title: Metastatic urinary bladder tumor from extragonadal germ cell tumor: a case report.
abstract: A 37-year old male patient complained of lower back pain. Investigations revealed a retroperitoneal tumor and left-sided cervical lymphadenopathy without abnormal findings in both testicles. The diagnosis of extragonadal germ cell tumor was made based on a lymph node biopsy. Following chemotherapy and retroperitoneal lymphoadenectomy, at outpatient follow-up, beta-HCG elevated again. He complained of gross hematuria, cystoscopy showed a bladder tumor, and abdominal MRI scan showed a right ureteral tumor. Total cystectomy and right nephroureterectomy were performed, which revealed that the bladder and ureteral tumors were metastatic germ cell tumors. Six months later, the patient developed hepatic and mesenteric lymph node metastases that failed to respond to treatment, and died. Germ cell tumors metastasizing to the urinary tract are extremely uncommon, and this is the first report of bladder metastases, other than through direct invasion, from an extratesticular germ cell tumor.
authors.affiliation: Department of Urology, Osaka City University Graduate School of Medicine, Abeno-ku, Osaka 545-8585, Japan. nakatani@msic.med.osaka-cu.ac.jp
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Nakatani
authors.forename: Kazunobu
authors.initials: K
authors.lastname: Sugimura
authors.forename: Toshihide
authors.initials: T
authors.lastname: Naganuma
authors.forename: Sadanori
authors.initials: S
authors.lastname: Kamikawa
authors.forename: Toshikado
authors.initials: T
authors.lastname: Sugimoto
mesh_terms: D000328:Adult; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D003131:Combined Modality Therapy; D017809:Fatal Outcome; D018237:Germinoma / Q000097:blood / Q000556:secondary* / Q000628:therapy; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000556:secondary; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008297:Male; D011860:Radiography, Abdominal; D012186:Retroperitoneal Neoplasms / Q000097:blood / Q000473:pathology* / Q000628:therapy; D014057:Tomography, X-Ray Computed; D001749:Urinary Bladder Neoplasms / Q000097:blood / Q000556:secondary / Q000628:therapy
chemical_list: D018997:Chorionic Gonadotropin, beta Subunit, Human