seminoma | Seminoma spermatocytic: About a case and review of the literature Spermatocytic Seminoma

Seminoma spermatocytic: About a case and review of the literature Spermatocytic Seminoma

Resume
Seminoma spermatocytic is a rare tumor, representing less than 2% of testicular cancers, occurring primarily in the elderly. We report a new observation from a patient aged 48 years. The tumor presented itself as a proliferation of cells in compact tablecloths, with 3 cell types, small cells, intermediate cells and large cells. It was not found either sarcomateux contingent or classical seminoma. Histochemistry Immune analysis did not find any expression of tumor cells for the classical antibodies tested, including the CA anti PLAP and the lymphoid markers. The Seminoma spermatocytic must be recognized because its evolution is very favorable and requires only a simple orchidectomy, in the absence of an exceptional sarcomateux contingent or metastasis where chemotherapy is required.

Keywords
Seminoma spermatocytic tumor Ttesticulaire Radiation therapy Evolution Abstract
Spermatocytic Seminoma is a rare tumor, representing less than 2% of testicular cancer, occurringly in elderly men.

We report a case of a 48-year-old male. The tumor appears as a cells proliferation in compact sheets with 3 cell types, small cell size, intermediate cells and large cells. It has been found neither sarcomatous contingent nor classic seminoma. Immunohistochemically, all markers examined were negative, especially anti PLAP and lymphoid markers. Spermatocytic Seminoma must be recognized, because its evolution is very favorable and requires only a simple orchidectomy, in the absence of a special sarcomatous transformation or metastasis for which chemotherapy is needed.

Seminoma spermatocytic: About a case and
Review of the literature Spermatocytic Seminoma
M. B. Andaloussi ¹, G. Rais ², S. Raeburn ², A. Barki ¹, El SAYEGH ¹,
A. Ibrhem ¹, Y. Nouini ¹, A. Lakshmanan ¹, L. Bear ¹, H. Ali ¹,
H. Elfeky ², M. FAIK ¹
1
Urology department "A" CHU Ibn Sina, 2
Medical Oncology Service,
National Institute of Oncology, Rabat, Morocco
RESUME
Seminoma spermatocytic is a rare tumor, representing less than 2% of cancers in the
Testicular, mainly occurring in the elderly. We report a new observation
of a 48-year-old patient. The tumor presented itself as a proliferation of cells in tablecloths
Compact, with 3 cell types, small cells, intermediate cells and
Large cells. It was not found either sarcomateux contingent or classical seminoma. The analysis
In immune histochemistry found no expression of tumor cells for antibodies
Classic tested, including the anti-PLAP Ac and lymphoid markers. The Seminoma
Spermatocytic must be recognised, because its evolution is very favorable and requires only a
Simple orchidectomy, in the absence of an exceptional sarcomateux contingent or metastasis
Where chemotherapy is required

Introduction
The Seminoma spermatocytic (SS) is
A rare tumor, described initially by
Masson in 1946 and rarely occurring
Before the fifth decade. It represents
1-2% of adult germ tumors
and 4 to 7% of all séminomes1, 3-5.
To date, about 200 cases have been
reported, most of them with a
Evolution Favorable2, 6-8, 11
This tumor has one aspect both clinical
and Anatomopathologic different from the
Classic Seminoma characterized essentially
By a slow evolution, an early stage
At the time of diagnosis, and the absence
of metastasis.

Because of its rarity, the Seminoma
Spermatocytic is difficult to diagnose,
Posing the differential diagnosis problem
Mainly with testicular lymphoma,
Especially after the fifties, and the Seminoma
Classic. Only the immunohistochemistry allows
To establish the DIAGNOSTIC8, 12,13.
Given its low potential
There is no certainty as to the
For the benefit of radiation therapy or
Chemotherapy Adjuvante9,14-15.
We propose to report a new
Observation of Seminoma spermatocytic, and
To analyze through a review of the literature seminoma spermatocytic

Diagnostic features, Anatomopathologic,
Therapeutic and evolutionary.
Observation
Mr. E. A. Aged 48 years, without background
Particular Médicochirurgicaux, was
Hospital in July 2008, outside of
Our establishment for exploration
Of a painless left testicular mass
of progressive appearance for more than
Year. The ultrasound showed a tumor
Tissue-like at the expense of the testicle
Left. The biological balance was normal
In particular, plasma levels of
Tumor markers (Alpha-fetoprotein
(AFP), and beta Chorionic gonadotropin
Hormone (ßHCG). A orchidectomy by
Inguinal track was carried out.
Macroscopically, the testicle measured
16, 5cm, fully occupied by a proliferation
Tumor of whitish coloration in
"Fish flesh", with some areas
Brownish and translucent.
On the cytological level, the cells were
Small, medium and large size (Fig. 1).
They had abundant cytoplasm and a
Oval and Vesicular core with
One to three Nucleoli. The mitoses were
(25 mitoses/10 fields X 40).
To this population, they associated small
Lymphocytes and plasma. The tumor

was localized to the testicle without flooding

spermatic cord or vascular bowls

or lymphatic.

This aspect first referred to a

Malignant lymphoma not Hodgkin to

Large cells. However, the study

Immunohistochemical showed a

Marking negativity for AntiPLAP antibody

(Fig. 2) as well as for antibodies

Anti-CD 30, anti-CK, anti-CD 10, anti CD 20,

Anti-Bc L2 and anti-CD 117.

The diagnosis of Seminoma spermatocytic

was therefore retained.

The patient was sent to us to

Support complement.

Thoraco-abdominal-pelvic CT

Post operative did not find any metastases

ganglion or visceral remotely.

The indication of chemotherapy or

Adjuvanted radiotherapy was not retained and

Close monitoring has been recommended.

The patient is currently free from any

Tumor recurrence at 30 months.

Discussion

The Seminoma spermatocytic described by

Masson in 1946, corresponds to an entity

Anatomo-Clinic which, because of its

Morphological and biological properties

Particular, deserves to be distinguished from the

Classic variety of Testicule1 Seminomas

.

The SS would derive from the Spermatogonia