title: [Case of a testicular germ cell tumor presenting with multiple metastasized pulmonary nodules and masses].
abstract: A 25-year-old man presented with a 2-month history of bloody sputum and unilateral gynecomastia. High-resolution computed tomography (HRCT) of his chest showed multiple nodules and masses. On physical examination, no enlargement of the testes was noted, but a tiny calcified lesion in his left testis was detected on a genital CT scan. He was referred to the urology department with a suspected testicular germ cell tumor. An echogram showed a micronodule in his left testis. A testicular mixed germ cell tumor was diagnosed on the basis of the histological features of the tumor removed by high orchiectomy, and systemic chemotherapy with bleomycin, etoposide, and cisplatin (BEP) was initiated. Testicular germ cell tumor should be considered in the differential diagnosis of multiple pulmonary nodules or masses in young men. Because high orchiectomy is indispensable for the treatment of testicular germ cell tumor, aggressive investigative studies of the testis are essential in patients with pulmonary, mediastinal, and retroperitoneal germ cell tumors.
authors.affiliation: Department of Internal Medicine, Hitachiomiya Saiseikai Hospital.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Nakayama
authors.forename: Takefumi
authors.initials: T
authors.lastname: Saito
authors.forename: Masashi
authors.initials: M
authors.lastname: Bando
authors.forename: Yuzuru
authors.initials: Y
authors.lastname: Kondo
authors.forename: Koji
authors.initials: K
authors.lastname: Kawai
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Sugiyama
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Akaza
authors.forename: Koichi
authors.initials: K
authors.lastname: Itoh
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D001761:Bleomycin / Q000008:administration & dosage; D002945:Cisplatin / Q000008:administration & dosage; D003937:Diagnosis, Differential; D005047:Etoposide / Q000008:administration & dosage; D006177:Gynecomastia / Q000209:etiology; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary* / Q000628:therapy; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary* / Q000628:therapy; D009919:Orchiectomy; D013736:Testicular Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D014057:Tomography, X-Ray Computed
chemical_list: D001761:Bleomycin; D005047:Etoposide; D002945:Cisplatin