[A case of occult testicular tumor]

Area of Science:

• Oncology
• Pathology

Background:

• Germ cell tumors (GCTs) are neoplasms originating from germ cells, typically found in the gonads.
• Extragonadal GCTs present outside the testes, posing diagnostic challenges.
• Distinguishing between primary extragonadal GCTs and occult testicular GCTs is critical for appropriate management.

Observation:

• A 43-year-old male presented with left supraclavicular and upper abdominal masses.
• Biopsy of the supraclavicular mass revealed a mixed germ cell tumor, including seminoma, embryonal carcinoma, and choriocarcinoma.
• Physical examination revealed a normal left testis and a slightly atrophic right testis.

Findings:

• Right orchiectomy identified a 1 cm primary testicular seminoma.
• Histological examination confirmed seminoma as the primary testicular tumor.
• The extragonadal masses were consistent with metastatic GCT from the occult right testicular primary.

Implications:

• This case highlights the importance of thorough testicular evaluation in patients with suspected extragonadal germ cell tumors.
• Histological confirmation of a primary testicular tumor is essential for accurate diagnosis and treatment planning.
• Early detection and management of occult testicular GCTs can improve patient outcomes.