Burned-out testis tumours may be present if there is metastatic retroperitoneal lymphadenopathy, but the primary testicular tumour is a relatively occult, scarred intratesticular focus. Approximately 50% of the "burned-out" tumours continue to harbour malignant cells.
Retroperitoneal germ cell tumours are more often secondary (unlike mediastinal and CNS germ cell tumours), and for secondary retroperitoneal germ cell tumours, the testicles are the most common origin. An occult burned out germ cell tumour may represent ~10% of apparently primary retroperitoneal germ cell tumours 3.
A germ cell tumour presumably "burns out" when it outstrips its blood supply and then regresses. Nonseminomatous germ cell tumours have the highest rate of regression.
- small echogenic intratesticular scar in a patient with metastatic-appearing retroperitoneal lymphadenopathy
- may be calcified
Treatment and prognosis
Orchiectomy is still performed because ~50% of "burned out" testicular tumours continue to harbour malignancy despite systemic chemotherapy 4. Radiotherapy is sometimes used.
History and etymology
The concept of the "burned out" testicular tumour was first described by Prim in 1927 1, but the term "Azzopardi tumour" arose in 1961 after Azzopardi described the phenomenon in patients who had died of metastatic choriocarcinoma and nonseminomatous germ cell tumours 5.
- testicular microlithiasis
- old testicular traumatic injury
- 1. Prim J. Spontanheilung eines bösartigen wahrscheinlich chorionepitheliomatosen: gewaches im hoden. Arch Pathol Anat 1927; 265:239–241.
- 2. Tasu JP, Faye N, Eschwege P et-al. Imaging of burned-out testis tumor: five new cases and review of the literature. J Ultrasound Med. 2004;22 (5): 515-21. Pubmed citation
- 3. Kühn MW, Weissbach L. Localization, incidence, diagnosis and treatment of extratesticular germ cell tumors. Urol. Int. 1985;40 (3): 166-72. Pubmed citation
- 4. Böhle A, Studer UE, Sonntag RW et-al. Primary or secondary extragonadal germ cell tumors?. J. Urol. 1986;135 (5): 939-43. Pubmed citation
- 5. AZZOPARDI JG, MOSTOFI FK, THEISS EA. Lesions of testes observed in certain patients with widespread choriocarcinoma and related tumors. The significance and genesis of hematoxylin-staining bodies in the human testis. Am. J. Pathol. 1998;38: 207-25. Free text at pubmed - Pubmed citation
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