title: Large teratoma at aortic bifurcation:  an unusual metastasis of testicular cancer.
abstract: A 29-year-old man presented with a right testicular mass.  Serum tumor markers were within normal limits.  When compared to a previous computed tomography (CT) scan, a new 4 cm presacral mass was present.  He underwent radical right inguinal orchiectomy that demonstrated a mature teratoma and seminomatous components.  The patient received four cycles of chemotherapy.  Over the course of chemotherapy, the mass grew in size and therefore he underwent retroperitoneal lymph node dissection.  Pathology confirmed it to be a teratoma with negative retroperitoneal lymph nodes.  The unusual presentation of an isolated metastasis to the presacral region raises the question of altered lymphatic drainage.
authors.affiliation: Department of Urology, Upstate Medical University, Syracuse, New York 13210, USA.
authors.forename: Yachao
authors.initials: Y
authors.lastname: Zhang
authors.forename: Timothy
authors.initials: T
authors.lastname: Byler
authors.forename: Steve
authors.initials: S
authors.lastname: Landas
authors.forename: Margaret
authors.initials: M
authors.lastname: Ekroth
authors.forename: Oleg
authors.initials: O
authors.lastname: Shapiro
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; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D008297:Male; D009919:Orchiectomy; D010386:Pelvic Neoplasms / Q000556:secondary* / Q000628:therapy*; D013724:Teratoma / Q000556:secondary* / Q000601:surgery; D013736:Testicular Neoplasms / Q000473:pathology* / Q000601:surgery
chemical_list: D001761:Bleomycin; D005047:Etoposide; D002945:Cisplatin