Histomorphology and IHC of Germ Cell Tumors at various anatomical sites:A 5 year study at a tertiary care centre

Abstract

 Background: Germ cell tumours (GCTs) are a heterogeneous group of neoplasms, which occur in the gonads, and indifferent extragonadal sites of the body. The relative proportion of teratoma is quite different in the two gonads, with about 95% of ovarian germ cell tumours represented by pure teratoma, and about 4% of testicular germ cell tumours having a pure form.

Objectives: 1. To study and evaluate parameters like frequency and patterns of histopathologically diagnosed germ cell tumours at different anatomic sites and their nature.

2. To study these parameters in various age groups and correlate them. 3. To study their IHC markers.

Study Design: It was a prospective and retrospective observational study of 5 years conducted in the Dept. Pathology, SKIMS Soura. We received Resected specimens and biopsies of germ cell tumours in our Department

Participants A total of 93 cases of Germ Cell Tumorsoccurring at all possible sites of origin were collected Only Primary GCTs were included while recurrent cases were excluded.

Methodology: In the prospective study the specimens obtained after surgical exploration of patients were examined In the retrospective study the slides and blocks were retrieved from the archives of the department The tumors were classified according to the WHO Classification of Germ Cell Tumors 2016. after studying the gross and microscopic features and reviewed.

Results Mean age for study population was 27.8 years. Mature cystic teratoma was the most common histopathological variant and were mostly ovarian in origin.Most of the malignant GCTs were gonadal while EGCTs were more likely to be benign. MGCTs were mostly testicular in origin. IHC was consistent with the histopathological variant.

Conclusion: Mature cystic teratomas were the most frequent histological subtypes MGCTs are not frequently encountered Choriocarcinoma, Post Pubertal Teratoma ,Spermatocytictumors were rarely observed in the study period Embryonalcarcinoma is seen mostly as a mixed component Tumors like Seminoma and YST are mostly gonadal and are very rare at the extragonadal sites.

IHC helped in confirming the diagnosis with certain markers being specific for a particular histological subtype