Appears to compress neighbouring testicular tissue
Oval cells with clear cytoplasm and large, rounded nuclei with predominant acidophilic nucleoli. Sheets of cells resembling spermatocytes are separated by a fine fibrous stroma. Active lymphocytic infiltration suggests a good host response and a better prognosis.
Two histological variants:
Anaplastic, or
Cells that closely resemble different phases of maturing spermatogonia (spermatocytic seminoma)
Mainly metastasise via the lymphatics (to para-aortic nodes near the origin of the gonadal vessels), but rarely haematogenous. Inguinal nodes only involved if scrotal skin is involved too.
Beta-hCG and LDH can be used as tumour markers, but not AFP
Non-seminomatous germ cell tumours
Subtypes: (multiple types may exist within a single tumour)
Teratoma - contain more than one cell type, with components from ectoderm, endoderm and mesoderm. 'Mature' - well-differentiated tissue elements. 'Immature' - undifferentiated primitive tissues.
Testicular tumours in children are usually anaplastic teratomas, presenting before the age of 3. Mostly fatal.
Choriocarcinoma - often produces hCG. Highly malignant. Metastasises via both lymphatics and blood.
These tumours are generally tiny but can reach the size of a coconut. May not even distort tunica albuginea.
Interstitial tumours (1-2%)
Typically small, well-circumscribed tumours with a yellow cut surface
