Spermato cell tumor

Introduction Seminoma originates from the primordial germ cells of the testis and is the most common tumor of the testis. It occurs mostly after middle age and is often unilateral, with the right side slightly more than the left side. The incidence of cryptorchidism is several times higher than that of normal testis. The tumor is low in malignancy. From the naked eye, the testicles are swollen, sometimes up to 10 times the normal volume, and in a few cases the testes are normal. Tumors vary in size from small to a few millimeters, and larger to more than ten centimeters, usually 3 to 5 cm in diameter. Summary of contents The tumor is highly sensitive to radiation therapy. Lymphatic metastasis is more common, and hematogenous metastasis occurs less frequently. Spermatoblastoma accounts for about 60% of testicular tumors, and the peak incidence is 30 to 50 years old, which is rare in children. In 85% of patients, the testicles were significantly enlarged, the local invasion of the tumor was low, and the tumors generally had obvious boundaries. The development of seminoma is slow, generally first transferred to the retroperitoneal lymph nodes, and extensive hematogenous dissemination can occur in the later stage. When diagnosed, clinical cases account for 60% to 80%. Disease Overview Spermatoblastoma is divided into 3 subtypes: 1 typical seminoma, about 80%, slow growth, good prognosis; 2 undifferentiated seminoma, about 10%, high degree of morbidity, The prognosis is worse than typical seminoma; 3 spermatogonial seminoma, about 10%, more common in patients over 40 years old. Semena cell tumors occur mostly after middle age, often unilateral, slightly more on the right side than on the left side. The incidence of cryptorchidism is several times higher than that of normal testis. The tumor is low in malignancy. In 85% of patients, the testicles were significantly enlarged, the local invasion of the tumor was low, and the tumors generally had obvious boundaries. The development of seminoma is slow, generally first transferred to the retroperitoneal lymph nodes, and extensive hematogenous dissemination can occur in the later stage. When diagnosed, clinical cases account for 60% to 80%. Pathologically, germ cell tumors accounted for 90-95%, and non-germ cell tumors accounted for 5-10%. Germ cell tumors can be classified into seminoma, non-seminoma such as embryonal carcinoma, teratoma, teratocarcinoma, chorionic epithelial cell carcinoma, and yolk sac tumor according to the differentiation of cells. Most testicular tumors can have early lymphatic metastasis, reaching the lymph nodes adjacent to the renal pedicle at the earliest, and there is blood transfer in the early stage of chorionic epithelial cancer. A typical seminoma has the characteristics of a single morphological structure of the tumor cells and lymphocytic infiltration in the interstitial. The tumor cells are diffusely distributed or have a cord-like structure. The morphology of the cells is the same. It is similar to the spermatogonial cells in the normal seminiferous tubules. The tumor cells are large, round or polygonal, with clear boundaries, transparent cytoplasm, large nuclei, central, and nuclear membrane. And the chromatin is thicker, there are 1 or 2 eosinophils, and mitosis is rare. Pathological analysis of seminoma of seminoma has a single morphological structure and lymphocytic infiltration in the interstitial. The two interstitial structures are fine fibrous tissue or dense collagen fibers, accounting for 60% of testicular tumors. In the 30 to 50 years old, it is rare in children. Since the testicular white membrane is relatively tough and not destroyed by the tumor, the original outline of the testicle is usually preserved. The tissue of the facet is yellowish or grayish yellow, solid and uniform, such as fish, and irregular necrotic areas are often seen. The interstitial is a fine fibrous tissue or dense collagen fibers, in which there are many inseparable lymphocytes infiltrated, and sometimes there are lymphoid follicles. From the naked eye, the testicles are swollen, sometimes up to 10 times the normal volume, and in a few cases the testes are normal. Tumors vary in size from small to a few millimeters, and larger to more than ten centimeters, usually 3 to 5 cm in diameter. Since the testicular white membrane is relatively tough and not destroyed by the tumor, the original outline of the testicle is usually preserved. The tumor cells are diffusely distributed or have a cord-like structure. The morphology of the cells is the same. It is similar to the spermatogonial cells in the normal seminiferous tubules. The tumor cells are large, round or polygonal, with clear boundaries, transparent cytoplasm, large nuclei, central, and nuclear membrane. And the chromatin is thicker, there are 1 or 2 eosinophils, and mitosis is rare. There are 3 subtypes of seminoma: typical seminoma, about 80%, slow growth, good prognosis; undifferentiated seminoma, about 10%, high degree of morbidity, prognosis than typical Poor progenitor cells; spermatogonial seminoma, accounting for about 10%, more common in patients over 40 years of age. The tissue of the facet is yellowish or grayish yellow, solid and uniform, such as fish, and irregular