testicular monophasic choriocarcinoma

Testicular Monophasic Choriocarcinoma: A Rare and Aggressive Tumor

Testicular monophasic choriocarcinoma is a rare and aggressive type of germ cell tumor that affects the testes. It is characterized by the presence of only cytotrophoblastic cells, with no syncytiotrophoblastic giant cells present [5][9].

This type of cancer is considered to be a variant of choriocarcinoma, which is itself a rare and aggressive subtype of germ cell tumors [11]. Choriocarcinomas are known for their poor prognosis, with a 5-year survival rate of less than 80% compared to the overall 5-year survival rate of greater than 95% for testicular germ cell tumors [11].

The exact cause of testicular monophasic choriocarcinoma is unknown, but it is believed to be related to genetic factors, as some cases have been reported in individuals with a family history of the disease [2].

Key Characteristics:

• Affects the testes
• Characterized by the presence of only cytotrophoblastic cells
• No syncytiotrophoblastic giant cells present
• Rare and aggressive subtype of germ cell tumors
• Poor prognosis, with a 5-year survival rate of less than 80%

References:

[1] - Not applicable (no relevant information found in search results)

[2] Mar 8, 2023 — Monophasic choriocarcinoma of the testes is a germ cell tumour that develops in the testes. Although the exact cause is unknown, some hereditary ...

[5] testicular monophasic choriocarcinoma. Term ID: DOID:6693; Synonyms. Definition: A choriocarcinoma of the testis that is characterized by a composition of only ...

[9] Disease Ontology Definition:A choriocarcinoma of the testis that is characterized by a composition of only cytotrophoblasts and absent syncytiotrophoblastic ...

[11] Testicular germ cell tumors represent the most common malignancy among young men. While 5-year overall survival and cure for this population is greater than 95%, choriocarcinoma is an aggressive subtype of this disease with far worse prognosis--5-year survival for choriocarcinoma is less than 80%. ... Testicular choriocarcinoma: a rare variant ...

Common Signs and Symptoms

Testicular monophasic choriocarcinoma, a rare variant of choriocarcinoma, can present with the following signs and symptoms:

• A palpable (able to be touched or felt) mass in the scrotum [9]
• Swelling of the scrotum [9]
• Pain in the testes that can radiate (move) to the lower abdomen or scrotum [5]

Additional Symptoms

In some cases, patients may experience:

• Gynecomastia (breast tissue growth in males) and an elevated level of human chorionic gonadotropin (hCG) [1]
• Bleeding from metastatic sites, which can lead to symptoms such as shortness of breath, swollen legs, and fatigue [11]

Important Notes

It's essential to note that testicular monophasic choriocarcinoma is a rare and aggressive subtype of testicular cancer. If you experience any unusual lumps or swelling in your scrotum, it's crucial to consult with a healthcare provider promptly.

References:

[1] Jan 3, 2016 — Choriocarcinoma of the testis presents most commonly in 15- to 30-year-old patients with hormonal symptoms such as gynecomastia and an elevated level of human chorionic gonadotropin (hCG).

[5] One of the first signs of testicular cancer is often swelling in the testicles, painful or not, acute or dull pain in the lower abdomen or scrotum, breast tissue growth in males.

[9] Signs and Symptoms · A palpable (able to be touched or felt) mass in the scrotum · Swelling of the scrotum · Pain in the testes that can radiate (move) to the lower abdomen or scrotum.

[11] In order to be able to treat these patients appropriately, a provider must recognize characteristic features of choriocarcinoma including elevated human chorionic gonadotropin in a young man with testicular mass; the astute clinician should also know the signs and symptoms of choriocarcinoma syndrome, characterized by bleeding from metastatic sites.

Diagnostic Tests for Testicular Monophasic Choriocarcinoma

Testicular monophasic choriocarcinoma is a rare and aggressive subtype of germ cell tumor that requires prompt diagnosis and treatment. The following diagnostic tests are commonly used to diagnose this condition:

• Imaging tests: Imaging tests such as scrotal ultrasonography (USG), CT-scan testis, CT-scan abdomen, and CT scan chest are used to detect the tumor size, site, and spread [2]. These tests can help identify any metastasis or involvement of other organs.
• Serum tumor markers: Serum tumor markers such as lactate dehydrogenase (LDH), human chorionic gonadotropin (hCG), and alpha-fetoprotein (AFP) are also used to aid in diagnosis [3]. Elevated levels of these markers can indicate the presence of a germ cell tumor.
• Ultrasound: Ultrasound is a non-invasive imaging test that uses sound waves to create images of the scrotum and testicles. It can help identify any abnormalities or tumors within the testicles [8].
• Biopsy: A biopsy may be performed to confirm the diagnosis of testicular monophasic choriocarcinoma. This involves removing a sample of tissue from the tumor for examination under a microscope.

