Extragenital gonadal neoplasia and metastatic testicular tumor

Patients with retroperitoneal or mediastinal neoplasms of gonadal tissue type and clinically normal testes pose interesting therapeutic dilemmas. Three major groups of patients are recognized: (1) tumor is primary extragenital gonadal neoplasm; (2) occult microscopic primary neoplasm in a testicle with metastases; (3) area of fibrosis in a testicle representing local regression of tumor, but with distant metastases. Review of case reports often indicates lack of data sufficient for classification. Every effort should be made to group patients into proper categories, since treatment will vary. Two patients classified as group 2 are presented.