Germinativni tumori testisa s malignom somatskom transformacijom

master's thesis

• Title (english): Testicular germ-cell tumors with malignant somatic transformation
• Author: Antonia Mrdeža
• Mentor: Marija Gamulin (mentor)
• Committee member: Fedor Šantek (predsjednik povjerenstva)
• Committee member: Jasmina Marić Brozić (član povjerenstva)
• Committee member: Marija Gamulin (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Clinical Oncology); Zagreb
• Defense date and country: 2022-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Oncology

Abstract

Germinativni tumori testisa (GCT) su najčešći solidni tumori u mlaĎih muškaraca izmeĎu puberteta i 35. godine ţivota. Biljeţi se porast u incidenciji tijekom posljednjih nekoliko desetljeća. Razlikujemo dva histološka tipa: seminom i neseminom. Neseminomima pripadaju embrionalni karcinom, koriokarcinom, tumor ţumanjčane vreće i teratom. Kod istog bolesnika se moţe dijagnosticirati bilo koja kombinacija seminoma s neseninomskim tumorima.
Dok je većina germinativnih tumora testisa samo lokalno agresivna, odreĎeni broj tumora ima potencijal maligne transformacije u tumore s elementima somatskog tkiva. Maligna somatska transformacija je rijedak entitet, a dokazana je u pribliţno 3-6 % bolesnika. Histološki se najčešće radi o adenokarcinomima i različitim vrstama sarkoma. Iako ne postoji sličnost u histologiji, postojanje izokromosoma 12p je dokaz njihova porijekla iz germinativnih tumora. Malignu alteraciju moţemo pronaći u uzorku tkiva nakon orhidektomije, a takoĎer i u retroperitonealnim limfnim čvorovima nakon kemoterapije s obzirom na njihov izostanak odgovora na kemoterapiju baziranu na cisplatini. Klinički se na prisutnost maligne transformacije moţe posumnjati kada postoji dokaz progresije tumora usprkos smanjenju vrijednosti tumorskih biljega.
Svrha ovog rada je bila opisati germinativne tumore testisa s malignom somatskom transformacijom s osvrtom na njihove epidemiološke, kliničke i morfološke karakteristike. Svaki kliničar koji liječi tumore testisa trebao bi imati na umu postojanje ovog entiteta u slučajevima progresije tumora unatoč apliciranoj klasičnoj kemoterapiji. Bolesnici s germinativnim tumorima testisa uz malignu somatsku transformaciju imaju lošu prognozu, osobito ako bolest nije dohvatljiva kirurškom liječenju.

Abstract (english)

Germ-cell testicular cancer (GCT) is the most common solid cancer in younger men between puberty and 35 years of age, with a recorded increase in incidence in the last several decades. There are two histologic types of GCTs: seminoma and nonseminomatous germ-cell tumours which include embryonic carcinoma, choriocarcinoma, yolk sac tumour and teratoma. Any kind of seminoma - nonseminomatous tumour combination can be diagnosed in the same patient.
While the majority of germ-cell tumours are only locally aggressive, a certain number has the potential for malignant transformation into tumours with somatic tissue elements. Development of somatic-type malignancy is rare and has been identified in approximately 3-6 % of patients. Histologically speaking, these are most commonly adenocarcinoma and various types of sarcomas. Although there is no histological resemblance, the presence of isochromosome 12p is evidence of their GCT origin. Somatic-type malignancy can be found in tissue samples after orchiectomy, and also in retroperitoneal lymph nodes after chemotherapy considering their lack of response to platinum-based chemotherapy. Clinically, presence of malignant transformation cay be suspected when there is evidence of tumour progression despite decreasing tumour marker levels.
The purpose of this study was to describe testicular germ-cell tumours with malignant somatic transformation and their epidemiological, clinical and morphological features. Every clinician treating germ-cell tumours should be aware of the existence of this entity in tumour progression cases despite implemented traditional chemotherapy. Patients with testicular germ-cell tumours with malignant somatic transformation have a poor prognosis especially if the disease cannot be surgically treated.
due to its lower sensitivity to chemotherapy and thus poorer prognosis.

• Keywords: germinativni tumori testisa; kemoterapija; maligna somatska transformacija; prognoza
• Keywords (english): testicular germ-cell cancer; chemotherapy; malignant somatic transformation; prognosis
• Language: croatian
• URN:NBN: urn:nbn:hr:105:581507
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-01-26 08:07:44