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Spermatocytic tumour, once called spermatocytic seminoma, is a rare testicular germ cell tumour of older men that arises from maturing sperm precursors rather than from the fetal germ cells behind ordinary testicular cancer. It almost never spreads, so removing the testis is the whole treatment and no chemotherapy or radiotherapy is needed.
The 2016 WHO classification renamed spermatocytic seminoma as spermatocytic tumour and placed it among the germ cell tumours unrelated to germ cell neoplasia in situ, because it derives from postpubertal spermatogonia rather than from the arrested fetal germ cells that give rise to seminoma and non-seminoma (Moch 2016). Marker studies identified two types characterised by OCT2 or SSX2-4 expression, corresponding to distinct spermatogonial subpopulations, supporting a spermatogonial stem cell origin (Journal of Pathology 2011). In the Australian registry study it made up 1.1 percent of seminomas, with a mean age of 53.5 but a range from 19 to 92, occurring as often under 55 as over (Journal of Urology 2007).
How it differs from its parent: it lacks isochromosome 12p and germ cell neoplasia in situ, is not associated with cryptorchidism or the other risk factors of testicular cancer, does not raise the serum markers, and metastasises almost never except in the rare sarcomatous transformation, so the surveillance and chemotherapy pathways of seminoma do not apply.
How common: 0.4 per million men a year (Journal of Urology 2007).
Treatment: radical orchidectomy alone, with no adjuvant therapy and no routine retroperitoneal imaging beyond a baseline scan; the rare tumour with sarcomatous transformation is treated as a sarcoma.
58 of 9,658 primary malignant testicular tumours in Australia over 1982 to 2002, 1.1 percent of all seminomas, an age-standardised incidence of 0.4 per million men a year; age 19 to 92, mean 53.5 (Journal of Urology 2007).
Germ cell tumours drain along the spermatic cord to the para-aortic nodes high in the abdomen, not to the groin, which is why staging scans look at the retroperitoneum.
Same organ: Retroperitoneal germ cell tumour, Leydig cell tumour of the testis, Sertoli cell tumour of the testis, Germ cell neoplasia in situ (GCNIS), Embryonal carcinoma of the testis, Yolk sac tumour of the testis, postpubertal type, Choriocarcinoma of the testis, Testicular germ cell tumours, Seminoma, Non-seminomatous germ cell tumour, Germ cell tumours of childhood and adolescence (extracranial and CNS)
No subtypes recorded beyond the ones named in the family strip above.
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