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seminoma

[Latin, semen(semin) = seed; greek, oma = tumor] Pathology: - radiosensitive malignant neoplasm. - arises from germ cells in the testis of young male adults - metastasizes to the paraaortic lymph nodes Laboratory: 1) serum beta-chorionic gonadotropin (serum beta-hCG) a) increased in 10% of seminomas b) may be increased in non-seminomas [3] c) correlates with trophoblasts within tumor 2) serum alpha-fetoprotein is NEVER increased in pure seminomas Management: - radical (inguinal) orchiectomy - stage 1 - active surveillance for stage I seminoma diagnosed after radical inguinal orchiectomy [3] - other options do not improve overall survival - carboplatin chemotherapy - para-aortic lymph node irradiation [3] - chemotherapy (bleomycin/cisplatin/etoposide) for patients with more advanced seminoma [3] - hematopoietic stem cell transplantation for recurrent or refractory disease

General

germinoma

References

  1. Stedman's Medical Dictionary 27th ed, Williams & Wilkins, Baltimore, 1999.
  2. Oliver RT, Mead GM, Rustin GJ et al Randomized trial of carboplatin versus radiotherapy for stage I seminoma: mature results on relapse and contralateral testis cancer rates in MRC TE19/EORTC 30982 study. J Clin Oncol. 2011 Mar 10;29(8):957-62 PMID: 21282539 - Oliver RT, Mason MD, Mead GM et al Radiotherapy versus single-dose carboplatin in adjuvant treatment of stage I seminoma: a randomised trial. Lancet. 2005 Jul 23-29;366(9482):293-300. PMID: 16039331
  3. Medical Knowledge Self Assessment Program (MKSAP) 17, American College of Physicians, Philadelphia 2015
  4. Tandstad T, Smaaland R, Solberg A et al Management of seminomatous testicular cancer: a binational prospective population-based study from the Swedish norwegian testicular cancer study group. J Clin Oncol. 2011 Feb 20;29(6):719-25. PMID: 21205748