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Malignant mixed germ cell tumor of the testis

Case contributed by Odina Gomez
Diagnosis certain

Presentation

Enlarging left scrotal mass and inguinal pain. Elevated alpha fetoprotein (AFP) and total beta-hCG.

Patient Data

Age: 18 years
Gender: Male

Large fairly circumscribed complex soft tissue mass in the left scrotum

Large complex, heterogeneously-enhancing mass in the left scrotum, either paratesticular or testicular in etiology.

Small and marginal-sized lymph nodes in the both inguinal regions. Soft tissue fullness in the para-aortic, aortocaval and paracaval regions which may represent retroperitoneal lymphadenopathy (not shown).

Case Discussion

Histopathology revealed malignant mixed germ cell tumor ( 95% teratoma, 5% embryonal carcinoma), with tumor size of about 9.5 cm in its largest dimension.  The tumor was organ confined with the spermatic cord margin and all other surgical margins negative for tumor.

Intratubular germ cell neoplasia (ITGCN) and lymphovascular invasion was said to be present.

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