Section Editor: Dharam M. Ramnani, MD

Virginia Urology, Richmond, VA, USA

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Clinical Features of Mixed Germ Cell Tumors (MGCTs): As with other nonseminomatous germ cell tumors, the patients usually present with a testicular mass. The average age at diagnosis is 30 years. They are extremely rare in prepubertal patients. Serum tumor markers (LDH, alpha-fetoprotein, beta-hCG) are frequently elevated and reflect the components present.

The pathology report should list all the components and their approximate percentages since it may influence the prognosis, especially in clinically Stage 1 patients. This MGCT from a 38 y/o male was composed of embryonal carcinoma (about 70% of the tumor; large variegated nodule with necrosis in the center of the testis) and seminoma (about 30%; multiple homogenous pink-tan nodules near the upper pole of the testis).

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