Distribution of testicular tumors in Lebanon: a single institution overview.

BACKGROUND: Testicular tumors constitute a rare type of cancer affecting adolescents and young adults with recent reports confirming an increase in incidence worldwide. The purpose of this study was to estimate the epidemiological characteristics and histological subtypes of testicular tumors in the Lebanese population according to the WHO classification of testicular and paratesticular tumors. MATERIALS AND METHODS: In this single institutional retrospective study, all patients diagnosed with a testicular tumor in Hotel-Dieu de France Hospital University in Beirut between 1992 and 2014 were enrolled. The age, subtype based on the 2004 WHO classification and body side of tumor were analyzed. RESULTS: A total of two hundred and forty-four (244) patients diagnosed with a testicular tumor in our institution were included in the study. Two hundred and one patients (82.4% of all testicular tumors) had germ cell tumors (TGCT). Among TGCT, 50% were seminomatous tumors, 48% non-seminomatous tumors (NST) and 2% were spermatocytic seminomas. The NST were further divided into mixed germ cell tumors (63.9%), embryonic carcinomas (18.6%), teratomas (15.4%) and yolk sac tumors (2.1%). The mean age for testicular tumors was 32 years. The mean age for germ cell tumors was 31 years and further subtypes such as seminomatous tumors had a mean age of 34 years, 28 years in non-seminomatous tumors and 56 years in spermatocytic seminoma. Patients with right testicular tumor were the predominant group with 55% of patients. Three patients (1.2%) presented with bilateral tumors. CONCLUSIONS: The distribution of different subgroups and the mean age for testicular tumors proved comparable to most countries of the world except for some Asian countries. Germ cell tumors are the most common subtype of testicular tumors with seminomatous tumors being slightly more prevalent than non-seminomatous tumors in Lebanese patients.

El reto de mejorar el pronóstico de los niños y adolescentes con cáncer: modelo de investigación traslacional del cáncer pediátrico del Hospital Universitario Vall d´Hebron / The challenge of improving the prognosis of children and adolescents with cancer: translation research model of teh University Hosptial Vall d´Hebron

La neoplasias malignas en niños y adolescentes son enfermedades raras que muestran un pronóstico y comportamiento biológico muy diverso. Aunque el pronóstico del cáncer en la edad pediátrica ha mejroado considerablemente en las últimas décadas, incluso con los tratamiento actuales, un número considerable de estos pacientes sigue padeciendo recaídas y el cáncer es una de las causas más frecuentes de muerte en este grupo de edad. En consecuencia, los pediatras oncólogos necesitamos nuevos enfoques para mejorar la eficacia de las terapias contra el cáncer. En este artículo describimos las estrategias seguidas en nuestro programa de investigación (AU)

Malignancies in childrena nd adolescent are rare diseases with diverse prognosis and biological behaviour. The prognosis of childhood cancer has improved considerably in recent decades and suvival is approximately 70% in developed countries. However, even with current treatments, a significant number of these patients stills suffer relapse and cancer in the second most common cause of death among children and adolescents. Inour research progam, molecular diagnostic, detectionof minimal disseminated disease and identification of new therapeutic strategies are the pillars that can improve the results of current treatments for childhood cancer. In this report we describe the research strategies of our program (AU)

Subtype-specific incidence of testicular cancer in Germany: a pooled analysis of nine population-based cancer registries.

Comparisons of incidence estimates of testicular cancer subtypes beyond seminoma and non-seminoma are virtually missing in the epidemiologic literature. We analysed incidence data from population-based German cancer registries to provide subtype-specific incidences of testicular cancer. We pooled data from nine cancer registries from 1998 to 2003. We estimated incidence and mortality time trends of West and East Germany. Incidence and mortality were standardized by the European standard population. The annual percentage incidence change from 1961 through 1989 was 4.9% in East Germany and 3.0% from 1970 through 2004 in Saarland. Incidence increases were the most pronounced among adolescents and young men aged 15-49 years. In 1998-2003, the seminoma incidence rate was 5.1 per 100,000; among non-seminomas, the rates were the highest for malignant teratoma (1.6 per 100,000), followed by embryonal carcinoma (1.2 per 100,000). Testicular lymphomas were rare (0.1 per 100,000). The incidence of testicular cancer among children aged 0-14 years was nearly constant from 1987 through 2004. Majority of these cancers were yolk sac tumours (0.1 per 100,000). In East and West Germany, rates of embryonal carcinoma in the early periods were considerably lower than the rates of malignant teratoma. In the most recent periods, rates of embryonal carcinoma became quite similar to the rates of malignant teratoma. The mortality decline started in West Germany roughly 12 years earlier than in East Germany. The later start of the mortality decline in East Germany may be because of a later introduction of platinum-based chemotherapy compared to West Germany.

