Testicular Nonseminomatous Germ Cell Tumor

In the United States, testicular cancer is relatively uncommon. However, tumors can form in the testicles (testes) at any age, and they are most frequently diagnosed in men aged 20 through 34. The two main types of testicular cancer are seminoma and testicular nonseminomatous germ cell tumor (NSGCT), both of which arise from abnormal germ cells in the testes.

Unlike seminoma, which is composed of only one cell type, NSGCT encompasses various histological subtypes, including embryonal carcinoma, yolk sac carcinoma, choriocarcinoma, teratoma and mixed germ cell tumors. NSGCT is also more likely to spread beyond the testicle where it originated and spread (metastasize) to distant areas of the body.

Testicular nonseminomatous germ cell tumor causes

Scientists believe NSGCT occurs when sperm-producing germ cells in the testes do not fully mature. However, the precise causes of this developmental abnormality remain unclear.

Testicular nonseminomatous germ cell tumor risk factors

Researchers have linked several risk factors with the development of NSGCT. These include:

• An undescended testicle (cryptorchidism)
• A personal or family history of testicular cancer
• Certain genetic conditions, such as Klinefelter syndrome

While these factors may increase the likelihood of developing testicular cancer, it is important to note that not everyone who has one or more risk factors will develop the condition. Likewise, NSGCT can occur in males who have no known risk factors.

Testicular nonseminomatous germ cell tumor symptoms

NSGCT symptoms are similar to those of other types of testicular cancer, including:

• A lump that can be felt in a testicle
• Swelling in one testicle that causes it to become larger than the other
• A feeling of heaviness or aching in the scrotum
• Aching pain in a testicle or the scrotum

Testicular nonseminomatous germ cell tumor diagnostic testing

If a physician suspects NSGCT based on the symptoms, the diagnostic process may include:

• A clinical evaluation of the testicles and surrounding areas to check for abnormalities, such as swelling, lumps and pain
• Imaging studies, such as ultrasound scans, to help the physician visualize the testicles and identify any masses or other abnormalities
• Blood testing to check for tumor markers, such as alpha-fetoprotein (AFP), beta-human chorionic gonadotropin (beta-hCG) and lactate dehydrogenase (LDH)
• Surgical removal of the affected testicle (orchiectomy) to confirm the cancer diagnosis and begin treatment

Once the diagnosis is confirmed, additional staging tests may be performed to help the physician determine whether the cancer has spread beyond the affected testicle.

Testicular nonseminomatous germ cell tumor treatment

Effective treatment of NSGCT requires a multispecialty approach aimed at removing the cancer, preventing recurrence and preserving the patient’s overall health. Treatment specifics can vary based on factors such as the type and stage of the tumor and the patient’s health and preferences. Common options include:

• Surveillance - For early-stage and low-risk NSGCT, a wait-and-watch approach may be used to monitor the tumor through regular check-ups, imaging scans and blood tests.
• Orchiectomy - Surgical removal of the affected testicle is a standard initial treatment for NSGCT. In addition to providing a definitive diagnosis, this procedure can eliminate the primary source of the cancer.
• Retroperitoneal lymph node dissection (RPLND) - If the cancer has spread to nearby lymph nodes, the cancerous tissues may be surgically removed.
• Chemotherapy - If the cancer has spread to distant areas of the body, a combination of powerful drugs may be administered intravenously or orally to target and destroy widespread tumor cells.
• Radiation therapy - In some cases, radiation therapy may be used to target the cancerous cells, particularly if the tumor has spread to certain areas of the body.

Benefit from world-class care at Moffitt Cancer Center

The multispecialty team in Moffitt’s renowned Urologic Oncology Program offers the latest diagnostic and treatment options for all types of testicular cancer, including NSGCT. Through our robust portfolio of clinical trials, our patients have unique opportunities to benefit from promising new therapies that are not yet available in other settings.

If you would like to learn more about NSGCT, you can request an appointment with a specialist in our Urologic Oncology Program by calling 1-888-663-3488 or submitting a new patient registration form online. We do not require referrals.