Testes tumors are commonly seen in young males and present as painless swelling. The majority are germ cell tumors, with seminomas comprising 45% and non-seminomas 45%. Seminomas typically occur in adults aged 20-40 and have a good prognosis, while non-seminomas have a poorer prognosis and can include embryonal carcinoma, teratoma, and choriocarcinoma. Clinical features and tumor markers help distinguish between tumor types.

2. CLINICAL PATHOLOGY
The foundation of clinical medicine.
Shashidhar Venkatesh Murthy
A/Prof & Head of Pathology
College of Medicine & Dentistry
MGS4: Male Genital: Testes Tumors
CPC : Term4 Week4 - MGS 4/6
System : Male Genital System.
Topic : 1: Overview 2: STD 3: Orchitis 4: Tumours 5: Penis 6: GLS

3. 3
Testes Tumors: Features:
 Commonest tumour of young males, painless swelling.
 Etiology: Idiopathic, Undescended testes (10%, 10 times)
 Classification:
 95% Germ cell Tumours,
 Seminoma 45% - good prognosis.
 Non seminoma (NSGT) 45% - poor prognosis.
Embryonal ca, Teratoma, Chriocarcinoma,
Mixed - common
 5% Sertoli / Leydig cell tumours.
 Clinical features:
 Adults 20-40y – Seminoma.
 Children <10y – NSGT- Yolksac tum.
 Painless, dragging, unilateral, solid.
 Metastases – Para aortic LN*.

4. 4
Seminoma:
 Commonest Germ cell tumour, 20-40y.
 Firm, grey, smooth, painless,
 Many subtypes: classical*, spermatocytic etc..
 Microscopy: uniform clear cells + lymphocytes.
 Mixed seminoma  Seminoma + Teratoma, embryonal carcinoma or
choriocarcinoma (βhCG 10%). Etc.

5. 5
Seminoma Testes:
Lymphocytes
Clear cells

6. 6
Seminoma Testes:
Lymphocytes
Clear tumour cells

8. 8
NSGT: Embryonal Ca
 Clinical: painless swelling, hemorrhagic,
malignant, poor prognosis, metastases.
 Germ cell tumor – embryonic cells.
 Gross: Hemorrhagic, necrotic tumor.
 Adults: Embryonal Ca.
 Children: Yolksac tumor.
 Tumor Marker: AFP (α feto protein)
 Microscopy: Pleomorphic cells, embryoid
structures. Pink AFP globules in cells.

9. 9
NSGT: Teratoma / Teratocarcinoma
 > 1 tissue type (mature / immature)
 Teratoma + other germ cell tum (Embryonal ca)
 Common, 10-30y, aggressive, poor prognosis.
 Both βhCG & AFP +ve - if mixed.

10. 10
Testes Tumors: summary
 Germ cell Tumours (95%)
 Gonadal: Seminoma
Non Seminoma Germ Cell tum (NSGT)
 Embryonic: Embryonal ca.
 Extraembryonic: Yolk sac tum, Choriocarcinoma.
 Somatic: Teratoma
 Mixed: (40%)
Tumor – Incidence Age Tumor Marker
Seminoma 50% 40-50y 10% βhCG
Embryonal ca. 20-30y Negative (pure)
Yolk sac tumour < 3y 90% AFP
Choriocarcinoma 20-30y 100% βhCG
Teratoma (Pure) All ages Negative
Mixed 15% 15-30y 90% βhCG & AFP