[Double germinal tumor of the mediastinum and testis]

We report our experience gained with the observation and treatment of malignant testicular tumors, retro-peritoneal seminomas and malignant germinal tumors of the mediastinum. In particular we describe one patient operated for a pure seminoma of the thymic space followed by radiation therapy. Three years later he developed a texticular tumor of an entirely different origin; an embryonal cell carcinoma. An unilateral orchidectomy was performed. Subsequent generalized pulmonary metastases were treated with poly-chemotherapy followed by temporary radiological regression of the metastases. The patient expired & years after the mediastinal--and 3 years after the scrotal intervention with generalized liver, spleen, brain and pulmonary metastases originating from the testicular embryonal cell carcinoma. The origin, however controversial of these germinal gonadal and extra-gonadal tumors is discussed. In the above mentioned case, we do think that 2 autonomous germinal tumors developed on a (hormonal ?) predisposed terrain. Nevertheless it is not possible to prove beyond any doubt that it was not a single primary tumor with early large mediastinal metastases which disclosed the disease. Careful periodical examination of the testis during 3 years preceding the development of the embryonal cell carcinoma of the testis did not reveal anything abnormal.