Testicular tumors in children and adolescents.

OBJECTIVE: To analyze the spectrum of testicular tumors in children in an unselected population-based series, as well as the results of testis-preserving surgery. PATIENTS AND METHODS: Our hospital database was analyzed for operations for testicular tumors from 1981 to 2006. The clinical data and findings during follow up (4.7 years) were recorded. RESULTS: Thirty-four patients were operated on because of testicular tumors. In 23 (68%) the tumor was benign: benign teratoma (16), Leydig-cell tumor (2), epidermoid cyst (2), Sertoli-cell tumor (1), cystic dysplasia (1), intratesticular focal fibrosis (1). Eleven patients (32%) had a malignant tumor: yolk-sac tumor (6), embryonal carcinoma (5). Twenty out of the 26 (77%) prepubertal boys had a benign tumor in contrast to only three of the eight (38%) adolescent males (P=0.079). Testis-preserving surgery was performed in 10 patients. In eight, the tumor was curatively excised and remaining testis preserved. Two patients with benign teratoma had a recurrence due to incomplete primary resection. In one patient who underwent orchiectomy for benign teratoma, two metachronous teratomas were detected in the contralateral testis 6 years after primary surgery. CONCLUSIONS: In children, most testicular tumors are benign, especially before puberty. If testis-preserving surgery is contemplated, complete excision of the tumor should be ascertained. The possibility of metachronous bilateral tumors should be considered in the follow up of testicular teratomas.

Testicular-sparing surgery for the prepubertal testicular tumor. Experience of two cases with large cell calcifying Sertoli cell tumors.

PURPOSE: We review prepubertal germ cell tumors of testis in our institute and the Japanese registry and present 2 cases with a large cell calcifying Sertoli cell tumor (LCCSCT) and discuss the possibility of testis-sparing surgery. MATERIALS AND METHODS: Incidence, age, pathology and clinical stages of prepubertal germ cell tumors are surveyed for 30 years at our department and 10 years of the malignant tumor registry of the Japanese Society of Pediatric Surgery. Two representative prepubertal boys with LCCSCT are presented. One of them was treated by partial orchiectomy. RESULTS: The majority of testicular germ cell tumors in the prepubertal age were composed of embryonal cell carcinoma/yolk sac tumors or teratoma, occurred in preschool age, were limited to clinical stage I and did not metastasize irrespective of histology. Benign behavior which included recovery from hormonal derangement, no tumor recurrence and negative antisperm antigen was observed in 2 cases with LCCSCT who underwent either radical orchiectomy or partial orchiectomy. CONCLUSION: Partial orchiectomy should be considered as a standard option in prepubertal schoolboys with a testicular mass if surgically feasible. This surgical treatment is safe and preserves fertility and is psychologically advantageous. It is not recommended for yolk sac tumors that may recur, however they are rare in prepubertal boys and can be differentiated preoperatively by prudent evaluation.

[Clinical statistics of stage I testicular tumor].

