Testis and epididymis
Germ cell tumors
Nonseminomatous germ cell tumors (NSGCT) - general

Author: Turki Al-Hussain, M.D. (see Authors page)

Revised: 30 June 2017, last major update January 2013

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PubMed Search: Nonseminomatous germ cell tumors [title] (NSGCT)

Cite this page: Nonseminomatous germ cell tumors (NSGCT) - general. PathologyOutlines.com website. http://pathologyoutlines.com/topic/testisnsgctgeneral.html. Accessed August 19th, 2017.
Definition / general
  • More aggressive than seminoma
  • 60% present with stage 2 or 3 disease
  • Metastasize earlier than seminoma, using hematogenous route
  • Metastases may not resemble primary tumor
  • Radioresistant
  • 80% have elevated AFP or hCG at diagnosis
  • May have increased metastases in Stage A patients if < 50% of cells are Ki67+ (Mod Pathol 1995;8:492)
  • 60% of testicular tumors are mixed germ cell tumors; recommended to list components with percentage involvement
    • Don't overlook yolk sac tumor foci or nongerm cell component
Prognostic factors
  • 95% cure rate if no lymph node or metastatic involvement; 40 - 95% with metastases
  • Poor prognosis if extensive pulmonary disease
Treatment
  • Surgery plus chemotherapy
  • 80 - 85% have complete response to chemotherapy, most are cured
Gross description
  • Variegated appearance since usually a mixture of different components
Gross images

Images hosted on other servers:

Embryonal carcinoma and mature teratoma

Seminoma and immature teratoma

Mixed germ cell tumor

Large areas of necrosis

Soft yellow areas

Microscopic (histologic) images

Images hosted on other servers:

Mature teratoma and embryonal carcinoma

Embryonal carcinoma component

Various images