Testis & paratestis

Nonseminomatous germ cell tumors-general

Last author update: 1 January 2013
Last staff update: 9 September 2020

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PubMed Search: Nonseminomatous germ cell tumors [title] (NSGCT)

Turki Al-Hussain, M.D.
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Cite this page: Al-Hussain T. Nonseminomatous germ cell tumors-general. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/testisnsgctgeneral.html. Accessed March 28th, 2023.
Definition / general
  • More aggressive than seminoma
  • 60% present with stage 2 or 3 disease
  • Metastasize earlier than seminoma, using hematogenous route
  • Metastases may not resemble primary tumor
  • Radioresistant
  • 80% have elevated AFP or hCG at diagnosis
  • May have increased metastases in Stage A patients if < 50% of cells are Ki67+ (Mod Pathol 1995;8:492)
  • 60% of testicular tumors are mixed germ cell tumors; recommended to list components with percentage involvement
    • Don't overlook yolk sac tumor foci or nongerm cell component
Prognostic factors
  • 95% cure rate if no lymph node or metastatic involvement; 40 - 95% with metastases
  • Poor prognosis if extensive pulmonary disease
  • Surgery plus chemotherapy
  • 80 - 85% have complete response to chemotherapy, most are cured
Gross description
  • Variegated appearance since usually a mixture of different components
Gross images

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Mixed germ cell tumor

Large areas of necrosis

Soft yellow areas

Microscopic (histologic) images

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Variety of histologic patterns

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