title: Isolated bone metastasis in testicular germ cell tumors: a case report and review of the literature.
abstract: BACKGROUND
  In testicular germ cell tumors (GCT), bone metastases are usually seen late in the disease progress and are almost always associated with involvement of other sites. However, isolated bone metastasis is an extremely rare finding in these patients.
  
  
  METHODS
  A 43- year-old man was admitted to the neurosurgery department of our hospital suffering from dysarthria, ataxia, headaches and a progressive swelling above the parietooccipital region of the skull. Radiological, biochemical and pathologic tests showed that the lesion of the skull was an isolated skull metastasis as an initial manifestation of nonseminomatous GCT of the testis.
  
  
  CONCLUSIONS
  When a young patient presents with bone pain or painless swelling, even if it is an unusual site and isolated, testicular GCT should be considered as a differential diagnosis, as these lesions could be the first evidence of metastatic GCT.
authors.affiliation: Medical Oncology Department, Medical Faculty, Trakya University, Edirne, Turkey. kzuygun@hotmail.com
authors.forename: Kazim
authors.initials: K
authors.lastname: Uygun
authors.forename: Hakan
authors.initials: H
authors.lastname: Karagol
authors.forename: Zafer
authors.initials: Z
authors.lastname: Kocak
authors.forename: Irfan
authors.initials: I
authors.lastname: Cicin
authors.forename: Omer
authors.initials: O
authors.lastname: Yalcin
authors.forename: Murat
authors.initials: M
authors.lastname: Caloglu
authors.forename: Osman
authors.initials: O
authors.lastname: Simsek
authors.forename: Ferda Akbay
authors.initials: FA
authors.lastname: Harmandar
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009373:Neoplasms, Germ Cell and Embryonal / Q000175:diagnosis / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D009777:Occipital Bone / Q000473:pathology / Q000601:surgery; D009919:Orchiectomy; D010294:Parietal Bone / Q000473:pathology / Q000601:surgery; D012888:Skull Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D013736:Testicular Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D013737:Testis / Q000473:pathology