necrotic areas are often seen. Microscopically, a typical seminoma. How many lymphocytes infiltrate, and sometimes there are lymphoid follicles. The tumor is highly sensitive to radiation therapy. Lymphatic metastasis is more common, and hematogenous metastasis occurs less frequently. The cause of the disease Semena cell tumor can be divided into two types of germ cell tumor and non-germ cell tumor. The former occurs in the reproductive epithelium of the curved fine tube, accounting for about 95%; the latter is from the interstitial cells, accounting for about 5%. More common in the 25-44 years old, with regional differences in ethnicity. The cause of seminoma is unclear and may be related to race, heredity, cryptorchidism, chemical carcinogens, injury, endocrine, etc. Insufficiency of spermatogonial cells: this is the main cause of this disease. Testicular local temperature rise, blood supply disorders, endocrine dysfunction, testicular atrophy, spermatogenic disorders, prone to malignant transformation. In addition, congenital testicular dysfunction, incomplete decline, is also prone to malignant transformation. Genetics: In recent years, some people with semen cell tumors have a family history of oncology in about 16% of their close relatives. Testicular female syndrome: According to the World Health Organization (WHO) 1977 classification of seminoma, the testicular female syndrome is also prone to seminoma. Trauma: It is considered that trauma is not the direct cause of tumorigenesis, but after testicular trauma, local small hematoma formation or blood circulation disorder, tissue degeneration and atrophy, etc., on the basis of this tumor. Infection: A variety of viral diseases, such as measles, smallpox, viral mumps and bacterial inflammation, can be complicated by orchitis, resulting in testicular cell deformation and spermatogonia. Hormones: Clinical and animal experiments suggest that endocrine is related to the genesis of testicular tumors. For example, testicular tumors occur mostly in young adults with strong gonads, or in active endocrine; animal experiments such as long-term administration of estrogen to rats can induce seminoma. Chinese medicine believes that: emotional dysfunction, or angry liver injury, liver qi stagnation, spleen spleen, spleen and dampness, leaving the liver, long-term formation of hard lumps. "Zheng deficiency and evil spirits" is its pathological mechanism. Dialectical analysis of seminoma is a low-grade malignant tumor, which develops slowly and the testicles are painlessly enlarged. About 75% of seminomas are confined to the testis at the time of diagnosis, 10% to 15% of patients have both metastatic and regional retroperitoneal lymph node lesions, and 5% to 10% of patients have advanced regional lymph nodes. Or an organ transfer. The preferred treatment for most patients after groin orchiectomy is radiation therapy. The irradiation field included the para-aortic and ipsilateral axillary lymphatic drainage area, and the dose was DT20～30Gy. The time to start radiotherapy should be performed as soon as possible after orchiectomy, usually 10 days after surgery, and should not exceed 1 month. Long-term complications of radiation therapy include infertility, gastric ulcer, and second primary tumor caused by radiation. Testicular seminoma goes through five long stages in oncogene, precancerous lesions, subclinical, carcinoma in situ, metastatic cancer, etc. It takes about 2-20 years, and the enveloping circle of colloidal fibers is getting weaker and weaker. The number of capillaries is from nothing, from small to many, and finally becomes a capillary group. In other words, cancer is a sudden increase in capillaries, a lack of hard proteins, and a chronic disease. Chinese medicine knows that testicular seminoma, called renal cystoma, is a blood-heat syndrome, just like milkstone; therefore, the treatment is the same. Surgical resection began in the 1950s, but the survival rate of patients with testicular seminoma is still very low. Testicular seminoma tumors are less than three centimeters, no metastasis, can be surgically removed, but because of the destruction of the cancer encirclement, it is easy to provoke metastasis; after resection, no radiotherapy and chemotherapy. In patients with testicular seminoma, regardless of marital status, whether unilateral or bilateral testicular disease, the doctor should inform the possible birth hazard, and remind patients to consider refrigerated sperm before surgery or before radiotherapy. Surgery may cause immune infertility. Radiotherapy may cause damage to the gonads, accessory gonads and insemination pipelines, seriously affecting the testicular spermatogenesis process, killing sperm, and severe patients may cause azoospermia. Refrigerating sperm can solve the worries of fertility problems. Diffusion mode testicular seminoma spreads in four ways: 1. In the testicular tissue, cancer cells spread in the testis on the side. 2, testicular cancer cells into the lymphatic system growth, called lymphatic metastasis, the chest is next to the bronchi, the hilar, mediastinal lymph nodes; chest outside the clavicle, armpit and upper abdomen lymph nodes. 