Twenty-Year Pathology Records Trace Testicular Seminoma in the West Bank

Researchers have compiled the first dedicated series of testicular seminoma from the Palestinian population, drawing on two decades of diagnostic records from a single pathology network serving the West Bank. The retrospective study, published in Diagnostic Pathology, analyzed 93 cases of pure testicular seminoma diagnosed between February 2004 and June 2026, offering an unprecedented baseline for a tumor type whose profile had never been described in this population.

The team searched the laboratory information system of Medicare Laboratories for germ cell tumor terms and individually reviewed every candidate report. Of 123 germ cell tumor records retrieved, 93, or 75.6 percent, were pure seminoma. The remainder consisted of 18 mixed germ cell tumors, 10 non-seminomatous germ cell tumors, and 2 non-germ-cell or unclassifiable cases. After excluding these, the researchers de-identified the records and consolidated them to one index diagnostic specimen per patient.

All 93 patients were male, consistent with seminoma’s status as the most common germ cell tumor of young men. The mean age at diagnosis was 35.7 years, with a standard deviation of 9.6 years; the median was 35, the interquartile range spanned 29 to 42 years, and the full range extended from 19 to 68 years. Notably, 70.3 percent of patients fell within the 25 to 44 year age bracket, underscoring the tumor’s concentration in reproductive-age men.

The diagnostic pathway varied considerably across the series. A radical orchiectomy specimen established the diagnosis in 58 patients, or 62.4 percent of the cohort. The specimen-type field was uncoded in 27 cases, accounting for 29.0 percent, while only 4 patients, or 4.3 percent, were diagnosed on biopsy or fine-needle aspiration and another 4 on nodal or extragonadal material. Classic seminoma, the standard histological subtype, was explicitly documented in 55 cases, or 59 percent of the series.

Recorded cases rose from an average of 3.6 per year during 2006 to 2015 to 5.7 per year during 2016 to 2025, a difference that reached statistical significance with a p value of 0.003.

The authors are careful to interpret this upward trend with caution. Because the study is laboratory-based rather than population-based, no denominator exists to calculate incidence rates. The rising recorded caseload, they conclude, most likely reflects the expanding activity and catchment area of the pathology network itself rather than a true change in disease occurrence in the underlying population. The study is explicitly descriptive and makes no inference about population incidence.

These limitations shape what the data can and cannot show. Without population-based cancer registration in the region, laboratory records cannot distinguish between more tumors occurring, more patients reaching these laboratories, or simply more complete record-keeping over time. The uncoded specimen-type field in nearly a third of cases also illustrates gaps in standardized reporting that complicate any attempt to reconstruct diagnostic pathways retrospectively.

Despite these constraints, the series delivers concrete value as an initial reference point. It establishes the demographic shape of seminoma in this setting, with a young median age and a strong concentration in men aged 25 to 44, and it documents the proportion of diagnoses made on definitive orchiectomy specimens versus limited biopsy material. The authors argue that their findings support two practical priorities: standardized synoptic pathology reporting, which would make future records more complete and comparable, and the development of population-based cancer registration, which would finally allow incidence to be measured rather than inferred. As the first dedicated seminoma series from the Palestinian population, the work provides a foundation that future studies can build upon and a concrete demonstration of how laboratory data, even without denominators, can begin to fill gaps in regional cancer surveillance.

Subject of Research: A 20-year laboratory-based clinicopathological series of testicular seminoma diagnosed within a West Bank pathology network

Article Title: Testicular seminoma in the West Bank, Palestine: a 20-year laboratory-based clinicopathological series

Article References: Salhi, I., Bannoura, S., & Salah, Z. (2026). Testicular seminoma in the West Bank, Palestine: a 20-year laboratory-based clinicopathological series. Diagnostic Pathology. https://doi.org/10.1186/s13000-026-01852-1

Image Credits: AI Generated

DOI: 10.1186/s13000-026-01852-1

Keywords: testicular seminoma, germ cell tumor, West Bank, Palestine, clinicopathology, pathology network, retrospective study, Mann-Kendall trend test, orchiectomy, cancer registration, Diagnostic Pathology, young men