Testicular seminoma after the complete remission of extragonadal yolk sac tumor : a case report
1 Department of Urology, Saitama Medical School, Moroyama, Saitama, Japan
2 Department of Pathology, Saitama Medical School, Moroyama, Saitama, Japan
3 Department of Urology, Keio University, School of Medicine, Shinanomachi, Shinjyuku, Tokyo, Japan
BMC Urology 2004, 4:13 doi:10.1186/1471-2490-4-13Published: 16 November 2004
Between 2% and 5% of malignant germ-cell tumors in men arise at extragonadal sites. Of extragonadal germ cell tumors, testicular carcinoma in situ (CIS) are present in 31–42% of cases, and CIS are reported to have low sensitivity to chemotherapy in spite of the various morphology and to have a high likelihood of developing into testicular tumors. A testicular biopsy may thus be highly advisable when evaluating an extragonadal germ cell tumor.
A 36-year-old man was diagnosed as having an extragonadal non-seminomatous germ cell tumor, that was treated by cisplatin-based chemotherapy, leading to a complete remission. In the meantime, testicular tumors were not detected by means of ultrasonography. About 4 years later, a right testicular tumor was found, and orchiectomy was carried out. Microscopically, the tumor was composed of seminoma.
We herein report a case of metachronous occurrence of an extragonadal and gonadal germ cell tumor. In the evaluation of an extragonadal germ cell tumor, a histological examination should be included since ultrasonography is not sufficient to detect CIS or minute lesions of the testis.