title: [Bilateral and synchronous testicular teratoma: a case report and literature review].
abstract: BACKGROUND
  Testicular germ-cell carcinoma is the most frequent neoplasm in males aged 15 to 35 years old. It is bilateral in 2% to 3%, and synchronous in 20% to 25% of the cases.
  
  
  METHODS
  The case is presented of a 19 year-old male, with abdominal pain. Physical examination revealed abdominal mass in the umbilical region, and the computed tomography scan showed a retroperitoneal tumour, with α-fetoprotein, lactate dehydrogenase, and human chorionic gonadotropin above limits. Testicular ultrasound showed bilateral lesions. Exploratory laparotomy was performed, identifying an unresectable retroperitoneal tumour. Biopsies were taken, reporting mixed germ cell tumour composed of choriocarcinoma and embryonal carcinoma. Six cycles of chemotherapy were given, based on bleomycin, etoposide and cisplatin, with partial tumour response. Later on, the patient underwent bilateral radical orchiectomy, with pathology reporting a synchronous bilateral testicular teratoma. A second line of chemotherapy was given, based on vincristine, etoposide, ifosfamide and cisplatinum. Nevertheless, the disease progressed, with metastatic dissemination and the patient died.
  
  
  CONCLUSIONS
  Germ cells tumours can present in primary extra-gonadal locations. It is difficult to distinguish a retroperitoneum primary germ cell tumour from metastatic disease of a clinically undetected gonadal tumour or one that has regressed, like the situation described in the case presented.
  
  
  CONCLUSIONS
  Ninety percent of patients diagnosed with germ cell tumours can be cured. However, delay in diagnosis correlates with an advanced clinical stage and poor prognosis.
authors.affiliation: Servicio de Cirugía Oncológica, Hospital Regional de Zona 1, Instituto Mexicano del Seguro Social, Santiago de Querétaro, Querétaro, México. Electronic address: pmatabuena@hotmail.com.
authors.forename: Pedro
authors.initials: P
authors.lastname: Matabuena-Tamez
authors.affiliation: Facultad de Medicina, Universidad Autónoma de Querétaro, Santiago de Querétaro, Querétaro, México.
authors.forename: Patricio
authors.initials: P
authors.lastname: Canepa-Fernández
authors.affiliation: Servicio de Cirugía General, Centro Médico ABC, México DF, México.
authors.forename: Luis César
authors.initials: LC
authors.lastname: Valencia-García
authors.affiliation: Investigación y docencia, Universidad Autónoma de Querétaro, Santiago de Querétaro, Querétaro, México.
authors.forename: César
authors.initials: C
authors.lastname: Gutiérrez-Samperio
authors.affiliation: Servicio de Patología, Hospital Regional de Zona 1, Instituto Mexicano del Seguro Social, Santiago de Querétaro, Querétaro, México.
authors.forename: Marco Alonso
authors.initials: MA
authors.lastname: Gallegos-Corona
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001761:Bleomycin / Q000008:administration & dosage; D018236:Carcinoma, Embryonal / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D002822:Choriocarcinoma / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D002945:Cisplatin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D017809:Fatal Outcome; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D009919:Orchiectomy; D012186:Retroperitoneal Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D013724:Teratoma / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D013736:Testicular Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D014750:Vincristine / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D001761:Bleomycin; D014750:Vincristine; D005047:Etoposide; D002945:Cisplatin; D007069:Ifosfamide
keywords: Cáncer testicular de células germinales; Metástasis; Synchronous bilateral testicular teratoma; Teratoma testicular sincrónico bilateral; metastases