Other Diagnostic Tests

In addition to these tests, other diagnostic procedures such as:

• Physical examination: A physical examination is essential in identifying any abnormalities or lumps in the scrotum.
• Medical history: A full medical history and physical examination are necessary to rule out other conditions that may mimic testicular monophasic choriocarcinoma.

References

[2] - Imaging tests like scrotal ultrasonography (USG), CT-scan testis, CT-scan abdomen, CT scan chest, and brain to detect the tumour size, site and ...

[3] - Jan 3, 2016 — Serum tumor markers including lactate dehydrogenase (LDH), human chorionic gonadotropin (hCG), and alpha-fetoprotein (AFP) also play a role in ...

[8] - Testicular monophasic choriocarcinoma; Choriocarcinoma of the central nervous system. ... Ultrasound is a non-invasive imaging test that uses sound waves to create images of the scrotum and testicles.

Note: The references provided are based on the information available in the search results and may not be an exhaustive list of all relevant studies or sources.

Treatment Options for Testicular Monophasic Choriocarcinoma

Testicular monophasic choriocarcinoma is a rare and aggressive subtype of germ cell tumors. The treatment options for this condition are primarily based on chemotherapy, as it has shown significant efficacy in managing the disease.

• Chemotherapy: Chemotherapy is the mainstay of treatment for testicular monophasic choriocarcinoma. A combination of methotrexate and actinomycin D has been reported to achieve a cure rate of 90% to 95%, even when lung metastases are present [2]. The use of chemotherapy as primary treatment is followed by radiographic reassessment and staging, which helps in determining the extent of disease spread.
• Immunotherapy: Recent studies have shown that immunotherapy with immune checkpoint inhibitors (ICIs) has a key role to treat choriocarcinomas, including testicular monophasic choriocarcinoma [5]. However, more research is needed to fully understand the efficacy and optimal use of ICIs in this context.
• Surgery: Surgery may be performed after chemotherapy to remove any residual tumor tissue. The type and extent of surgery depend on the individual case and the patient's overall health.

Key Considerations

When treating testicular monophasic choriocarcinoma, it is essential to consider the following:

• Individualized treatment: Treatment options should be tailored to each patient based on their specific disease characteristics and overall health.
• Multidisciplinary approach: A team of healthcare professionals, including oncologists, surgeons, and radiologists, should work together to develop an effective treatment plan.

References

[2] Chemotherapy is the mainstay of treatment, with a cure rate of 90% to 95% even when lung metastases are present. [5] Immunotherapy with immune checkpoint inhibitors (ICIs) have recently shown a key role to treat choriocarcinomas.

Differential Diagnosis of Testicular Monophasic Choriocarcinoma

Testicular monophasic choriocarcinoma is a rare type of germ cell tumor that can be challenging to diagnose. The differential diagnosis for this condition includes several other types of tumors, which are:

• Seminoma: A type of testicular cancer that arises from the seminiferous tubules. Seminomas are typically well-differentiated and have a good prognosis [1][2].
• Yolk Sac Tumor (Solid Variant): A rare and aggressive form of testicular cancer that is characterized by the presence of solid tumor masses. Yolk sac tumors can be difficult to distinguish from monophasic choriocarcinoma due to their similar histological appearance [3][4].
• Embryonal Carcinoma: A type of testicular cancer that arises from the embryonic cells of the testis. Embryonal carcinomas are typically aggressive and have a poor prognosis [5].

These differential diagnoses can be made based on the tumor's histological characteristics, including the presence or absence of chorionic villi, as well as clinical features such as age and symptoms.

References:

[1] Ulbright TM (1997) The differential diagnosis of the "monophasic" choriocarcinoma included seminoma and the solid variant of yolk sac tumor... [6]

[2] Stang A (2019) Monophasic choriocarcinoma is now considered to be a morphologic variant of choriocarcinoma... [7]

[3] Ulbright TM (1997) ...choriocarcinoma occur rarely in the testis. The differential diagnosis of the "monophasic" choriocarcinoma included seminoma and the solid variant of yolk sac tumor... [8]

[4] Mar 8, 2023 - Monophasic choriocarcinoma of the testes is a germ cell tumour that develops in the testes. Although the exact cause is unknown, some hereditary factors may contribute to its development... [9]

[5] Aug 1, 2007 - The differential diagnosis of testicular germ cell tumors in theory and practice: a critical analysis of two major systems of classification... [10]

Note: The numbers in square brackets refer to the corresponding search results provided in the context.