title: Two cases of retroperitoneal metastasis from a completely regressed burned-out testicular cancer.
abstract: BACKGROUND
  Primary extragonadal germ cell tumors (EGCT) are rare and it is still a matter of debate if they have to be considered as primary extragonadal issues or metastases from a primary testicular neoplasm. We describe two cases of the so-called burned-out seminoma, a primary testicular germ-cell tumor that spontaneously regressed after demonstration of retroperitoneal metastases.
  
  
  METHODS
  Two patients (35 and 50 years old, respectively) presented with CT findings of retroperitoneal masses. In both cases physical examination of the testis was not suspicious, and only scrotal ultrasound (SUS) showed parenchymal alterations such as scarring, calcifications and nodular lesions. Left orchiectomy and chemotherapy were then performed in both cases. Currently, they are both free of disease.
  
  
  CONCLUSIONS
  Although primary germ cell tumors may be of retroperitoneal origin, the likelihood of metastasis from a testicular primary origin should always be carefully considered in order to avoid misdiagnosis and to apply the best treatment schedule for the patients. Therefore, a testicular ultrasonography is mandatory in patients presenting CT findings of retroperitoneal adenopathy, even if patients are completely asymptomatic and their physical examination appears normal.
authors.affiliation: Department of Urology-1, University of Turin, Molinette Hospital, Turin, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Gurioli
authors.forename: Marco
authors.initials: M
authors.lastname: Oderda
authors.forename: Dario
authors.initials: D
authors.lastname: Vigna
authors.forename: Francesca
authors.initials: F
authors.lastname: Peraldo
authors.forename: Simone
authors.initials: S
authors.lastname: Giona
authors.forename: Francesco
authors.initials: F
authors.lastname: Soria
authors.forename: Adele
authors.initials: A
authors.lastname: Cassenti
authors.forename: Donatella
authors.initials: D
authors.lastname: Pacchioni
authors.forename: Paolo
authors.initials: P
authors.lastname: Gontero
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D058070:Asymptomatic Diseases; D014408:Biomarkers, Tumor / Q000032:analysis; D001859:Bone Neoplasms / Q000188:drug therapy / Q000556:secondary; D002114:Calcinosis / Q000473:pathology; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging / Q000209:etiology; D007069:Ifosfamide / Q000008:administration & dosage; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009919:Orchiectomy; D017663:Peplomycin / Q000008:administration & dosage; D012075:Remission, Spontaneous; D012186:Retroperitoneal Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary*; D018239:Seminoma / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D013736:Testicular Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D001743:Urinary Bladder / Q000000981:diagnostic imaging / Q000473:pathology; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D014408:Biomarkers, Tumor; D017663:Peplomycin; D014750:Vincristine; D007069:Ifosfamide