The first reported case of a palpable and hypoechoic burned out testicular tumor

Abstract

Primary extra gonadal germ cell tumors are rare.In case of the diagnosis of a midline retroperitoneal mass in a male, germ cell tumors should be taken into consideration. It is commonly accepted to consider  retroperitoneal germ cell tumors as the metastasis of a viable or burned out testicular tumor. In such casesorchiectomy should be performed since the burned out site in the testis could continue to harbor malignancy despite systemic chemotherapy.A 45-year-old man presented as an outpatient with complaints of back pain.He was diagnosed with a retroperitoneal mass and a palpable testis mass.Due to increased serum tumor markers and the testicular mass,he underwent radical orchiectomy. Pathological study revealed a burned out tumor.Following chemotherapy, retroperitoneal lymph node dissection(RPLND)was performed and despite the residual and enhanced retroperitoneal lymph nodes in his CT scan, none of the resected lymph nodes showed a viable tumor.However and despite the rising number of reports onthis disease, our case had adifferent presentation both at initial diagnosis and during follow up after chemotherapy.This is the first reported case of a palpable and hypoechoic burned out testicular tumor.

Key words testis,burned out tumor,lymphadenectomy,tumor