3, testicular cancer cells into the blood system growth, called blood transfer, lung transfer is most common, followed by growth in the liver, bones, etc. 4, iatrogenic transfer, is the Western medicine surgery, cancer cells are planted in the abdominal cavity or in the incision, more common. Infertility seminoma is the most common testicular tumor in adults, accounting for 60% to 8% of testicular germ cell tumors. The accepted treatment for seminoma is the in vitro radiotherapy of retroperitoneal lymph nodes after orchiectomy, with a 5-year survival rate approaching 95%. Spermatogonia cells are extremely sensitive to radiation, but may cause infertility after irradiation. The treatment of infertility caused by radiotherapy of seminoma cells, especially azoospermia, has few clinical reports. Traditional Chinese medicine method is used to diagnose and treat azoospermia caused by postoperative radiotherapy in patients with right spermatogonia. The spouse is successfully conceived by intracytoplasmic perfusion (ICSI). Adult men have a total testicular weight of about 30g, and can produce 10 million sperm per gram of testicular tissue per day, producing about 200-300 million sperm per day. The sperm is shaped like a scorpion and has a length of about 60 μm. It is divided into four parts: the head, the neck, the body and the tail. The head is large, the neck and the body are equal to the length of the head, and the tail is 10 times the length of the head. The head of the sperm has acrosome and nucleus. The acrosome covers 2/3 of the nucleus. There are many enzymes in the head. These are called acrosome enzymes. They are substances that break through the "shell" of the egg and the transparent band during fertilization. There are chromosomes in the nucleus of the head, which are substances that carry the genetics of the father. The neck and body are mainly cytoplasmic components, which are the parts that maintain sperm life and provide energy for sperm activity. The tail is very long and consists of some proteins. When these protein fibers shrink, the sperm tail can be swung in all directions, and sperm movement occurs. Generally, the forward movement speed of sperm is about 50 to 60 μm per second. Sperm with strong fertility can climb up to a height of about 5cm. Sperm production requires a suitable temperature, and the temperature inside the scrotum is about 2 °C lower than the temperature in the abdominal cavity, which is suitable for sperm production. During embryonic development, for some reason, the testicle does not fall into the scrotum and stay in the abdominal cavity or in the groin, called cryptorchidism, the seminiferous tubules can not develop normally, and no sperm is produced. If the testicles of mature animals are warmed or experimental cryptorchidism is performed, the spermatogenic cells may be degraded and atrophied. The newly released sperm is released into the luminal lumen of the curve, and it does not have the ability to exercise itself. Instead, it is transported into the epididymis by the contraction of the peripheral muscle-like cells of the small tube and the movement of the lumen fluid. In the epididymis, the sperm further matures and gains exercise capacity. A small amount of sperm can be stored in the epididymis, and a large amount of sperm is stored in the inferior tube and its ampulla. In sexual activity, sperm is transported to the urethra by peristalsis of the vas deferens. Sperm is mixed with the secretions of the epididymis, seminal vesicles, prostate and urethral glands to form semen, which is injected outside the body during orgasm. Normal men shoot about 3-6ml of semen each time. Each milliliter of semen contains about 20 to 400 million sperm, less than 20 million sperm, and it is not easy to fertilize the egg. The pathological type of clinically staged seminoma is related to prognosis. The extent of tumor spread and the extent of metastasis also affect the prognosis. Therefore, the clinician should not only understand the pathological type of the tumor, but also develop a corresponding treatment plan according to the difference of the extent of the disease. Therefore, it is practical to determine the stage of disease in each patient. The most commonly used staging methods today are: Stage I: The tumor is confined to the testis and epididymis, but has not yet broken through the capsule or invaded the spermatic cord, and has no lymph node metastasis. Stage II: Physical examination, X-ray examination confirmed that there has been metastasis, can spread to the spermatic cord, scrotum, and inguinal lymph nodes, but did not exceed the retroperitoneal lymphatic area. Those with clinical metastasis of metastatic lymph nodes were stage IIa, and those with clinical examination of abdominal and abdominal lymph nodes were stage IIb. Stage III: There have been lymph node metastasis or distant metastasis above the diaphragm. Some researchers have also classified distant distant people into stage IV. Clinical features Semena cell anterior lateral spermatogonia is the most common mediastinal malignant blastoma, accounting for 2% to 4% of mediastinal tumors, accounting for 13% of mediastinal malignancies, accounting for mediastinal malignant germ cell tumors. 50%. Almost all young men, the peak age of onset is 20-40 years old, located in the anterior mediastinum, 80% have symptoms. Read more...