title: "Burned out" testicular seminoma presenting as a primary gastric malignancy.
abstract: In contrast to primary gastric adenocarcinomas, germ cell tumors are potentially curable even when metastatic. It is therefore essential for clinicians and pathologists to be aware of the spectrum of unusual manifestations of germ cell malignancies. Here we report on a 55-year-old man who presented with clinical and endoscopic features indicative of a primary gastric carcinoma. Surprisingly, the ulcerative mucosal lesion was found to be due to a metastasis from an occult, "burned-out" testicular seminoma. This case describes the radiological and pathological features that helped differentiate this rare situation from the much more common gastric adenocarcinoma, and extends the diagnostic possibilities that must be considered in patients presenting with gastric ulcers.
authors.affiliation: Department of Pathology 113, VA Medical Center, Minneapolis, MN 55417, USA. Hector.Mesa@va.gov
authors.forename: Hector
authors.initials: H
authors.lastname: Mesa
authors.forename: Ajay
authors.initials: A
authors.lastname: Rawal
authors.forename: Anthony
authors.initials: A
authors.lastname: Rezcallah
authors.forename: Carlos
authors.initials: C
authors.lastname: Iwamoto
authors.forename: Gloria A
authors.initials: GA
authors.lastname: Niehans
authors.forename: Paul
authors.initials: P
authors.lastname: Druck
authors.forename: Pankaj
authors.initials: P
authors.lastname: Gupta
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D003937:Diagnosis, Differential; D005047:Etoposide / Q000008:administration & dosage; D005743:Gastrectomy; D005773:Gastroscopy; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary; D009919:Orchiectomy; D049268:Positron-Emission Tomography; D018239:Seminoma / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D013736:Testicular Neoplasms / Q000188:drug therapy / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D005047:Etoposide; D002945:Cisplatin; D007069:Ifosfamide