Spermatocytic seminoma: clinicopathological study of 22 cases.

Twenty-two cases of spermatocytic seminoma are reported. This neoplasm comprises 4.4% of all seminomas seen during the period under study. Nineteen patients were older than 40 years. Painless testicular enlargement was the presenting symptom in 19 patients. The duration of symptoms was more than six months in 12 patients. Macroscopically the tumor was soft, friable, grey, and edematous. Microscopically it is characterized by cellular pleomorphism, round cells and nuclei, scanty stroma, and absence of lymphocytes and granulomas. In none of the cases was the tumor associated with other neoplastic germ cell elements or with classical seminoma. Metastases were not encountered in any of the cases. Apart from 3 patients who died from unrelated causes, all the patients were alive and well for periods varying from two months to 27 years. Spermatocytic seminoma is a distinctive clinicopathological entity. It is unique among germ cell neoplasms because it occurs only in the testis and is not associated with other neoplastic germ cell elements. It has good prognosis and is not associated with metastases. Orchidectomy is the treatment of choice and there is no good evidence indicating that it should be followed by radiotherapy.