Abstract
Testicular cancer is the most frequent solid tumor detected in young adult men. Germ cell tumors (GCTs), particularly seminomas, are the most common type of testicular neoplasms seen in that age population. Most publications have reported decreasing incidence of GCTs in patients above forty years of age. Since the biologic activity of seminomas appears similar across ages, recommended management of senior adults involves a multimodal therapy of radical inguinal orchiectomy with radiation or cytotoxic treatment as needed. Attenuating chemotherapy dosages are critical to ensure better tolerability of associated adverse events. Here we report a case series of 2 men older than fifty years of age with metastatic testicular seminoma. We aim to emphasize a rare clinical entity encountered in the senior adult population.
Highlights
Testicular Germ cell tumors (GCTs) account for most testicular cancers in young adult men and have a peak incidence in the second and third decades of life [1, 2]
Seminoma incidence rates were highest in European and Northern American countries and lowest in Asian and African countries [4]. e highest incidence rates were witnessed in Norway and Denmark (5.5/100,000 man-years), and the lowest rates were encountered in India and Uganda (
Despite their high incidence in young adults, testicular GCTs are rarely encountered in senior adults
Summary
Testicular GCTs account for most testicular cancers in young adult men and have a peak incidence in the second and third decades of life [1, 2]. E World Health Organization’s (WHO) 2016 updated classi cation of testicular GCTs categorizes them based on histopathology into seminomas, non-seminomas, and spermatocytic tumors [5]. Despite their high incidence in young adults, testicular GCTs are rarely encountered in senior adults. Less than 4% of patients with testicular GCTs are above sixty ve years of age [6]. Recent epidemiologic studies highlight an increased incidence of seminomas across all age groups as well as an older age at diagnosis [7]. In most clinicopathological studies seminomas, non-seminomas, and spermatocytic tumors account for 50–55%, 45–50% and 1% of testicular cancers, respectively [7, 8]. In most clinicopathological studies seminomas, non-seminomas, and spermatocytic tumors account for 50–55%, 45–50% and 1% of testicular cancers, respectively [7, 8]. e biological phenotype and malignant potential remain the same across age groups suggesting that similar treatment regimens should be pursued [9]
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