title: Nonseminomatous germ cell tumor after chemotherapy with residual mass invading the spine.
abstract: Bony metastasis is a rare feature of metastatic nonseminomatous germ cell tumor. A 25 year-old man presented with back pain radiating down both legs, and a subsequent work-up demonstrated a right-sided testicular mass with bilateral retroperitoneal lymphadenopathy and tumor involvement of the L2 vertebra. Radical inguinal orchiectomy confirmed nonseminomatous germ cell tumor, and the patient underwent chemotherapy with a residual mass and vertebral involvement by MRI. Combined vertebral resection with spinal reconstruction and retroperitoneal lymph node dissection demonstrated residual fibrosis. While bony metastasis of nonseminomatous germ cell tumors is rare, resection with spinal reconstruction can be accomplished with acceptable morbidity.
authors.affiliation: Section of Urologic Oncology, Glickman Urological Institute, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
authors.forename: Ryan K
authors.initials: RK
authors.lastname: Berglund
authors.forename: Sean P
authors.initials: SP
authors.lastname: Lyden
authors.forename: Eve C
authors.initials: EC
authors.lastname: Tsai
authors.forename: Isador
authors.initials: I
authors.lastname: Lieberman
authors.forename: Eric A
authors.initials: EA
authors.lastname: Klein
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D018450:Disease Progression; D006801:Humans; D008159:Lumbar Vertebrae; D008207:Lymphatic Metastasis; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery*; D009919:Orchiectomy; D013125:Spinal Neoplasms / Q000556:secondary* / Q000601:surgery*; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000473:pathology*