PURPOSE: A survey of stage I testicular tumors in the Chugoku-Shikoku district was taken in order to explore the clinical characteristics. PATIENTS AND METHODS: Three hundred and forty eight cases of stage I testicular tumor treated at 46 facilities in the Chugoku-Shikoku district between 1984 and 1992 were collected. Subjects' background factors, treatment methods and prognosis were studied. RESULTS: Tissue types were 249 (71.6%) seminoma and 99 (28.4%) non-seminoma. Adjuvant therapy for seminoma cases included 138 post-operative radiotherapy (4 recurrences, 3 cancer deaths), 57 chemotherapy (no recurrences, 2 contralateral testis tumor cases) and 48 were under surveillance (no recurrence). Adjuvant therapy for non-seminoma cases included 47 chemotherapy (1 recurrence) and retroperitoneal lymph node dissection was performed on 6 cases. Forty cases were under surveillance (1 recurrence). Of 8 (2.3%) cases with recurrence, 6 showed onset within two years and 2 after two years. Four of the 8 cases with recurrence were seminoma (1.1% of seminoma cases) and the other 4 were non-seminoma (4.0% of non-seminoma cases). All 3 (0.9% of all cases) of the cancer death cases were seminoma that received post-operative radiotherapy, while there were no cancer deaths in non-seminoma cases. CONCLUSION: Prognosis of stage I testicular tumor is good. Although the recurrence rate was higher in non-seminoma cases, cancer deaths were only observed in seminoma cases.

Genital anomalies and risk for testicular cancer in Danish men.

In a cohort of Danish boys characterized by (1) being born between 1941 and 1957, (2) having attended schools in a defined area of Denmark, and (3) having a school health record available, 183 were registered in the Danish Cancer Registry with testicular cancer diagnosed before January 1, 1985. We selected 366 age- and sex-matched controls from the same cohort. Using information recorded by school physicians, we performed logistic regression analyses to estimate the relative risks (RR) associated with various genital anomalies. We found the risk for testicular cancer to be raised for men with a history of cryptorchidism [RR = 5.2; 95% confidence interval (CI) = 2.1-13.0], inguinal hernia (RR = 1.8; 95% CI = 0.9-3.7), hypospadias (RR = 4.2; 95% CI = 0.4-42.7), and hydrocele (RR = 2.4; 95% CI = 0.6-9.0). We observed no decrease in the risk associated with cryptorchidism after correction of the maldescent in early childhood. The RR of testicular cancer in the contralateral, normally descended testis in unilateral cryptorchid men was increased to 3.6. The results add to the growing evidence for a common causal factor for both testicular cancer and cryptorchidism and support the findings from other studies of associations between other genital anomalies involving the closure of the processus vaginalis and the risk of testicular cancer.

Familial testicular carcinoma: in search of genetic triggers.

Two cases of testicular tumours in non-twin brothers of a cancer-prone family are described. Cytogenetic studies of these two patients and human leucocyte antigen (HLA) typing of the family failed to identify any genetic defects. The authors propose using linkage analysis for further genetic studies but would require additional families for this to be performed.

A 18 years study of testicular tumours in Jodhpur, western Rajasthan.

The present study based on WHO histologic typing of testicular tumours deals with 100 cases recorded in the files of the Department of Pathology from 1969 to 1987. These tumours accounted for 2.57% malignancies of male genital system. Maximum number of tumours were recorded in the third and fourth decades. Right testis was affected in 60% cases. Scrotal swelling was the predominant presenting feature, followed by pain. Five cases of testicular tumours were observed in undescended testis. Germ cell tumour of one histologic type constituted 76% of testicular tumors. Germ cell tumors of more than one histologic type were 23%. One case (1%) belonged to lymphoid and haemopoietic system and was of large cell lymphocytic lymphoma. Amongst the germ cell tumors with one histologic type, seminoma (34%) and embryonal carcinoma (28%) were predominant while teratocarcinoma was a predominant tumour in combination group.

Incidencia de neoplasia testicular en hermanos no mellizos: 2 familias / Incidence of testicular neoplasia in brothers non-twins: 2 families

Se presentan 2 familias en las que se observó incidencia de cáncer de testículo en 2 y 4 hermanos no mellizos. Los tipos histológicos fueron: carcinoma embrionario 4 casos, seminoma puro 1 caso y teratocarcinoma 1 caso. Fallecen 4 de los 6 casos, a los 4, 4, 10 y 32 meses. Los 2 casos que sobreviven tienen 4 y 15 meses de observación