Abstract

SORIANO SARRIO, Pilar; CHIRIVELLA, Isabel  and  NAVARRO FOS, Samuel. Coexistence of two tumors, seminomatous and nonseminomatous, with an uncommon clinical presentation. Arch. Esp. Urol. [online]. 2008, vol.61, n.5, pp.626-630. ISSN 0004-0614.

Objectives: The existence of non seminomatous mixed germ cell tumors of the testis is a frequent event in urologic oncology. Nevertheless, the presence of both components, seminomatous and non seminomatous, in a germ cell tumor is unusual. Methods: We present a case of pure classic seminoma of the testis with a lymph node metastasis of pure embryonal carcinoma, with confirmatory immuohistochemical study and clinical outcome of the patient. Results: A 34 year old man presented with 3 cm supraclavicular tumor. CT scan also revealed multiple metastases in lymph nodes, liver, kidney and left adrenal gland. Tumor markers were negative and the biopsy performed discovered a lymph node metastasis of embryonal carcinoma of probable testicular origin. Ultrasound revealed a 6 mm hypoechoic nodule in the right testis. Orchyectomy was performed and pathologic analysis demonstrated a tu-mor, 1 cm of diameter, histopathologically compatible with classical seminoma with pagetoid extension to rete testis. Albuginea and spermatic cord did not present neoplastic involvement. Currently the patient is being treated with chemotherapy. Conclusion: The interest of the case is to remark an unusual aggressive clinical presentation as well as to perform a bibliographic review with emphasis in the theories regarding heterogeneous differentiation and spontaneous regression of germ cell tumors of the testis.

Keywords : Mixed germ cell tumours; Seminoma; Testicular embryonal carcinoma; Testicular malignant neoplasia; Metastasis.

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