Histopathological Trends of Testicular Neoplasm: An Experience over a Decade in a Tertiary Care Centre in the Malwa Belt of Central India

Abstract

Introduction: Testicular and para-testicular neoplasm are rare type of tumours affecting adolescents and young adults, reflected by the paucity of published data in India.

Aim: This study was undertaken to estimate the epidemiological characteristics and histological types and subtypes of testicular neoplasm according to the WHO classification in our patient group. Identification of histopathological pattern of testicular tumour is immensely important for improved management protocols.

Materials and methods: This was a retrospective study done over a period of ten years from 2004 to 2014 in a tertiary care centre. All relevant clinical data including patient's age, laterality, history of risk factors and serum tumour markers were collected from records. Histopathological slides were retrieved and reviewed for tumour and its subtype and classified according to WHO classification (2004).

Results: A total of 37 cases of testicular and paratesticular neoplasm were encountered in our study with a mean age of 38.1 years. Right testis was affected in 70.3% of cases. The most common clinical presentation was scrotal swelling with heaviness. Germ cell tumour was the most common type accounting for 77.1% followed by lymphomas (17.1%). Germ cell tumours were categorized into seminomatous (48.2%) and non-seminomatous tumours (51.8%). The most common subtype of non-seminomatous tumours was mixed germ cell tumour accounting for 85.8%.

Conclusion: The incidence of testicular neoplasm among general population in Asian countries is low, as reflected in the very few studies that have been performed and published in literature. Epidemiological and histomorphological spectrum of our study was comparable to most of the countries except for some African and Western countries.

Keywords: Carcinoma testis; Germ cell tumor; Seminoma.

[Table/Fig-5]:

Gross photograph of seminoma showing a well defined, yellow homogenous testicular mass.

[Table/Fig-6]:

High power view showing monotonous tumour cells divided by thin fibrovascular septae (H & E- 400x).

[Table/Fig-7]:

Scanner view of mixed germ cell tumour showing teratomatous (black arrow) and embryonal carcinomatous (blue arrow) component. (H & E- 40x).

[Table/Fig-8]:

Low power view of mixed germ cell tumour showing teratomatous (black arrow) and embryonal carcinomatous (blue arrow) component. (H & E- 100x).

[Table/Fig-9]:

Gross photograph of lymphoma showing a well defined, tan homogenous testicular mass.

[Table/Fig-10]:

High power view of lymphoma showing tumour cells with prominent nucleoli in few, infiltrating the interstitium and few seminifereous tubules. (H & E- 400x).