Synchronous mixed germ cell tumor of testis and renal cell carcinoma: A rare presentation

Synchronous presentation of mixed germ cell tumor of testis and renal cell carcinoma is a rare presentation and has not been reported in literature. RCC accounts for 3% of all adult malignant neoplasms (Marzouk et al., 2014). It is the most lethal urologic cancers. Testicular cancer is of generally aggressive form and is the most common form of cancer in young men aged 15-35 years.

We report a case of incidental finding of left renal cell carcinoma with mixed germ cell tumor of right testis in our patient. A 36 years old male patient came with complaints of painless swelling in the right side of the scrotum since 1 year. On palpation a hard swelling of size 5 x 4 cm was palpable in right scrotum. Ultrasonography suggested likelihood of a neoplastic etiology. On Contrast enhanced CT of abdomen, a well defined mass in the lower pole of left kidney likely to be an Oncocytoma, which was not palpable. CT guided biopsy of renal mass, was suggestive of epithelial renal tumor probably oncocytoma or low grade renal cell carcinoma.

In literature there are very few cases reported of metachronous mixed germ cell tumor of testis and renal cell carcinoma. There are 12 reports of patients having metachronous testicular and renal malignancy. During the metastatic work up to mixed germ cell tumor we found the mass in the left kidney which was ultimately diagnosed to be renal cell carcinoma. The management of both the malignancies depend on their merit and is a real challenge for a surgeon.

Treatment strategies for both malignancies depend on accurate clinical staging and should be integrated to provide optimal results.