title: 'Burned-out' primary testicular cancer.
abstract: OBJECTIVE
  To report the natural history of 'burned-out' testicular tumour (a testicular tumour that has regressed spontaneously with no treatment and that generally presents at the stage of metastases).
  
  
  METHODS
  We report five cases of burned-out testicular tumours to illustrate the clinical, radiological and histopathological features, and discuss the hypothesis of natural history of these neoplasms.
  
  
  RESULTS
  The findings in the five patients tended to indicate that metastatic progression appears to induce spontaneous regression of the previous tumour site. Patients explored for extragonadal germ cell tumour present with various clinical features depending on the site of the metastases.
  
  
  CONCLUSIONS
  Despite the controversial hypotheses of the origin of these tumours, extragonadal germ cell tumours should be considered to be metastases of a 'burned-out' primary testicular tumour that must be investigated. When a primary testicular tumour is detected, the testis must be removed, and standard chemotherapy yields good long-term results. The hypothesis of an immunological reaction against the tumour inducing the spontaneous necrosis of the primary tumour and possibly the metastases should be considered. Immunological screening should be proposed in patients to investigate this interesting model of spontaneous tumour regression.
authors.affiliation: Service d'Urologie, CHU Bicêtre, Bicêtre, France.
authors.forename: Elodie
authors.initials: E
authors.lastname: Fabre
authors.forename: Hassan
authors.initials: H
authors.lastname: Jira
authors.forename: Vincent
authors.initials: V
authors.lastname: Izard
authors.forename: Sophie
authors.initials: S
authors.lastname: Ferlicot
authors.forename: Yacine
authors.initials: Y
authors.lastname: Hammoudi
authors.forename: Christine
authors.initials: C
authors.lastname: Theodore
authors.forename: Mario
authors.initials: M
authors.lastname: Di Palma
authors.forename: Gerard
authors.initials: G
authors.lastname: Benoit
authors.forename: Stephane
authors.initials: S
authors.lastname: Droupy
mesh_terms: D000293:Adolescent; D000328:Adult; D001706:Biopsy / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009365:Neoplasm Regression, Spontaneous; D009373:Neoplasms, Germ Cell and Embryonal / Q000000981:diagnostic imaging / Q000473:pathology*; D009382:Neoplasms, Unknown Primary / Q000000981:diagnostic imaging / Q000473:pathology*; D012186:Retroperitoneal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D013736:Testicular Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D013737:Testis / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed