The differences between gonadal and extra-gonadal malignant teratomas in both genders and the effects of chemotherapy

The effect of gonadal and extragonadal malignant cancers on sperm quality

Background

Many studies have reported that testicular germ cell tumours (TGCTs) give rise to a decrease in sperm production and may further lead to infertility. However, little is known regarding sperm production in extragonadal germ cell tumours (EGCTs). We have studied the differences in the characteristics and sperm quality of patients with testicular cancer and patients with EGCTs.

Methods

We collected and analysed demographic factors, semen parameters, and the disposition of banked sperm.

Results

TGCTs accounted for the majority of malignant cancers compared with EGCTs (83.9% vs. 16.1%, respectively). There were no statistically significant differences in semen volume, pre-freeze concentration, pre-freeze motility, post-thaw concentration, post-thaw motility or recovery rate between patients with TGCTs and those with EGCTs. Both patients with TGCTs and EGCTs showed low pre-freeze and post-thaw sperm concentrations. Men with a seminoma had a higher median level of thaw-sperm motility in their ejaculate than men with non-seminomas. TGCT (67%) and EGCT (72%) patients chose to keep their specimens in storage.

Conclusions

Our study provides evidence that both patients with TGCTs and EGCTs have a high risk for impaired semen quality and gonadal dysfunction. This suggests that oncologists and patients should consider the effects of both TGCTs and EGCTs on fertility among males.

Mediastinal Teratoma: A Pictorial Essay

종격동은 생식선 이외에서 발생하는 기형종의 가장 호발하는 부위로 알려져 있다. 종격동 성숙 기형종은 주로 젊은 성인에서 나타나고 남녀 간 발생 빈도의 큰 차이 없이 나타난다. 종격동 기형종은 대부분 전종격동에서 관찰되고, 일반적으로 증상을 보이지 않지만 종괴의 크기가 크거나 파열이 발생할 경우 여러 합병증이 나타날 수 있다. 종격동 기형종은 대부분 조직 검사 없이 전산화단층촬영(CT)만으로 진단될 수 있다. 하지만 파열된 기형종 혹은 악성 기형종의 경우 임상적 그리고 영상의학적으로 비전형적인 양상을 보여 진단이 어려울 수 있다. 본 종설에서는 종격동 기형종의 다양한 발현 양상을 영상 검사 소견을 중심으로 살펴보고자 한다.

Teratoma of the adrenal gland: clinical experience and literature review

Teratoma originates from pluripotent cells of two or more than two germ cell layers, and most of them are benign. Teratomas are found in the ovaries and testes. Retroperitoneal teratoma is rare, especially adrenal teratoma. Here, we describe a rare case of a 17-year-old woman who was diagnosed with pulmonary tuberculosis and a right adrenal mass at the age of eight. So, she received anti-tuberculosis treatment. Nine years later, chest X-rays showed prior lesions in both lungs, and abdominal CT showed the mass in the right adrenal gland was larger than before, during this period she had no clinical symptoms. She underwent retroperitoneal laparoscopic adrenalectomy, and the pathological diagnosis was a mature teratoma of the right adrenal gland. During a one-year follow-up, the patients recovered well without any discomfort. Thirty-two cases were found in the literature review, among which no patients had a history of pulmonary tuberculosis. Adrenal teratoma is often seen in females and the left adrenal gland. The imaging features of adrenal teratoma can be cystic, solid, and cystic solids. Mature fat and calcification can be seen in most teratomas. Comprehensive analysis of clinical features and imaging characteristics can enhance the diagnostic confidence of radiologists in adrenal teratoma.