Metastatic Mixed Germ Cell Tumor Presented With Hemoptysis- A Case Report

A 35 year’s old male presented with right testicular swelling for last six month. He developed hemoptysis and mild dyspnea for 2 weeks. Ultrasonography revealed testicular malignancy with multiple heterogenecity. CT scan of the abdomen did not reveal any lymph node metastasis. His X-ray chest showed extensive pulmonary metastasis. All three tumor markers were raised. Histology was suggestive of mixed germ cell tumor with a rare combination of Seminoma and Choriocarcinoma. Because of this rare combination of 2 varieties of testicular germ cell tumor and advanced systemic metastasis we presented this case.

Download Full-text

Mixed Germ Cell Tumor of Testis with Isolated Scapular Metastasis: A Case Report and Review of the Literature

Case Reports in Urology ◽

10.1155/2015/205297 ◽

2015 ◽

Vol 2015 ◽

pp. 1-3

Author(s):

Dipti Rani Samanta ◽

Chaitali Bose ◽

Roopesh Krishnappa ◽

Saumyaranjan Mishra ◽

Sulagna Mohanty ◽

...

Keyword(s):

Bone Metastasis ◽

Germ Cell ◽

Germ Cell Tumor ◽

Testicular Germ Cell Tumor ◽

Serum Markers ◽

Cell Tumor ◽

Testicular Germ Cell ◽

Mixed Germ Cell Tumor ◽

Nonseminomatous Germ Cell Tumor ◽

Poorly Differentiated

Bone metastasis is a rare entity in germ cell tumor of testis and is a poor prognostic site. It is usually associated with synchronous metastasis at other sites. Till now very few cases of isolated bone metastasis of germ cell tumor of testis have been reported but none have reported scapular metastasis. We are reporting a case of nonseminomatous germ cell tumor of right testis that was operated eight months ago and now presented with isolated scapular metastasis. Histopathology of the scapular tissue revealed rhabdomyosarcoma or poorly differentiated synovial sarcoma. Immunohistochemistry with serum markers concluded it to be metastatic germ cell tumor. To the best of our knowledge this is the first reported case of scapular metastasis of testicular germ cell tumor. This case is being reported here due to dilemmatic way of presentation and also to emphasize that histopathology may sometimes misguide and immunohistochemistry is necessary in such cases.

Download Full-text

Nephroblastoma Arising from Primary Testicular Germ Cell Tumor: A Case Report and Literature Review

Case Reports in Pathology ◽

10.1155/2016/7318672 ◽

2016 ◽

Vol 2016 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Houda Alatassi ◽

Brittany E. O’Bryan ◽

Jamie C. Messer ◽

Zhenglong Wang

Keyword(s):

Germ Cell ◽

Germ Cell Tumor ◽

Embryonal Carcinoma ◽

Lung Metastases ◽

English Literature ◽

Germ Cell Tumors ◽

Testicular Germ Cell Tumor ◽

Cell Tumor ◽

Testicular Germ Cell ◽

Mixed Germ Cell Tumor

Adult extrarenal nephroblastoma is a very rare tumor. Nephroblastoma arising from primary testicular germ cell tumor is exceedingly rare. To our knowledge, only three cases have been reported in the English literature. We report a case of a 19-year-old man who presented with a large right testicle. Image studies showed a large retroperitoneal mass along with liver and lung metastases. Orchiectomy demonstrated a mixed germ cell tumor composed of yolk sac tumor, embryonal carcinoma, and mature and immature teratoma with a significant portion of nephroblastoma. The patient received chemotherapy and no recurrence was noted during six months of followup. WT-1 expression was also studied due to the lack of consistency of its expression in testicular nephroblastoma in the literature. We also present a discussion and review of the literature due to its rarity, which indicate an adverse prognosis for patients with nephroblastoma components receiving standard chemotherapeutical regimes for testicular germ cell tumors.

Download Full-text

Lower abdominal and pelvic radiation and testicular germ cell tumor risk

PLoS ONE ◽

10.1371/journal.pone.0239321 ◽

2020 ◽

Vol 15 (11) ◽

pp. e0239321

Author(s):

Kevin T. Nead ◽

Nandita Mitra ◽

Benita Weathers ◽

Louisa Pyle ◽

Nnadozie Emechebe ◽

...

