Testicular teratoma

Testicular teratomas produced during a period of testicular growth stimulated by increased photoperiod (Guthrie 1971). 

Guthrie, J. 1971. Zinc induction of testicular teratomas in Japanese quail (Cotumix cotumix japonica) after photo-periodic stimulation of testis. Brit. Jour. Cancer 25 311-314. 

Patients with malignant disease show increased LD activity in serum up to 70% of patients with fiver metastases and 20% to 60% of patients with other nonhepatic metastases have elevated total LD activity. Notably elevated LD-1 is observed in germ cell tumors (61% of cases), such as teratoma, seminoma of the testis, and dysgerminoma of the ovary. Patients with seminoma have a raised LD-1 m 63% of cases compared with 60% in nonseminoma cases. The percent of patients with increased LD-1 depended on the stage of the disease. LD-1 appeared to be a useful predictor of outcome in patients with testicular germ cell tumors. 

Walker AH, Bernstein L, Warren DW, Warner NE, Zheng X, Henderson BE (1990) The effect of in utero ethinyl oestradiol exposure on the risk of cryptorchid testis and testicular teratoma in mice. Br J Cancer 62 599-602... 

To be of value in progntrsis, the concentration of the tumour marker should correlate with tumour mass. For example, HCG correlates well with the tumour mass in choriocarcinoma. HCG and alphafetoprotein (AFP) correlate with the tumour ma.ss in testicular teratoma, and paraproteins correlate with the tumour mass in multiple myeloma. 

Fig. 2 The use of AFP measurements In the management of a patient with a testicular teratoma.

Newell DR, Eeles RA, Gumbrell LA, Boxall FE, Horwich A, Calvert AH. Carboplatin and etoposide pharmacokinetics in patients with testicular teratoma. Cancer Chemoiher Pharmacol 9Z9) 23, 376-72,... 

Liver metastases are rare in nonseminomatous testicular tumors and are always associated with bulky lateroaortic involved lymph nodes, and frequently with mediastinal lymph node and multiple lung metastases. Thus, local approaches often take place long after systemic chemotherapy. Survival is directly correlated with the final histopathologic diagnosis virtually all patients with fibrosis or necrosis and with mature teratoma are alive at 5 years, versus only 50% of patients when cancer cells are present [50]. For renal tumors (Wilms or adenocarcinoma), the results are satisfactory after hepatectomy and are close to those achieved for colorectal primaries [51]. For sarcomas, several series report a survival rate of approximately 20% at 5 years [52]. In the largest series in the literature [53], 11% of the patients submitted to hepatectomy for liver metastases from sarcoma were alive at 5 years, and 80% of recurrences arose in the liver. For melanoma, some rare long-term survivors have been reported [54]. Nevertheless, median overall survival improved in the resected patients versus the patients who underwent exploration but were not resected. 

Pulmonary metastases are very common, being more frequently associated with tumors that have a rich systemic venous drainage, such as bone sarcomas, choriocarcinomas, melanomas, testicular teratomas, and renal and thyroid carcinomas. The detection of pulmonary metastases is crucial in the treatment of patients with cancer. 

Kahan, B. W. and Ephrussi, B. 1970. Developmental potentiahties of clonal in vitro cultures of mouse testicular teratoma. /Natl Cancer Inst 44(5) 1015-36. 

Pera, M. F., Blasco Lafita, M. J., and Mills, J. 1987. Cultured stem-cells from human testicular teratomas The nature of human embryonal carcinoma, and its comparison with two types of yolk-sac carcinoma. Int J Cancer 40(3) 334 3. 

Pierce, G. B. and Dixon, F. J. 1959. Testicular teratomas. 1. Demonstration of teratogenesis by metamorphosis of mrdtipotential cells. Cancer 12(3) 573-83. 

Stevens, L. C. and Little, C. C. 1954. Spontaneous testicular teratomas in an inbred strain of mice. Proc Natl Acad Sci USA 40(11) 1080-7. 

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