What are other Names for this Condition? (Also known as/Synonyms)

• Spermatocytic Seminoma of the Testicles
• Testicular Spermatocytic Seminoma

What is Spermatocytic Seminoma of the Testis? (Definition/Background Information)

• Spermatocytic Seminoma of the Testis is a type of testicular cancer affecting the germ cells. Germ cells are precursors to sperm cells that will eventually transform into sperms
• Spermatocytic Seminoma should not be confused with seminoma of testis. These are two different types of tumors and are unrelated to each other
• The testes are the male reproductive organs, equivalent to the ovaries in women. They are housed in the scrotum; the sac-like structure in the groin. The testis have 2 main functions:
  • Male hormone production
  • Sperm production
• Testicular cancer is cancer of the testicle, or testis. It is the most common form of cancer in young men aged 15-35 years. It is generally aggressive, but treatable when identified early
• More than 90% of testicular cancers arise from abnormalities in the germ cells. Germ cells are one of the two types of cells in the body. They form sex cells - the sperms and eggs, while the other type, somatic cells, forms everything else (all other body organs and parts)
• Normal germ cells arise from pluripotent stem cells. Pluripotent stem cells can differentiate into, or become, any cell in the body. Thus, pluripotent stem cells may become either germ cells or somatic cells
• The process of pluripotent stem cells becoming other cell types is mediated by chemical signaling. Chemicals that act as signals include growth factors, nutrients, and hormones
• Stem cells that do not respond to normal signals may grow uncontrollably and cause tumors. This tumor-causing potential makes them “neoplastic”. Neoplastic cells that grow aggressively and spread to other areas are cancerous
• There are two types of testicular germ cell cancer:
  • Seminoma: It is a slow-growing cancer affecting men in their 30s and 40s, which is usually confined to the testis. These are of 2 types - classical and spermatocytic seminoma
  • Nonseminoma: It is a fast-growing cancer affecting males in their late teens through 30s, which aggressively metastasizes, or spreads. These are of 4 types - embryonal carcinoma, yolk sac carcinoma, choriocarcinoma, and teratoma
• Mixed germ cell tumor of the testis is made up of 2 or more different types of germ cell tumors; those that are both seminomas and nonseminomas
• The cause for Spermatocytic Seminoma of the Testis that affects older men, is unknown
• Under the microscope, Spermatocytic Seminoma resembles the secondary spermatocytes of developing sperm, and hence the term “spermatocytic”. Its name is misleading, as Spermatocytic Seminoma is not related clinically to classical seminoma. Spermatocytic Seminoma of the Testis is much less common than classical seminoma. It also grows and spreads much less aggressively

Who gets Spermatocytic Seminoma of the Testis? (Age and Sex Distribution)

Individuals at risk for Spermatocytic Seminoma include:

• Adult men aged 65 years
• Caucasians

What are the Risk Factors for Spermatocytic Seminoma of the Testis? (Predisposing Factors)

Following are factors that increase one’s susceptibility to Spermatocytic Seminoma of the Testis:

• Family history of testicular cancer
• Caucasian descent
• Decreased immunity, especially due to HIV
• Kidney transplant
• Hypospadias (male birth defect affecting the urethra)
• Inguinal hernia
• Testicular atrophy
• Gonadal dysgenesis
• Infertility 
• Smoking
• Exposure to radiation and industrial chemicals
• Chemotherapy 
• Viruses (in some rare cases)

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Spermatocytic Seminoma of the Testis? (Etiology)

The cause of Testicular Spermatocytic Seminoma is unknown in a majority of cases. In some cases, abnormalities in chromosome 9 have been noted.

• It is believed that abnormal differentiation of germ cells gives rise to cancerous cells that lead to the formation of this condition
• However, how this occurs and the factors that cause it remain under investigation
• Spermatocytic Seminoma, unlike many other testicular cancers, is not associated with undescended testicles (cryptorchidism)

What are the Signs and Symptoms of Spermatocytic Seminoma of the Testis?

