Abstract：
The development of somatic-type malignancy (SM) in testicular germ cell tumor represents a major challenge in the diagnosis and treatment of testicular cancer. Most SMs are derived from teratoma, and the remainder is associated with yolk sac tumor. They occur more frequently in metastases than in primary testicular tumors. SMs demonstrate a variety of histologic types, including sarcoma, carcinoma, embryonic-type neuroectodermal tumor, nephroblastoma-like tumor, and hematologic malignancy. Sarcoma, particularly rhabdomyosarcoma, accounts for the majority of SMs in the primary testicular tumors, whereas carcinoma, particularly adenocarcinoma, is the most common SM in metastases. Although SMs derived from testicular germ cell tumors mimic their histologic counterparts in other organs with overlapping immunohistochemical profiles, isochromosome 12p is present in most SMs, which can be useful in the differential diagnosis. The presence of SM in the primary testicular tumor may not worsen the outcome, but the development of SM in metastasis is associated with a poor prognosis. Furthermore, somatic-type carcinoma is likely associated with a worse prognosis than somatic-type sarcoma. Although SMs respond poorly to the cisplatin-based chemotherapy, timely surgical resection is an effective treatment for most patients.
摘要：
睾丸生殖细胞肿瘤中体细胞型恶性肿瘤（SM）的发展是睾丸癌诊断和治疗的主要挑战。大多数SM来自畸胎瘤，其余与卵黄囊瘤有关。它们在转移瘤中比在原发性睾丸肿瘤中更常见。SM表现出多种组织学类型，包括肉瘤,癌,胚胎型神经外胚层肿瘤，肾母细胞瘤样肿瘤,和恶性血液病.肉瘤,尤其是横纹肌肉瘤,占原发性睾丸肿瘤中SMs的大多数，而癌症，特别是腺癌，是转移瘤中最常见的SM。尽管来自睾丸生殖细胞肿瘤的SM在其他器官中模拟了其组织学对应物，具有重叠的免疫组织化学特征，在大多数SMs中存在12p染色体，这在鉴别诊断中很有用。原发性睾丸肿瘤中SM的存在可能不会恶化结果，但转移中SM的发展与不良预后有关。此外，与躯体型肉瘤相比，躯体型癌的预后可能较差。尽管SM对基于顺铂的化疗反应较差，及时手术切除是大多数患者的有效治疗方法。
