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Bladder

Other tumors

Germ cell tumor


Reviewers: Gillian Levy, M.D., Yale Medical Center (see Reviewers page)
Revised: 23 April 2011, last major update April 2011
Copyright: (c) 2003-2011, PathologyOutlines.com, Inc.

Definition
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● Includes choriocarcinoma, dermoid cyst, seminoma, teratoma, yolk sac tumors

Epidemiology
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● Dermoid cyst: typically females 30-49 years of age

Clinical features
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● Dermoid cysts can contain hair and calcified material
● Ovarian dermoid cysts may perforate into the bladder and must be excluded

Case reports
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● 1 year old boy with yolk sac tumor of bladder, increased AFP (J Urol 1983;129:591)
● 7 month old male with primary yolk sac tumor of urachus (Arch Pathol Lab Med 2002;126:1106)
● 37 year old man with choriocarcinoma of bladder and no known testicular primary (Clin Oncol (R Coll Radiol) 1996;8:59)
● 44 year old woman with dermoid cyst arising from bladder dome (Clin Exp Obstet Gynecol 2008;35:309)
● 81 year old man with choriocarcinoma of bladder (Pathol Int 2005;55:216)

Treatment
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● Excision, radiation for seminomas

Gross description (Macroscopy)
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● Yolk sac: yellow, soft
● Seminoma: gray-tan mass

Micro description (Histopathology)
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● Choriocarcinoma: syncytotrophoblasts capping sheets of cytotrophoblasts (sheets or aggregates of single irregularly shaped nuclei)
● Seminoma: sheets or lobules of seminoma cells divided by fibrous trabeculae with aggregates of lymphocytes
● Yolk sac tumor: multiple patterns (microcystic, macrocystic, papillary and solid)

Micro images
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Urachal yolk sac tumor

Cytology description
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● Seminoma: loosely cohesive cell clusters of highly atypical large cells and occasional large, single cells with macronucleoli; background of mainly lymphocytes and histiocytes (Diagn Cytopathol 2008;36:734)

Stains
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● Choriocarcinoma: positive for hCG (syncytotrophoblasts), EMA and HPL, variable PLAP
● Yolk sac tumor: AFP+, cytokeratin+, EMA-, CD30-
● Seminoma: CD117+, PLAP+

Molecular / cytogenetics description
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● Isochromosome 12 present in germ cell tumors

Differential diagnosis
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● Metastases or extension of germ cell tumor from adjacent site
● Urothelial carcinomas with choriocarcinomatous differentiation (Hum Pathol 1984;15:793, Cancer 1993;71:3972)

Additional references
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J Urol 1956;75:801

End of Bladder > Other Tumors > Germ cell tumor


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