Testis & paratestis

Germ cell tumors

Teratoma with somatic type malignancy



Last author update: 23 January 2022
Last staff update: 21 November 2022 (update in progress)

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PubMed Search: Teratoma with somatic type malignancy

See Also: Teratoma

Christopher Dall, M.D.
Debra L. Zynger, M.D.
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Cite this page: Dall C, Zynger DL. Teratoma with somatic type malignancy. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/testisteratocarcinoma.html. Accessed December 10th, 2022.
Definition / general
  • Testicular germ cell tumor with somatic malignancy arising from germ cell tumor progenitor cells that occupies ≥ 1 microscopic field using 4x objective
Essential features
Terminology
  • Previously termed teratoma with malignant transformation and teratoma with somatic malignancy
Epidemiology
Sites
  • 90% with gonadal primary but primary tumor may be found in the mediastinum or retroperitoneum (J Urol 2016;196:95)
Pathophysiology
Clinical features
  • Somatic malignancies more commonly found as relapse, rather than at initial diagnosis (J Urol 2014;192:1403)
  • Timing of relapse varies based on type of somatic malignancy (J Urol 2014;192:1403)
    • Carcinomas diagnosed later than sarcomas
  • Scarce data regarding differences in presentation of somatic type malignancy and germ cell tumors
Diagnosis
  • Found as metastatic disease, within the testis or both (J Urol 1998;159:133)
  • Histologic features and immunohistochemistry determine somatic malignancy subtype
Radiology description
  • Imaging may suggest specific somatic malignancy in germ cell tumors (Eur J Radiol 2009;69:230)
    • Ossified lymph nodes and soft tissue reported in osteosarcoma
    • Peritoneal carcinoma seen in adenocarcinoma
    • Septal thickening and opacifications reported in a case of bronchoalveolar carcinoma
Radiology images

Images hosted on other servers:
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Ossified left
retroperitoneal mass

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Adenocarcinoma type
malignant transformation

Prognostic factors
Case reports
Treatment
Gross images

Contributed by Christopher Dall, M.D. and Debra L. Zynger, M.D.
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Retroperitoneal metastasis with sarcoma, NOS

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Lung metastasis with rhabdomyosarcoma

Microscopic (histologic) description
Microscopic (histologic) images

Contributed by Christopher Dall, M.D. and Debra L. Zynger, M.D.
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Rhabdomyosarcoma in
metastatic testicular
germ cell tumor

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Chondrosarcoma in metastatic testicular germ cell tumor

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Primitive neuroectodermal tumor within testis

Positive stains
Differential diagnosis
Board review style question #1

    Teratoma with somatic type malignancy most commonly contains which histologic type?

  1. Adenocarcinoma
  2. Primitive neuroectodermal tumor
  3. Rhabdomyosarcoma
  4. Sarcoma, not otherwise specified
  5. Squamous cell carcinoma
Board review style answer #1
Board review style question #2
    Which genetic feature would be most commonly found in teratoma with somatic type malignancy?

  1. Isochromosome 12p
  2. MYC amplification
  3. TERT promoter mutation
  4. Upregulation of ERG
Board review style answer #2
A. Isochromosome 12p

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Reference: Teratoma with somatic type malignancy
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