| 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. |
| Phenotype / cell stem origin | 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. 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 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 nuclear size: large, small and intermediate. Some nuclei may exhibit a presence of nuclear thread-like chromatin. |
| |  |
| |
| A high power image showing characteristic polymorphism of the cell nucleus size of spermatocytic seminoma. |
| |
| Pathology | There is no specific marker for spermatocytic seminoma. Proteins/antigens that are highly expressed in spermatogonia (most of them of them also present in gonocytes and primary spermatocytes), such as SSX (synovial sarcoma on X chromosome), NSE (neuron-specific 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. |
| |  |
| |
| 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). |
| |
| Treatment | Spermatocytic seminoma is treated by surgery (orchiectomy). |
| Evolution | Some cases of spermatocytic seminoma may undergo sarcomatous transformation and spread outside the testis. An anaplastic variant was also described. |
| Spermatocytic seminoma. I. Clinicopathologic study of six cases and review of the literature. |
| Rosai J, Silber I, Khodadoust K |
| Cancer. 1969 ; 24 (1) : 92-102. |
| PMID 5790295 |
| |
| Testicular tumours _ Introduction. |
| Pugh RC |
| In.. |
| |
| Comparison of various clinical and pathological classifications of tumors of testes. |
| Mostofi FK |
| Seminars in oncology. 1979 ; 6 (1) : 26-30. |
| PMID 572090 |
| |
| The spermatocytic seminoma: views on pathogenesis. |
| Mºller J, Skakkebaek NE, Parkinson MC |
| International journal of andrology. 1987 ; 10 (1) : 147-156. |
| PMID 3583416 |
| |
| Placental-like alkaline phosphatase and DNA flow cytometry in spermatocytic seminoma. |
| Dekker I, Rozeboom T, Delemarre J, Dam A, Oosterhuis JW |
| Cancer. 1992 ; 69 (4) : 993-996. |
| PMID 1310437 |
| |
| A new classification of germ cell tumours of the testis. |
| Grigor KM |
| European urology. 1993 ; 23 (1) : 93-100. |
| PMID 8386662 |
| |
| [Ultrastructure and histogenesis of spermatocytic seminoma] |
| Romanenko AM, Persidski IuV |
| Voprosy onkologii. 1983 ; 29 (7) : 60-66. |
| PMID 6880135 |
| |
| Spermatocytic seminoma. |
| Eble JN |
| Human pathology. 1994 ; 25 (10) : 1035-1042. |
| PMID 7927308 |
| |
| Anaplastic variant of spermatocytic seminoma. |
| Albores-Saavedra J, Huffman H, Alvarado-Cabrero I, Ayala AG |
| Human pathology. 1996 ; 27 (7) : 650-655. |
| PMID 8698307 |
| |
| Chromosomal constitution of human spermatocytic seminomas: comparative genomic hybridization supported by conventional and interphase cytogenetics. |
| Rosenberg C, Mostert MC, Schut TB, van de Pol M, van Echten J, de Jong B, Raap AK, Tanke H, Oosterhuis JW, Looijenga LH |
| Genes, chromosomes & cancer. 1998 ; 23 (4) : 286-291. |
| PMID 9824200 |
| |
| Expression of the RNA component of human telomerase in adult testicular germ cell neoplasia. |
| Delgado R, Rathi A, Albores-Saavedra J, Gazdar AF |
| Cancer. 1999 ; 86 (9) : 1802-1811. |
| PMID 10547554 |
| |
| Spermatocytic seminoma as compared to classical seminoma: an immunohistochemical and DNA flow cytometric study. |
| Kraggerud SM, Berner A, Bryne M, Pettersen EO, Fossa SD |
| APMIS : acta pathologica, microbiologica, et immunologica Scandinavica. 1999 ; 107 (3) : 297-302. |
| PMID 10223302 |
| |
| Tumors of the testis, adnexa, spermatic cord, and scrotum. |
| Ulbright TM, Amin MB, Young RH |
| In.. |
| |
| Reactivity of germ cell maturation stage-specific markers in spermatocytic seminoma: diagnostic and etiological implications. |
| Stoop H, van Gurp R, de Krijger R, Geurts van Kessel A, Kberle B, Oosterhuis W, Looijenga L |
| Laboratory investigation; a journal of technical methods and pathology. 2001 ; 81 (7) : 919-928. |
| PMID 11454979 |
| |
| The cancer-testis gene, NY-ESO-1, is expressed in normal fetal and adult testes and in spermatocytic seminomas and testicular carcinoma in situ. |
| Satie AP, Rajpert-De Meyts E, Spagnoli GC, Henno S, Olivo L, Jacobsen GK, Rioux-Leclercq N, J©gou B, Samson M |
| Laboratory investigation; a journal of technical methods and pathology. 2002 ; 82 (6) : 775-780. |
| PMID 12065688 |
| |
| The immunohistochemical expression pattern of Chk2, p53, p19INK4d, MAGE-A4 and other selected antigens provides new evidence for the premeiotic origin of spermatocytic seminoma. |
| Rajpert-De Meyts E, Jacobsen GK, Bartkova J, Aubry F, Samson M, Bartek J, Skakkebaek NE |
| Histopathology. 2003 ; 42 (3) : 217-226. |
| PMID 12605640 |
| |
