[Metachronous testicular tumor of an extragonadal germ cell tumor].
BACKGROUND
Approximately 5 - 7 % of germ cell tumors are of extragonadal origin. Biology and genetics are unclear, especially when the primary location is in the retroperitoneum. Chemotherapy is the initial treatment of choice for extragonadal germ cell tumors (EGGCTs), followed by surgical resection of the residual tumor mass. A primary testicular tumor must be ruled out by sonographic investigation and biopsy. The rate of metachronous testicular cancer in men with primary EGGCT is largely unknown.


METHODS
We present the first patient in the literature who developed a metachronous testicular cancer 10 months after primary occurrence of EGGCT in the retroperitoneum.


CONCLUSIONS
This case report emphasizes the importance of follow-up examinations of patients with primary EGGCTs. They should include careful sonographic investigation of the testis in order to detect metachronous testicular cancer early. Suspicious findings require open surgery biopsy. Intraoperative histopathology can be false-negative for cancer detection, as an immunohistochemical examination is not available.
Urologische Universitätsklinik, Klinikum Mannheim gGmbH, Fakultät für Klinische Medizin Mannheim der Ruprecht-Karls-Universität Heidelberg, Mannheim. axel.haecker@chir.ma.uni-heidelberg.de
A
A
Häcker
M
M
Hatzinger
T
T
Knoll
M S
MS
Michel
K U
KU
Köhrmann
P
P
Alken
M
M
Siegsmund
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D001761:Bleomycin / Q000008:administration & dosage; D002278:Carcinoma in Situ / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003952:Diagnostic Imaging; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D008297:Male; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D009373:Neoplasms, Germ Cell and Embryonal / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D016609:Neoplasms, Second Primary / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D009919:Orchiectomy; D012086:Reoperation; D012186:Retroperitoneal Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D013736:Testicular Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D013737:Testis / Q000473:pathology
D001761:Bleomycin; D005047:Etoposide; D002945:Cisplatin