Question
A 30-year-old man presents with a painless testicular mass. Ultrasound reveals a well-circumscribed, homogeneous, non-hemorrhagic testicular lesion. Histopathology is shown below. What is the most likely diagnosis?
| A. |
Yolk sac tumor
|
| B. |
Choriocarcinoma
|
| C. |
Seminoma
|
| D. |
Teratoma
|
Show Answer
|
Correct Answer � C
Explanation
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|
The histology shows large polygonal cells with clear “watery” cytoplasm, central nuclei, and prominent nucleoli, arranged in sheets.
This morphology is characteristic of seminoma, often described as resembling “fried-egg” cells.
Fibrous septa infiltrated by lymphocytes are a common finding in seminomas (though not clearly shown in this cropped image).
– Seminomas are the most common testicular germ cell tumor in 30–40-year-olds.
Characteristics:
– Painless, slow-growing mass.
– Homogeneous & hypoechoic on ultrasound.
– Lacks hemorrhage/necrosis unlike non-seminomatous tumors.
Tumor markers:
– Mild ↑ β-hCG; normal AFP (alpha-fetoprotein).
– Highly radiosensitive with a good prognosis.
Incorrect Options:
A. Yolk sac tumor – Common in children
B. Choriocarcinoma – Highly malignant, spreads quickly; ↑ β-hCG, often hemorrhagic.
D. Teratoma – Contains multiple germ layers; heterogeneous ultrasound; malignant in adults.
