Description
Clinical History
A 37-year old male patient presents with a 1-month history of lethargy, cough and weight loss. He had a history of an orchiectomy 18 months previous for a testicular tumor. Then 12 months post-op he underwent neck radiotherapy to treat metastasis. On admission, he became acutely dyspnoeic and hypoxic and died.
Pathology
This right lung specimen (and portions of 4 ribs) has been sliced longitudinally. There are numerous rounded tumor nodules evident in the lung parenchyma ranging from 5 to 30mm in diameter. The tumors are variegated in appearance with pale yellow and dark brown cut surfaces. One tumor is extending along the bronchus of the lower lobe forming a cast. Several nodules project from the pleural surface and some show central umbilication from necrosis and hemorrhage. This is an example of pulmonary metastases from a mixed germ cell testicular tumor, most likely choriocarcinoma arising in a malignant teratoma.
Further Information
Germ cell testicular tumors (GCT) are the most common tumors found in men. Average age of diagnosis is 30 year of age and are rarely diagnosed pre-puberty. Risk factors for development include cryptorchidism and a positive family history of GCT. Familial GCT increased risk can be linked to genes encoding for kinases, e.g. KIT and BAK.
They can be divided into two groups: seminomatous (resemble primordial germ cells) and non-seminomatous (resemble embryonic stem cells). Over one third of GCT are mixed GCT, with two or more GCT types in one mass. Many possible combinations of seminoma, teratoma, embryonal carcinoma, yolk sac tumor, and choriocarcinoma can be seen. Teratomas components are found in one third of mixed GCT. Elevated serum Alpha Fetoprotein and beta-HCG are produced by choriocarcinoma. Lymphatic spread involves the retroperitoneal para aortic nodes initially. Mediastinal and supraclavicular nodes may later become involved. The lungs are the most common site for hematogenous spread but the liver, brain or bones may also be affected.
Symptoms may include a painless testicular mass and haematospermia. Later symptoms of distant metastases may occur. Common symptoms of lung metastases include cough, dyspnoea, hemoptysis, recurrent infection
Treatment depends on clinical stage but usually involves radical orchiectomy, chemotherapy and sometimes radiotherapy. More than 95% on early stage GCT can be cured.
Advantages
- Anatomically accurate and identical to real specimen
- No ethical issues - not real human body parts
- Reasonably priced
- Available within a short lead time
- Reproducible, several identical prints can be used as a classroom set
- Can be produced in different sizes to cater for the needs of the teacher
Human Cadavers
- Access to cadavers can be problematic. Many countries cannot access cadavers for cultural and religious reasons
- Cadavers cost a lot money
- High cost for establishing your own plastination suite
- Wet specimens cannot be used in uncertified labs
- Dissection of cadavers is a lot of staff time and that is a cost
- Storage of cadaver material needs special refrigeration etc. which has coast
- If you want another specimen you have to start all over again
Plastinates
- Costs
- Ethical issues
- Timeframe for plastination process
- Many countries do not allow their importation
- One of a kind
Superior 3D print results compared with conventional methods
- Vibrant color offering with 10 million colors
- UV-curable inkjet printing
- High quality 3D printing that can create products that are delicate, extremely precise and incredibly realistic
Clear Support Material
- To avoid breakage of fragile, thin, and delicate arteries, veins or vessels, a clear support material is printed on such spots. This makes the models robust and can be handled by students easily.
