Testicular mixed germ cell tumor presenting with seizure as the initial symptom: a case report and literature review

Int Braz J Urol. 2019 May-Jun;45(3):629-633. doi: 10.1590/S1677-5538.IBJU.2018.0523.

Abstract

Most patients with testicular germ cell tumor present with a painless scrotal mass. We report a 19-year-old patient who presented with neurological complains. Rapid clinical progression to coma was noted during the staging work up. A diagnosis of testicular mixed germ cell tumor with multiorgan metastasis (lymph node, lung, liver and brain) was made. Patients with brain metastasis should receive chemotherapy alone or combined with surgery or radiotherapy. Because the clinical symptoms deteriorated quickly, surgery was used upfront followed by chemotherapy and radiotherapy for the brain tumor. After the first stage of treatment, the clinical symptoms, tumor markers and imaging findings were improved. The residual brain tumor was eliminated by chemotherapy, and only sparse degenerated tumor cells were noted in the brain tissue. Longer follow up is required to assess the impact of our treatment strategy.

Keywords: Neoplasm Metastasis; Testicular Germ Cell Tumor 1 [Supplementary Concept]; Testis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Brain Neoplasms / secondary*
  • Brain Neoplasms / therapy
  • Chorionic Gonadotropin, beta Subunit, Human / blood
  • Humans
  • L-Lactate Dehydrogenase / blood
  • Male
  • Neoplasms, Germ Cell and Embryonal / diagnostic imaging
  • Neoplasms, Germ Cell and Embryonal / secondary*
  • Neoplasms, Germ Cell and Embryonal / therapy
  • Seizures / diagnostic imaging
  • Seizures / pathology*
  • Testicular Neoplasms / diagnostic imaging
  • Testicular Neoplasms / pathology*
  • Testicular Neoplasms / therapy
  • Time Factors
  • Tomography, X-Ray Computed
  • Young Adult
  • alpha-Fetoproteins / analysis

Substances

  • Chorionic Gonadotropin, beta Subunit, Human
  • alpha-Fetoproteins
  • L-Lactate Dehydrogenase