title: Extragonadal germ cell tumour with the "burned out" phenomenon mimicking a retroperitioneal tumour of neurogenic origin.
abstract: OBJECTIVE
  To describe a case of retroperitoneal metastasis of a gonadal germ cell tumour with the "burned-out" phenomenon in a 35 year old patient with a  suspected diagnosis of retroperitoneal tumour of neurogenic origin.
  
  
  METHODS
  With the clinical and radiological suspicion of retroperitoneal tumour of neurogenic origin the tumour was removed, via the retroperitoneal space.
  
  
  RESULTS
  Pathology showed classic seminoma with foci of atypical or anaplastic seminoma, confined to the tissue sample. After a genital examination showing  no alterations, a scrotal ultrasound was requested. This revealed a badly delimited hypoechogenic mass with microcalcifications in the left testis and a heterogeneous  echostructure in the right testis, with hypoechogenic areas and some microcalcification. Bilateral orchiectomy was performed, with a pathological study compatible with  residual scar tissue in the left testicle and focal findings of germ cell neoplasia, with no intratubular seminoma in the right testis.
  
  
  CONCLUSIONS
  The suspicion of an extragonadal germ cell tumour with the "burned-out" phenomenon modifies the therapeutic attitude, which should begin  with orchiectomy,  followed by systemic chemotherapy and the surgery kept in reserve for those cases where residual malignant tissue persists.
authors.affiliation: General Surgery, Urology Department, Hospital Xeral Calde, Lugo, Spain. rgonlop@gmail.com
authors.forename: Rocío
authors.initials: R
authors.lastname: González
authors.forename: Paula
authors.initials: P
authors.lastname: Montoto Santomé
authors.forename: Eva
authors.initials: E
authors.lastname: Iglesias Porto
authors.forename: M Isabel
authors.initials: MI
authors.lastname: Pérez Moreiras
authors.forename: Mohammed
authors.initials: M
authors.lastname: Salem Ali
authors.forename: Luis A
authors.initials: LA
authors.lastname: Mateo Cambón
authors.forename: Fernando
authors.initials: F
authors.lastname: Bal Nieves
authors.forename: J Felix
authors.initials: JF
authors.lastname: Arija Val
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D009919:Orchiectomy; D012186:Retroperitoneal Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D018239:Seminoma / Q000473:pathology / Q000601:surgery; D013736:Testicular Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed