Testicular malignant mixed germ cell tumor

Case contributed by Dr Dalia Ibrahim

Presentation

Scrotal swelling.

Patient Data

Age: 20 years
Gender: Male

There is a large, irregular, infiltrative soft tissue mass within the left testicle. It is heterogeneous with generally low T1 and high T2 signal. There is heterogenous enhancement with internal areas of degeneration. The lesion invades the overlying skin with an anterior sinus tract.

Enlarged left spermatic cord.

Multiple enlarged inguinofemoral lymph nodes, larger and numerous on the left.

After orchiectomy, pathology showed:

Malignant mixed germ cell tumor ”postpupertal type”. (60% yolk sac tumor, 20% embryonal carcinoma and 15% seminoma, and 5% choriocarcinoma) infiltrating the tunica and epididymal tissue. Associated with focal dartos muscle and scrotal skin tumor infiltration with tumor sinus formation.

Case Discussion

Testicular mixed germ cell tumors are tumors composed of two or more types of germ cell tumor.

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