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Seminoma with Syncytial Trophoblastic Cells

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  • Seminoma with Syncytial Trophoblastic Cells

    Hi Everyone,
    I just received the pathology report from my I/O, and the pathologist has determined the tumor to be a Seminoma with Syncytial Trophoblastic Cells.

    The tumor was small, 0.7cm x 0.6cm x 0.6cm, and no metastatic spread was identified on the CT scans. The lymph nodes are not enlarged.

    The microscopic description reads: "Sections through a testicle reveal a mass composed of polygonal cells separated by a delicate fibrovascular stroma including a sprinkling of lymphocytes. The tumor cells appear to be of high nuclear grade with vesicular nuclei and medium to large sized nucleoli. The nuclei are enlarged and irregular. Multi-nucleated giant cells are present, and this may represent Syncytial Trophoblastic Cells. The tumor is entirely contained within the testicular parenchyma. The spermatic cord and blood vessels are free of tumors. There is no evidence of a teratomatous component."

    My urologist has asked the pathologist to send the tumor slides to University of VA in Charlottesville, for a second opinion. He is doing this because my beta HCG level before the surgery was elevated (33). Before the surgery, he informed us to expect a nonseminoma with likely choriocarcinoma make-up. So, long-story-short, we are a bit surprised at the pathology, given the results of the HCG.

    Can any of you veterans shed a little light on this diagnosis?
    Right I/O 5/19/06
    Seminoma with Trophoblastic Cells: 0.7cm
    Left I/O ?

  • #2
    Originally posted by c-w
    ...my beta HCG level before the surgery was elevated (33). Before the surgery, he informed us to expect a nonseminoma with likely choriocarcinoma make-up. So, long-story-short, we are a bit surprised at the pathology, given the results of the HCG.
    Not such a surprise -- hCG is elevated in about 10-25% of pure seminoma cases.
    Scott, [email protected]
    right inguinal orchiectomy 6/5/2003 > nonseminoma, stage I > surveillance > L-RPLND 6/24/2005 for recurrence, suspected teratoma but found seminoma, stage II > chylous ascites until 9/2005 > surveillance and "all clear" since


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    • #3
      It's most likely the syncitial trophoblastic cells which are producing the hcg, and they are not always present in seminoma. I don't remember for sure, but I don't think this finding affects your staging or prognosis. Based on the small size of the tumor, I 'd say you were very fortunate and found it quite early. Let us know what the UVa pathology report says.

      Best wishes.
      Fish
      TC1
      Right I/O 4/22/1988
      RPLND 6/20/1988
      TC2
      Left I/O 9/17/2003
      Surveillance

      Tho' much is taken, much abides; and though we are not now that strength which in old days moved earth and heaven; that which we are, we are; one equal temper of heroic hearts, made weak by time and fate, but strong in will; to strive, to seek, to find, and not to yield.

      Comment


      • #4
        Thanks, thats the first I've heard that syncitial trophoblastic cells produce hcg.

        Fish: By the way, did you get radiation for your first round of TC? Or just the RPLND? I am guessing the embryonal portion of your tumor caused your treatment to go the route of nonseminoma? I'm still learning so please bear witrh me.

        My urologist acts like the terms "seminoma with syncytial trophoblastic cells" might actually mean we treat this as a nonseminoma. Do you (or anyone else) understand this?
        Right I/O 5/19/06
        Seminoma with Trophoblastic Cells: 0.7cm
        Left I/O ?

        Comment


        • #5
          I too had elevated HCG (24 rising to 48 during 1st round of chemo) AND an elevated AFP of 24 with a diagnosis of "Pure Seminoma" from IU. Sounds like you are lucky and have caught this in its very earliest stage! You will be cured shortly!
          Brian
          Brian, [email protected]
          left inguinal orchiectomy 9/21/2005 > seminoma, stage IIC 12cm x 12cm retroperitoneal mass> 3XBEP completed 11/30/2005 > residual 9cm x 7cm mass removed 3/29/06. All necrotic tissue found > Surveillance

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          • #6
            Hi C-W:

            Sorry for the delay in replying, I've been out of town. You're correct, my first TC was managed as nonseminoma. I had just the RPLND, they didn't find anything in the lymph nodes, so I did surveillence for 3 years.

            I don't think the trophoblastic cells will put you in the nonseminoma category, but I just don't remember for certain. You might want to also contact the pathologist at Indiana University and send them your slides for a consult. Did you get the report back from UVa yet?
            Fish
            TC1
            Right I/O 4/22/1988
            RPLND 6/20/1988
            TC2
            Left I/O 9/17/2003
            Surveillance

            Tho' much is taken, much abides; and though we are not now that strength which in old days moved earth and heaven; that which we are, we are; one equal temper of heroic hearts, made weak by time and fate, but strong in will; to strive, to seek, to find, and not to yield.

            Comment


            • #7
              No, I haven't received the results from UVa yet, its supposed to be back late this week.

              You make it sound easy to get IU to review my slides. Do you have a contact there, or is it just that easy?
              Right I/O 5/19/06
              Seminoma with Trophoblastic Cells: 0.7cm
              Left I/O ?

              Comment


              • #8
                C-W:

                Here it the info from the TCRC site. I tried to check IU's website, but it doesn't seem to be working this morning.

                Indiana University, Department of Pathology


                Dr Thomas Ulbright
                Dept of Pathology, Director of Anatomic Pathology
                Phone: (317) 274-2498
                For pathology consults, send slides to Dr Ulbright at this address:


                Indiana University Hospital - Room 3465
                550 North University Blvd
                Indianapolis, IN 46202-5280

                The slides should be accompanied by the original pathology report. IU will charge a consultation fee for this service, so include a copy of your insurance information if you want them to bill insurance directly.
                If anyone has updated or different information hopefully they will post it for you.

                You can try the links to IU, maybe they will be working later, they're on this webpage. Or you could try to call and find out more info.




                Best wishes,
                Fish
                Fish
                TC1
                Right I/O 4/22/1988
                RPLND 6/20/1988
                TC2
                Left I/O 9/17/2003
                Surveillance

                Tho' much is taken, much abides; and though we are not now that strength which in old days moved earth and heaven; that which we are, we are; one equal temper of heroic hearts, made weak by time and fate, but strong in will; to strive, to seek, to find, and not to yield.

                Comment

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