Indications for Spermatocytic Seminoma of the Testis include:

• Blood in vomit and cough
• Blood in stool, urine
• Trouble breathing
• Headache
• Low blood pressure
• Anemia
• Testicular pain, lump in the testes
• Feeling of heaviness in the scrotum; the tumor size may vary from 2-20 cm
• Abdominal pain and swelling
• Breast pain, especially if accompanied by enlargement
• Back pain
• Swelling of the legs
• Constipation
• Changes in appetite
• Fatigue
• Frequent urination
• Paralysis

How is Spermatocytic Seminoma of the Testis Diagnosed?

Following are techniques that aid in identifying Spermatocytic Seminoma of the Testis:

• Physical examination to detect lumps in the testicles, which do not allow light to pass through
• Tissue biopsy followed by microscopic analysis and staining
• Blood tests that include:
  • Complete blood cell count (CBC) blood test
  • Liver function blood test (LFT)
  • Serum tumor marker blood test to detect increases in human chorionic gonadotropin (hCG)
  • Alpha-fetoprotein (AFP) blood test
  • Lactate dehydrogenase (LDH) blood test
  • Testosterone levels blood test
• Genetic testing to determine mutations associated with Testicular Spermatocytic Seminoma
• Radiological imaging including:
  • X-ray of the chest, abdomen, and pelvis
  • Ultrasound of the pelvis
  • Computerized tomography (CT) scan of the brain
  • Vascular radiological studies
  • Whole body bone scan
  • Positron emission tomography (PET) scan

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Spermatocytic Seminoma of the Testis?

Following are complications that may arise from Spermatocytic Seminoma of the Testis:

• Infertility
• Retrograde ejaculation
• Excessive blood loss
• Rarely, sarcomas (high-grade cancers) are known to arise from a Spermatocytic Seminoma
• Occasionally, the tumor may spread to the soft tissues around the testis (paratesticular soft tissue)

How is Spermatocytic Seminoma of the Testis Treated?

Treatments for Spermatocytic Seminoma of the Testis may include the following procedures:

• Removal of the original tumor; Spermatocytic Seminoma rarely metastasizes
• Usually, a surgical removal of the testis is adequate therapy
• De-bulking surgery to reduce tumor size, followed by chemotherapy; if there is a metastasis
• Clotting the vessels in the tumor (embolization)
• Chemotherapy and radiotherapy (in rare cases of metastasis)
• Undertaking treatment of underlying conditions

How can Spermatocytic Seminoma of the Testis be Prevented?

Spermatocytic Seminoma of the Testis may be avoided through the following measures:

• Monthly testicular self-examination
• Genetic testing in individuals with a family history
• Limiting exposure to radiation and industrial chemicals
• Limiting chemotherapy
• Not smoking

What is the Prognosis of Spermatocytic Seminoma of the Testis? (Outcomes/Resolutions)

• The following factors determine the prognosis of the condition:
  • Size of the tumor
  • Stage of the tumor
  • Age of the individual
  • Overall health of the individual
  • Location in the testes of the tumor
  • Number of tumor masses present within the testes
• The prognosis for Spermatocytic Seminoma of Testis is excellent with appropriate treatment, as the tumors formed are mostly benign (harmless). The most common treatment undertaken involves the removal of the testis

Additional and Relevant Useful Information for Spermatocytic Seminoma of the Testis:

• Testicular cancers are aggressive in nature; they are also very quick to develop. Nonetheless, they are readily treatable
• It is the most common form of cancer in US men aged 15 to 35 years. However, it is still relatively uncommon, with 5,500 cases in the US each year and 0.2-10.3 cases worldwide per 100,000 persons
• Spermatocytic Seminoma is a rare condition that makes up for only 2% of the cases of testicular cancer. Less than 400 cases have been reported since the condition was recognized