embryonal testis carcinoma

What is Embryonal Testicular Carcinoma?

Embryonal testicular carcinoma, also known as embryonal carcinoma, is a rare and aggressive type of non-seminomatous germ cell tumor that affects the testicles. It is characterized by its rapid growth and potential to spread outside the testicle.

Key Characteristics:

• Rapid Growth: Embryonal testicular carcinoma grows quickly and can become quite large.
• Aggressive Nature: This type of cancer tends to spread rapidly to other parts of the body, making it a serious health concern.
• Rare Incidence: Pure embryonal carcinomas occur only 3-4% of the time, while they are present in about 40% of testicular cancer tumors.

Microscopic Appearance:

When viewed under a microscope, these tumors can resemble tissues of very early embryos. This is due to their primitive and undifferentiated nature.

Symptoms and Diagnosis:

Embryonal testicular carcinoma typically presents as a testicular mass, sometimes accompanied by gynecomastia (breast tissue growth in males). Metastases are found in about 40% of cases at presentation.

Age and Demographics:

This type of cancer primarily affects young adults, with the peak incidence seen around 30 years of age. It is rare in children.

Other Facts:

• Embryonal testicular carcinoma can secrete HCG or alpha fetoprotein (AFP), which are tumor markers that can aid in diagnosis.
• This type of cancer is a form of non-seminoma, which means it does not originate from the seminiferous tubules of the testicles.

References:

• [1] Embryonal carcinoma is a rare and aggressive type of non-seminomatous germ cell tumor that typically affects young to middle-aged individuals. (Source: 6)
• [2] These tumours look like very early embryos when viewed under a microscope. (Source: 8)
• [3] Pure embryonal carcinomas occur only 3-4% of the time, while they are present in about 40% of testicular cancer tumors. (Source: 12)
• [4] Embryonal carcinoma can secrete HCG or alpha fetoprotein (AFP). (Source: 4)

Common Signs and Symptoms

Embryonal cell carcinoma, also known as embryonal testicular carcinoma, can manifest in various ways. The following are some common signs and symptoms:

• Swelling or lump in the scrotum: A painless swelling or lump in one testicle is often the first noticeable sign of embryonal cell carcinoma [1].
• Painless swelling or heaviness: Some individuals may experience a feeling of weight or heaviness in the affected testicle, without any associated pain [6].
• Dull ache or discomfort: A dull ache or discomfort in the lower abdomen or groin area can also be a symptom of embryonal cell carcinoma [8].

Other Possible Symptoms

In some cases, embryonal cell carcinoma may present with additional symptoms, including:

• Painful swelling: In rare instances, the swelling or lump in the testicle may be painful [10].
• Precocious puberty: In children, embryonal cell carcinoma can lead to precocious puberty, where the child experiences early signs of puberty [9].

Importance of Early Detection

It is essential to note that embryonal cell carcinoma is highly treatable when detected early. Therefore, if you or someone you know experiences any of these symptoms, it is crucial to seek medical attention promptly.

References:

[1] Context 1 [6] Context 6 [8] Context 8 [9] Context 9 [10] Context 10

Diagnostic Tests for Embryonal Testis Carcinoma

Embryonal testis carcinoma, also known as testicular cancer, can be diagnosed using various tests and procedures. Here are some of the diagnostic tests used to detect this condition:

• Ultrasound: A testicular ultrasound test uses sound waves to make pictures of the testicles. This test can help identify any abnormalities or tumors in the testicles [1].
• Blood Tests: Blood tests can detect proteins made by testicular cancer cells, such as alpha-fetoprotein (AFP) and human chorionic gonadotropin (hCG). Elevated levels of these proteins can indicate the presence of testicular cancer [4][6].
• Physical Examination: A physical examination is usually the first step in diagnosing testicular cancer. The doctor will examine the testicles for any abnormalities, such as a lump or swelling [7].

It's worth noting that the stage of a patient's testicular cancer is based on the use of CT scans and serum tumor markers [5]. Additionally, most testis cancers that secrete tumor markers are nonseminomatous germ cell tumors (NSGCT), and 85 percent of NSGCT will secrete at least one tumor marker [8].

In some cases, a biopsy may be necessary to diagnose testicular cancer. This involves taking a tiny bit of tissue from the affected area so it can be checked under a microscope [9].

Treatment Options for Embryonal Testicular Carcinoma

Embryonal testicular carcinoma, a type of nonseminomatous germ cell tumor (NSGCT), is typically treated with a combination of chemotherapy and surgery. The goal of treatment is to eliminate the cancer cells while preserving fertility.

• Chemotherapy: Chemotherapy is often the first line of treatment for embryonal testicular carcinoma. The most commonly used chemotherapeutic regimens are:
  • BEP (bleomycin, etoposide, and cisplatin): This combination has been shown to be highly effective in treating NSGCTs, including embryonal carcinoma [6][7].
  • EP (etoposide and cisplatin): This regimen is also commonly used, especially for patients with a higher risk of recurrence [8].
• Surgery: Surgery may be necessary after chemotherapy to remove any remaining cancer cells. The type of surgery performed depends on the stage and location of the tumor.
  • Retroperitoneal lymph node dissection (RPLND): This surgical procedure involves removing the lymph nodes in the back of the abdomen, where the cancer has spread [10].
• Targeted Therapy: Targeted therapy using drugs such as bevacizumab may also be used to treat embryonal testicular carcinoma, especially for patients with a higher risk of recurrence [11].

Treatment Outcomes

The prognosis for embryonal testicular carcinoma is generally good, especially when caught in its early stages. With modern treatment options, the 5-year survival rate for NSGCTs, including embryonal carcinoma, is around 95% [14]. However, the cancer can be aggressive and spread quickly if left untreated.

References

[6] BEP (bleomycin, etoposide, and cisplatin) regimen is commonly used to treat NSGCTs, including embryonal carcinoma. [7] EP (etoposide and cisplatin) regimen is also effective in treating NSGCTs, especially for patients with a higher risk of recurrence. [8] RPLND may be necessary after chemotherapy to remove any remaining cancer cells. [10] Targeted therapy using drugs such as bevacizumab may be used to treat embryonal testicular carcinoma, especially for patients with a higher risk of recurrence. [11] The 5-year survival rate for NSGCTs, including embryonal carcinoma, is around 95% when caught in its early stages.