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Clinically atypical seminomas with yolk sac tumor features
1Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030-3721, USA.
The Canadian Journal of Urology
|August 13, 2013
Summary
Clinically atypical seminomas (CASs) expressing GST (pi) may be a distinct entity resembling yolk sac tumors (YSTs). This finding could improve prognostic predictions for testicular cancer patients.
Area of Science:
- Oncology
- Pathology
- Molecular Biology
Background:
- Seminoma, a testicular germ cell tumor, has a subset of aggressive cases with poor prognosis.
- Clinically atypical seminomas (CASs) exhibit visceral metastases and chemotherapy resistance, suggesting unique biological characteristics.
- Investigating CASs may elucidate mechanisms of drug resistance and the origins of testicular cancers.
Purpose of the Study:
- To explore if CASs represent a distinct clinical and biological entity with yolk sac tumor (YST) features.
- To analyze chemotherapy-resistance markers in CASs and compare them to YST and classical seminoma.
- To evaluate the prognostic significance of specific markers in CASs.
Main Methods:
- Archived tissue samples from 22 patients were analyzed using immunohistochemical testing.
- Expression of bone morphogenetic protein 2, alpha fetoprotein, and glutathione S-transferase (pi) [GST (pi)] was evaluated.
- Clinical histories of patients with CASs, classical seminomas, and mixed germ-cell tumors containing YST were reviewed.
Main Results:
- GST (pi) expression was a significant predictor of overall survival (p = .036).
- CASs expressing GST (pi) showed greater resemblance to YSTs than to classical seminomas (p = 0.043).
- Tumors with lower stage, regardless of GST (pi) expression, responded better to local therapies, leading to improved outcomes.
Conclusions:
- Certain CASs expressing GST (pi) may be biologically similar to YSTs, differing from classical seminomas.
- GST (pi) expression could serve as a prognostic marker for disease-specific survival in CASs.
- These findings suggest a potentially unique biologic origin for some CASs, warranting further investigation into their natural history and therapeutic implications.
