Metastatic germ cell tumor involving the mediastinum and retroperitoneum

Case contributed by Mohammadtaghi Niknejad


Young adult male with right flank pain. Abdominal ultrasonography showed large abdominal mass with right sided hydronephrosis.

Patient Data

Age: 25 years
Gender: Male

Cystic mass compatible with lymphadenopathy is noted at the left upper paratracheal and posterior mediastinum stations.

Large septated cystic masses also are seen in the retroperitoneal cavity with displacement of the right kidney and subsequent hydronephrosis. There is a "double J" catheter in the collecting system of right kidney and right ureter. IVC compressed is by the mass. Further nodal enlargement of the left external iliac and common iliac chains. 

Note also the incomplete rings shown on the axial images, and the rows of dots on the coronal and sagittal reconstructions. This is due to "ring artifact", usually caused by CT detector malfunction.

Case Discussion

These findings were consistent with mediastinal and retroperitoneal metastases from a gonadal germ cell tumor.

Histology: non-seminomatous germ cell tumors (NSGCT) , immature teratoma.

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