The development of somatic-type malignancies (SMs) in testicular germ cell tumors (GCTs) is a rare but well-recognized phenomenon. We studied the pathologic features of 63 GCTs with SMs in the testis (n=22) or metastases (n=41) and correlated these features with clinical outcomes. The patients with SMs in the testis (median age, 26 y) were younger than those with metastatic SMs (median age, 38.5 y). The SMs consisted of carcinomas (n=21), sarcomas (n=21), primitive neuroectodermal tumors (n=15), nephroblastomas (n=3), and mixed tumors (n=3). Sarcoma was the most common SM in the testis (n=11), and most sarcomas were rhabdomyosarcomas (n=9). Carcinoma was the most common SM in metastases (n=20), and most carcinomas were adenocarcinomas (n=12). In metastases, carcinomatous SMs developed after a longer interval from the initial orchiectomy (median times, 213 mo) than sarcomatous SMs (median times, 68 mo). Patients with metastatic SMs had significantly poorer overall survival than those with SMs in the testis (5-y survival rate, 35% vs. 87%; P=0.011). Furthermore, patients with carcinomatous SMs had a significantly worse prognosis than those with sarcomatous or primitive neuroectodermal tumor SMs (5-y survival rates, 17%, 77%, and 73%, respectively; P=0.002), when the whole cohort, including testicular and metastatic SMs, were analyzed. Our results demonstrate that SMs in metastatic GCTs are associated with a significantly worse prognosis than those in the testis. Furthermore, the histologic subtype of SM has a significant effect on the clinical outcome, with the carcinomatous SM carrying the highest risk for mortality.

中文翻译：

---

睾丸生殖细胞肿瘤中的体细胞型恶性肿瘤：63 例临床病理学研究。

睾丸生殖细胞肿瘤（GCT）中发生体细胞型恶性肿瘤（SM）是一种罕见但众所周知的现象。我们研究了 63 例睾丸 (n = 22) 或转移 (n = 41) 中具有 SM 的 GCT 的病理特征，并将这些特征与临床结果相关联。睾丸SMs患者（中位年龄26岁）比转移性SMs患者（中位年龄38.5岁）年轻。SM 包括癌 (n=21)、肉瘤 (n=21)、原始神经外胚层肿瘤 (n=15)、肾母细胞瘤 (n=3) 和混合肿瘤 (n=3)。肉瘤是睾丸中最常见的 SM (n=11)，大多数肉瘤是横纹肌肉瘤 (n=9)。癌是转移瘤中最常见的 SM (n=20)，大多数癌是腺癌 (n=12)。在转移中，癌性 SM 的发展间隔时间（中位时间，213 个月）比肉瘤性 SM（中位时间，68 个月）更长。转移性 SM 患者的总生存率明显低于睾丸内 SM 患者（5 年生存率，35% vs. 87%；P=0.011）。此外，当整个队列包括：分析了睾丸和转移性 SM。我们的结果表明，转移性 GCT 中的 SM 与睾丸中的 SM 相比，预后明显较差。此外，SM 的组织学亚型对临床结果有显着影响，癌性 SM 的死亡风险最高。