The Testicular Cancer Resource Center

Testicular Cancer Tests: The Pathology Report


After the orchiectomy, the removed testicle and spermatic cord are sent to the pathology lab where they are evaluated by a pathologist. Once finished, the pathologist will create a report describing the specimen and findings. The pathology report is very important because the treatment plan is based on the pathologist's observations.

In the case of testicular cancer, you must be aware that pathologists are no different from general practitioners, urologists, or oncologists, and the pathology report is usually an opinion, not a hard fact. Testicular cancer is relatively rare, and chances are pretty good that a normal pathologist does not get to see testicular tumors more than a couple of times a year, if that. If your cancer is unusual or your treatment is highly dependent on the pathology report, then it probably is a good idea to get a second opinion from the pathology department at a referral center that sees testicular cancer frequently. Some pathologists that fall into this category can be found on our experts list. Some specific instances where a second opinion is advised are:

Microscopic Image of Normal Testicular Tissue Microscopic Image of Normal Testicular Tissue adjacent to Seminoma

In our opinion, the pathology report on a testicular germ cell tumor should include the following information1:

Review the pathology report with your doctor, and get a copy of it. If you do not understand any part of it, be sure to get an explanation from the doctor. If you think, based on what you read here, that information is missing, be sure the doctor knows. He can always ask the pathologist to review the slides again. The slides are not thrown away. They are probably kept by the hospital on the order of 7 years, so they are available for another look if that becomes important.

While not a part of the routine pathology report, other investigational items may be used at some time in the future. The genetic isochrome 12 [i(12)p] may be used to prove the germ cell origin of extragonadal tumors that are otherwise hard to identify. Some researchers2 have proposed the use of the immunohistochemical expression of Ki-67 to predict which Stage I non-seminoma patients should have an RPLND. However, it has not proved itself to be useful as of yet, and other researchers doubt its efficacy.3
 

Relevant Links:

References

  1. Brodsky, G.L. "Pathology of Testicular Germ Cell Tumors," Hematology/Oncology Clinics of North America, Vol. 5(6), 1991.
  2. Albers P, Bierhoff E, Neu D, Fimmers R, Wernert N, Müller SC. MIB-1 immunohistochemistry in clinical stage I nonseminomatous testicular germ cell tumors predicts patients at low risk for metastasis. Cancer Vol 79(9),1997;1710-6.
  3. Heidenreich A, Sesterhenn IA, Moul JW. Prognostic risk factors in low stage testicular germ cell tumors. Cancer Vol 79(9),1997;1641-5.


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This page was last updated on Dec 05, 2012
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