Clinical Analysis of Testicular Seminoma: A Review of 27 Cases

Lee, Soo Hyung; Hong, Sung Joon; Lee, Jin Moo

Abstract

We reviewed 82 testicular tumors (78 germ cell tumors and 4 non-germ cell tumors) from 1972 to 1991 retrospectively. Among them, the pure testicular seminomas were 27(24 typical seminoma and 3 anaplastic seminoma). The mean age at the time of diagnosis was 39.0 years(20-60). There were 15 stage I, 10 stage II and 2 stage III at the initial diagnosis. The number of patients with either present or history of cryptorchidism were 10(37.0%) and all being pathologically typical seminoma. The hCG was elevated in 30% (6/20), but either AFP(0/20) or LDH(0/8) were not elevated at all. Among the 15 stage I seminoma, 8 out of 9 cases followed-up more than 3 years were tumor free. One patient with anaplastic histology progressed at 6 month follow-up. Among the 10 cases of stage II, 7 cases were followed-up average 54.8 months. 6 out of 7 cases showed no progression and one case developed metastasis to the lung, and expired at the 13 months after initial diagnosis. In the 2 cases of stage III, patients expired each at 13 and at 18 months after initial management. The overall cumulative 5 year survival rates were 100% for stage I , 88.9% for stage II and none for stage III (p<0.05) respectively. Elevated hCG combined with history of cryptorchidism showed significant correlation with the tumor stage.