Giant testicular mixed germ cell tumor. a case report

Abstract

Objective: We report a case that we believe to be the largest example of a testicular mixed germ cell tumor with a clearly defined histology pattern.

Clinical presentation and interventions: A 21-year-old patient consulted a urologist concerning a giant testicular mass. At the time of presentation the tumor measured 29 x 20 x 16 cm, with a weight of 4,850 g. Serum alpha-fetoprotein was over 15,000 ng/ml, while beta-human chorionic gonadotropin was normal. Chest X-ray and CT revealed multiple bilateral metastases. Histopathology revealed a mixed germ cell tumor containing 80% of yolk sack tumor, 10% of teratoma and 10% of embryonal carcinoma. Orchiectomy and chemotherapy were successful in the treatment of primary tumor and bilateral lung metastases.

Conclusion: This tumor grew to extraordinary dimensions because of the patient's failure, due to fear, lack of knowledge and embarrassment, to seek medical help and to health professionals' negligence when performing regular check-ups.