Regressed Germ Cell Tumor : Clinical Features

Comments:
Clinical Presentation: The vast majority of the patients with regressed germ cell tumor (GCT) of the testis present with retroperitoneal metastasis. Retroperitoneal germ cell tumors were once thought to be extragonadal primaries; however, it is now believed that majority of them are caused by metastasis associated with a regressed primary testicular tumor.

The patients can develop back pain due to mass effect created by massive enlargement of the retroperitoneal lymph nodes. Serum tumor markers are frequently elevated. Uncommonly, the presentation consists of testicular enlargement and/or testicular pain. The diagnosis of a regressed GCT requires a high index of suspicion.

This image shows details of scarred area in a regressed GCT of the testis. The patient was an adult male (> 40 yrs.) who was found to have a hypoechoic lesion in his testicle on ultrasound during work-up for infertility. Tumor markers were negative. CT scan of abdomen and pelvis was negative for retroperitoneal lymphadenopathy. Orchiectomy showed a discrete scar and numerous coarse calcifications.