Most pathologists use the World Health Organization classification system for testicular tumors:
Germ cell tumors
Precursor lesions
Intratubular germ cell neoplasia
Unclassified type (carcinoma in situ)
Specified types
Tumors of one histologic type (pure forms)
Seminoma
Variant - Seminoma with syncytiotrophoblastic cells
Spermatocytic tumor
Variant - spermatocytic tumor with sarcoma
Embryonal carcinoma
Yolk sac tumor
Trophoblastic tumors
Choriocarcinoma
Variant - monophasic choriocarcinoma
Placental site trophoblastic tumour
Cystic trophoblastic tumor
Teratoma
Variant - Dermoid cyst
Variant - Epidermoid cyst
Variant - Monodermal teratoma (Carcinoid), Primitive neuroectodermal tumor (PNET), Nephroblastoma-like tumor, others.
In the UK, a similar trend has emerged: since improvements in treatment, survival rates have risen rapidly to cure rates of over 95%. Radiation therapy
Radiation may be used to treat stage II seminoma cancers, or as adjuvant (preventative) therapy in the case of stage I seminomas, to minimize the likelihood that tiny, non-detectable tumors exist and will spread (in the inguinal and para-aortic lymph nodes). Radiation is ineffective against and is therefore never used as a primary therapy for nonseminoma. Chemotherapy
Non-seminoma
Chemotherapy is the standard treatment for non-seminoma when the cancer has spread to other parts of the body (that is, stage 2B or 3). The standard chemotherapy protocol is three, or sometimes four, rounds of Bleomycin-Etoposide-Cisplatin (BEP). BEP as a first-line treatment was first reported by Professor Michael Peckham in 1983. The landmark trial published in 1987 which established BEP as the optimum treatment was conducted by Dr. Lawrence Einhorn at Indiana University. An alternative, equally effective treatment involves the use of four cycles of Etoposide-Cisplatin (EP).Lymph node surgery may also be performed after chemotherapy to remove masses left behind (stage 2B or more advanced), particularly in the cases of large nonseminomas. Seminoma
As an adjuvant treatment, use of chemotherapy as an alternative to radiation therapy in the treatment of seminoma is increasing, because radiation therapy appears to have more significant long-term side effects (for example, internal scarring, increased risks of secondary malignancies, etc.).