Primitive Neuroectodermal Tumor of the Testis.

Area of Science:

• Oncology
• Urology
• Pathology

Background:

• Testicular germ cell tumors are the most common solid malignancy in young men.
• Mixed germ cell tumors present unique diagnostic and therapeutic challenges.
• Primitive neuroectodermal tumor (PNET) component is rare in mixed germ cell tumors.

Observation:

• A 21-year-old male presented with a left testicular mass and retroperitoneal lymphadenopathy.
• Pathological examination revealed a mixed germ cell tumor: PNET with mature teratoma.
• Patient underwent sperm preservation, followed by orchiectomy and retroperitoneal lymph node dissection (RPLND).

Findings:

• Six cycles of IE (ifosfamide, etoposide) and VAC (vincristine, doxorubicin, cyclophosphamide) chemotherapy were administered.
• Post-chemotherapy RPLND showed no evidence of residual tumor.
• All resected lymph nodes exhibited reactive changes, indicating successful treatment response.

Implications:

• This case highlights the successful management of a rare mixed germ cell testicular tumor.
• Combined modality treatment (chemotherapy and surgery) can be effective.
• RPLND remains a crucial step in assessing treatment response and achieving remission in testicular cancer.