Walter P
Virchows Arch A Pathol Anat Histol. 1980;386(2):175-87. doi: 10.1007/BF00427229.
Spermatocytic seminoma is a distinct testicular germ cell tumor. Eight cases are described, one is examined by electron microscopy and 65 from the literature are reviewed. The most pertinent ultrastructural findings are the intercellular bridges which indicate maturation toward the spermatocytic cell line. They also give validity to the hypothesis that spermatocytic seminoma is derived from spermatogonia or spermatocytes. This neoplasm has distinct clinical features and peculiar biological proprieties: 50% of the patients are 50 years old or more at time of diagnosis. Only intrascrotal testis are involved. Association with other testicular germ cell tumors is rare (1 case). The neoplastic cells seem to have poor mobility. The potential for spread is limited: microscopic invasion of the albuginae and epididymis has been described in only 4 cases; metastases are not documented. The prognosis is outstanding: all but two patients are free of disease 1 month to 19 years after diagnosis (median 7 years). Two patients (3%) are dead with clinical evidence of dissemination. Postoperative radiotherapy to pelvic and lateroaortic areas has been administered to 60% of the cases. It is noteworthy that there is no appreciable survival diffference whether radiotherapy has been given or not. In our experience orchiectomy is sufficient.
精母细胞性精原细胞瘤是一种独特的睾丸生殖细胞肿瘤。本文描述了8例病例,其中1例进行了电子显微镜检查,并对文献中的65例进行了回顾。最相关的超微结构发现是细胞间桥,这表明其向精母细胞系成熟。它们也支持了精母细胞性精原细胞瘤起源于精原细胞或精母细胞的假说。这种肿瘤具有独特的临床特征和特殊的生物学特性:50%的患者在诊断时年龄在50岁及以上。仅累及阴囊内睾丸。与其他睾丸生殖细胞肿瘤的关联罕见(1例)。肿瘤细胞似乎移动性较差。扩散潜力有限:仅4例描述了白膜和附睾的微小浸润;未见转移记录。预后良好:除2例患者外,所有患者在诊断后1个月至19年(中位7年)均无疾病。2例患者(3%)死于有播散临床证据的情况。60%的病例接受了盆腔和腹主动脉旁区域的术后放疗。值得注意的是,无论是否进行放疗,生存率均无明显差异。根据我们的经验,睾丸切除术就足够了。