 1999. Todas las muestras fueron sometidas a estudio inmuno histoquímico (IHQ)para hMLH1 y hMSH2. Creemos que ambos genes se encuentra altamente expresados en los tumores localizados y su grado de expresión disminuye conforme el tumor es más avanzado (más indiferenciado). Esta observación nos permite plantear que tal vez estos genes son capaces de actuar en las primeras fases de la tumorogénesis. En resumen, el análisis IHQ aparece como una herramienta útil para ver la expresión de hMSH2 y hMLH1 en tumores testiculares, especialmente cuando se correlaciona con elementos pronóstico, entendiendo sinduda que el desarrollo de los tumores es multifuncional.
Subject(s)
DNA Mutational Analysis/methods , DNA-Binding Proteins , Seminoma/genetics , Testicular Neoplasms , Chile , Carcinoma, Embryonal/diagnosis , Carcinoma, Embryonal/genetics , Disease-Free Survival , DNA-Binding Proteins , Biomarkers, Tumor/genetics , Biomarkers, Tumor , Seminoma/diagnosis , Testicular NeoplasmsABSTRACT
Os autores apresentam um caso de carcinoma do testículo (CT) nao-seminoma (NS) num jovem índio Xikrin, Caiapó setentrional, do sudeste do Pará, na Amazônia oriental. RELATO DE CASO. O índio desenvolveu uma metásase supraclavicular vegetante à esquerda com evoluçao progressiva num prazo de cinco meses. No exame físico, após sua remoçao a Sao Paulo, observaram que o testículo direito era tumoral. Os exames laboratoriais mostraram alfa-fetoproteína (AFP) l82U/mL, gonadotropina coriônica fraçao (beta-HCG) 43mUI/mL. O exame anatomopatológico da metástase supraclavicular foi de carcinoma embrionário e o anatomopatológico do testículo direio foi de carcinoma NS, embrionário, com áreas de teratoma maduro. Foi submetido à ressecçao cirúrgica parcial da metástase supraclavicular, à retirada cirúrgica do testículo tumoral, a três ciclos de quimioterapia. A AFP e a beta-HCG normalizaram-se após a quimioterapia. DISCUSSAO E CONCLUSAO. No mundo há registro de aumento da incidência de carcinomas germinativos entre caucasóides. O interesse desta apresentaçao está no fato de ser a primeira incidência de carcinoma diferenciado, NS, no grupo étnico de índios brasileiros e na boa evoluçao do caso, apesar de o diagnóstico ter sido estabelecido tardiamente.
Subject(s)
Humans , Male , Adolescent , Carcinoma, Embryonal/diagnosis , Clavicle , Indians, South American , Teratoma/diagnosis , Testicular Neoplasms/diagnosis , Brazil , Carcinoma, Embryonal/pathology , Carcinoma, Embryonal/therapy , Teratoma/therapy , Testicular Neoplasms/pathology , Testicular Neoplasms/therapyABSTRACT
Twenty nine cases of primary mediastinal germ cell tumours (MGCT) were seen at the Tata Memorial Hospital over a 16--year period (1974-1989). There were 5 benign MGCT occurring predominantly in females (80%), with these patients having an excellent result after surgery with all patients disease free at an median follow-up of 27 months. Malignant MGCT occurred only in males and demonstrated wide variation in response to treatment depending upon whether the tumour was seminomatous or non-seminomatous. There were 11 Seminomas, 5 Embryonal carcinomas, 5 Endodermal sinus tumours and 3 Teratocarcinomas. The diagnosis was established by surgical exploration or by biopsy of a lymph node or chest wall nodule in 20 patients. Four patients had needle biopsy. Seminomatous MGCT received radiotherapy as their main treatment modality and did well with 75% of the patients alive without disease at an average follow up of 33 months. The non-seminomatous MGCT could be divided into two groups. The mean survival for patients receiving cisplatinum based chemotherapy was 14 months as compared to the group not receiving such therapy where the survival was only 5.3 months. However, because of the advanced disease at presentation even in the group receiving cisplatinum chemotherapy, a long term complete response rate of only 20% could be achieved.