Testicular Embryonal Carcinoma With Retroperitoneal Metastasis and Normal AFP and HCG: A Case Report

Area of Science:

• Oncology
• Urology

Background:

• Testicular germ cell tumors are prevalent in young males.
• Embryonal carcinoma, a non-seminomatous subtype, typically presents with elevated serum tumor markers.
• Atypical presentations, like marker-negative cases, pose diagnostic difficulties.

Purpose of the Study:

• To report a rare case of testicular embryonal carcinoma with normal serum tumor markers.
• To emphasize the diagnostic challenges and the importance of a multidisciplinary approach in marker-negative cases.
• To underscore the efficacy of standard treatment protocols and long-term surveillance.

Main Methods:

• Case report of a 24-year-old male patient.
• Diagnostic workup included imaging, histopathology, and immunohistochemistry.
• Treatment involved radical orchiectomy and standard bleomycin, etoposide, and cisplatin (BEP) chemotherapy.

Main Results:

• The patient presented with testicular embryonal carcinoma and retroperitoneal lymph node metastasis despite persistently normal serum tumor markers.
• Diagnosis was confirmed via a combination of imaging, histopathology, and immunohistochemistry.
• The patient showed no recurrence at 12-month follow-up after treatment.

Conclusions:

• Accurate diagnosis of testicular embryonal carcinoma requires a multidisciplinary approach, especially in marker-negative cases.
• Established chemotherapy regimens like BEP are effective for this condition.
• Heightened clinical vigilance and extended follow-up are essential for managing atypical presentations.