Giant Testicular Mixed Germ Cell Tumor

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 ! 20 ! 16 cm, with a weight of 4,850 g. Serum ·-fetoprotein was over 15,000 ng/ml, while ß-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. Copyright © 2004 S. Karger AG, Basel Introduction Malignant tumors of the testis are rare but constitute the most common tumor in men between the ages of 25 and 34 [1]. Over 90% of testicular cancers develop in germ cells giving two main types of testicular germ cell tumors: seminomas and nonseminomas. The latter include embryonal, teratoma, choriocarcinoma and yolk sack tumors. Tumors with features of two or more cell types are termed mixed germ cell tumors and are classified as nonseminomas [2].