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Benign neck metastasis of a testicular germ cell tumor
1Department of Surgical Oncology, Peter MacCallum Cancer Institute, Melbourne, Australia.
Abstract:
Germ cell tumors (GCTs) are relatively rare neoplasms considered to be curable malignancies since the introduction of cisplatin. The presence of neck metastasis has been reported, with fewer reports of metastatic mature teratoma. In this study, 3 cases of "benign neck" metastasis in patients with GCT between 1998 and 2010 were reviewed retrospectively. In all 3 cases the presenting clinical sign was a left lower neck mass, leading to the diagnosis of the primary site in the testis. All had surgical salvage following chemotherapy, with benign lesions or mature teratoma in histopathology of the neck mass. Chemotherapy was followed by salvage lower-half neck dissection showing benign features in the neck specimen, even though malignancy was proven histologically in other areas. Only 1 patient had a postoperative chyle leak, which resolved spontaneously after several days. Neck dissection is recommended in those patients because malignancy cannot be excluded.
Insights
Germ cell tumors (GCTs) can metastasize to the neck, sometimes presenting as benign lesions or mature teratoma. Neck dissection is recommended for GCT patients with neck masses to rule out malignancy.
Area of Science:
- Oncology
- Pathology
Background:
- Germ cell tumors (GCTs) are curable malignancies, but metastasis can occur.
- Neck metastasis from GCTs is rare, with limited reports on metastatic mature teratoma.
Observation:
- Retrospective review of 3 GCT cases (1998-2010) with neck metastasis.
- All patients presented with a left lower neck mass, leading to testicular GCT diagnosis.
- Histopathology revealed benign lesions or mature teratoma in the neck mass post-chemotherapy.
Findings:
- Salvage neck dissection showed benign features despite proven malignancy elsewhere.
- One patient experienced a spontaneous chyle leak post-surgery.
Implications:
- Neck dissection is crucial for GCT patients with neck masses to exclude malignancy.
- This approach aids in comprehensive staging and treatment planning for GCT metastasis.
