title: Natural progression of embryonal carcinoma.
abstract: OBJECTIVE
  We report a rare case of advanced testicular cancer that describes the natural progression of testicular cancer without medical treatment. This study also describes the effectiveness of chemotherapy, which was the approach used for treatment.
  
  
  METHODS
  37 year old male with history of mental retardation, presented to the emergency room with an ulcer on his right scrotum that had been present for a few months. He was diagnosed of pT4 embryonal carcinoma by biopsy. CT scan showed multiple lung nodes. He was treated with five cycles of Bleomycin/Etoposide/Cisplatin with complete response after treatment.
  
  
  RESULTS
  Testicular tumors are the most frequent solid tumors in males between the ages of 20 and 39 years old. Testicular tumors represent 1% of all neoplasias diagnosed in males and 0.1% of all male deaths due to cancer. Several studies have reported the current real incidence rate of testicular tumors has increased to 3%, which accounts for the diagnosis of 450 new cases of testicular cancer a year in Spain.
  
  
  CONCLUSIONS
  The cure rate for patients with intermediate risk non-seminoma is around 70% following a conventional treatment approach of four cycles of BEP. The present case is noteworthy because, in our experience, testicular tumors are diagnosed at an early stage without extensively affecting the skin or simulating another type of epithelial tumor. As a result, the present study describes the natural progression of testicular cancer.
authors.affiliation: Department of Urology, University Hospital Puerta de Hierro-Majadahonda, Madrid, Spain. alopgon2@hotmail.com
authors.forename: Ana
authors.initials: A
authors.lastname: López-González
authors.forename: María Alejandra
authors.initials: MA
authors.lastname: Egui Rojo
authors.forename: Constanza
authors.initials: C
authors.lastname: Maximiano
authors.forename: Juan Ignacio
authors.initials: JI
authors.lastname: Martínez-Salamanca
authors.forename: Concepción
authors.initials: C
authors.lastname: González Hernando
authors.forename: Rosario
authors.initials: R
authors.lastname: Sánchez Yuste
authors.forename: Félix
authors.initials: F
authors.lastname: Bonilla
authors.forename: Joaquín Alberto
authors.initials: JA
authors.lastname: Carballido Rodríguez
mesh_terms: D000328:Adult; D018236:Carcinoma, Embryonal / Q000188:drug therapy / Q000473:pathology*; D018450:Disease Progression; D006801:Humans; D008297:Male; D013736:Testicular Neoplasms / Q000188:drug therapy / Q000473:pathology*