Keyword(s):

Germ Cell ◽

Germ Cell Tumor ◽

Barium Enema ◽

Testicular Germ Cell Tumor ◽

Cell Tumor ◽

X Rays ◽

Testicular Germ Cell ◽

X Ray ◽

Diagnostic Radiation ◽

History Of

Background Testicular germ cell tumor (TGCT) incidence has increased in recent decades along with the use and dose of diagnostic radiation. Here we examine the association between reported exposure to diagnostic radiation and TGCT risk. Methods We conducted a case-control study of men with and without TGCT recruited from hospital- and population-based settings. Participants reported on exposures to 1) x-ray or CT below the waist and 2) lower GI series or barium enema, which consists of a series of x-rays of the colon. We also derived a combined measure of exposure. We used logistic regression to determine the risk of developing TGCT according to categories of exposures (0, 1–2, or ≥3 exposures) and age at first exposure, adjusting for age, year of birth, race, county, body mass index at diagnosis, family history of TGCT, and personal history of cryptorchidism. Results There were 315 men with TGCT and 931 men without TGCT in our study. Compared to no exposures, risk of TGCT was significantly elevated among those reporting at least three exposures to x-ray or CT (OR≥3 exposures, 1.78; 95% CI, 1.15–2.76; p = 0.010), lower GI series or barium enema (OR≥3 exposures, 4.58; 95% CI, 2.39–8.76; p<0.001), and the combined exposure variable (OR≥3 exposures, 1.59; 95% CI, 1.05–2.42; p = 0.029). The risk of TGCT was elevated for those exposed to diagnostic radiation at age 0–10 years, compared to those first exposed at age 18 years or later, although this association did not reach statistical significance (OR, 2.00; 95% CI, 0.91–4.42; p = 0.086). Conclusions Exposure to diagnostic radiation below the waist may increase TGCT risk. If these results are validated, efforts to reduce diagnostic radiation doses to the testes should be prioritized.

Download Full-text

Diagnostic radiation and testicular germ cell tumor risk.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.6_suppl.556 ◽

2018 ◽

Vol 36 (6_suppl) ◽

pp. 556-556

Author(s):

Kevin Thomas Nead ◽

Nandita Mitra ◽

Benita Weathers ◽

Louisa T Pyle ◽

Katherine L. Nathanson ◽

...

Keyword(s):

Germ Cell ◽

Germ Cell Tumor ◽

Testicular Germ Cell Tumor ◽

Cell Tumor ◽

The Body ◽

Testicular Germ Cell ◽

X Ray ◽

Increased Risk ◽

Diagnostic Radiation ◽

History Of

556 Background: Both incidence of testicular germ cell tumor (TGCT) and use of diagnostic radiation have increased in recent decades. In a quarter of diagnostic scans in children, direct and indirect radiation dose to the testes exceeds 20 mSv, which surpasses thresholds associated with malignancy risk (~5 mSv). Here, we examine the association between exposure to diagnostic radiation and TGCT risk in a case-control study. Methods: Cases were enrolled in a hybrid hospital- and population-based setting and controls were recruited from the community. Participants reported on exposures to x-ray/CT below the waist and lower GI series, and we derived a combined variable for any exposure. After imputation to infer missing data, we compared baseline characteristics and used multivariable logistic regression adjusting for age and race to determine the risk of developing TGCT according to number of exposures and age at first exposure. Results: As expected, cases (n = 1088) were more likely than controls (n = 1458) to be white, have a family history of TGCT, and have a history of cryptorchidism (p < 0.05). There was an increased risk of TGCT with a greater number of exposures for both x-ray/CT (ptrend= 0.002) and the combined diagnostic radiation variable (ptrend< 0.001). Compared to those without any exposure, risk was greatest among those reporting ≥6 exposures for x-ray or CT (OR, 9.6; 95% CI, 4.6-19.9; p < 0.001) and the combined variable (OR, 5.8; 95% CI, 3.2-10.4; p < 0.001), after adjusting for age at first exposure. Early first exposure before eleven years of age increased risk of TGCT for x-ray/CT (OR, 2.36; 95% CI, 1.17-4.77) and combined radiation exposure (OR, 1.96; 95% CI, 1.05-3.67) compared to later first exposure after seventeen years of age, adjusting for total exposures. Analyses limited to observed data only yielded similar results. Conclusions: Exposure to diagnostic radiation below the waist, particularly among younger individuals, may increase TGCT risk. These results should be validated. As the testes are present outside the body and rarely examined using diagnostic radiation, a unique opportunity for shielding exists. Efforts to reduce testicular dose and optimize shielding practices should be prioritized.

Download Full-text