TY - JOUR
T1 - Metachronous bilateral testicular germ cell tumors with different histopathology
T2 - A case report
AU - Valentino Torry, Stivano Rizky
AU - Warli, Syah Mirsya
AU - Taher, Akmal
AU - Rahman, Fakhri
AU - Lisnawati, null
N1 - Publisher Copyright:
© 2023 The Authors
PY - 2023/11
Y1 - 2023/11
N2 - Background: Testicular cancer is the most common solid tumor affecting men aged 20–39 years old. About 95% of all testicular tumor is testicular germ cell tumor. Bilateral testicular tumor is a rare incident and has similar histopathology only in less than 5% of all testicular cancer patients. Besides oncological issues, bilateral testicular tumors could lead to further consequences, such as psychosocial and hormonal issues. This article shows a case of different histopathology in the metachronous bilateral testicular tumors. Case presentation: A 34-years-old male came with right radical orchiectomy due to testicular pure seminoma pT1N0M0S0 three and half years ago. He underwent bleomycin, etoposide phosphate (BEP) chemotherapy for progressive multiple lymphadenopathies in paracaval and interaortacaval region from positron emission tomography (PET)/computerized tomography (CT) scan a year later. Sperm banking was done before initiated chemotherapy. High metabolic activity was detected in contralateral testis from follow up PET-scan. Left testicle enlargement with hard consistency was found on physical examination and there is an elevation of alpha-feto protein (AFP) and β-hCG. Intraoperatively, the frozen section identified a malignant tumor and the patient was decided to undergo radical left orchiectomy. Postoperative pathological results showed a mixed germ cell tumor of 3.5 × 2.5 × 2 cm consisting of immature teratoma, yolk sac tumor and embryonic carcinoma without lympho-vascular invasion and involvement of the spermatic cord. Post-operative imaging and testicular tumor marker did not identify any metastases. BEP chemotherapy, testosterone replacement therapy was planned for further management in this patient with complete blood count, prostate serum antigen (PSA) and digital rectal examination should be measured three to six weeks after initiation. Conclusion: Metachronous bilateral TGCT with different histopathology is a rare disease. The treatment depends on histology of second tumor and its stage. TRT is mandatory for patient undergoing bilateral orchidectomy to address lack if testosterone.
AB - Background: Testicular cancer is the most common solid tumor affecting men aged 20–39 years old. About 95% of all testicular tumor is testicular germ cell tumor. Bilateral testicular tumor is a rare incident and has similar histopathology only in less than 5% of all testicular cancer patients. Besides oncological issues, bilateral testicular tumors could lead to further consequences, such as psychosocial and hormonal issues. This article shows a case of different histopathology in the metachronous bilateral testicular tumors. Case presentation: A 34-years-old male came with right radical orchiectomy due to testicular pure seminoma pT1N0M0S0 three and half years ago. He underwent bleomycin, etoposide phosphate (BEP) chemotherapy for progressive multiple lymphadenopathies in paracaval and interaortacaval region from positron emission tomography (PET)/computerized tomography (CT) scan a year later. Sperm banking was done before initiated chemotherapy. High metabolic activity was detected in contralateral testis from follow up PET-scan. Left testicle enlargement with hard consistency was found on physical examination and there is an elevation of alpha-feto protein (AFP) and β-hCG. Intraoperatively, the frozen section identified a malignant tumor and the patient was decided to undergo radical left orchiectomy. Postoperative pathological results showed a mixed germ cell tumor of 3.5 × 2.5 × 2 cm consisting of immature teratoma, yolk sac tumor and embryonic carcinoma without lympho-vascular invasion and involvement of the spermatic cord. Post-operative imaging and testicular tumor marker did not identify any metastases. BEP chemotherapy, testosterone replacement therapy was planned for further management in this patient with complete blood count, prostate serum antigen (PSA) and digital rectal examination should be measured three to six weeks after initiation. Conclusion: Metachronous bilateral TGCT with different histopathology is a rare disease. The treatment depends on histology of second tumor and its stage. TRT is mandatory for patient undergoing bilateral orchidectomy to address lack if testosterone.
KW - Bilateral testicular tumors
KW - Different histopathology
KW - Metachronous tumors
UR - http://www.scopus.com/inward/record.url?scp=85176728678&partnerID=8YFLogxK
U2 - 10.1016/j.eucr.2023.102612
DO - 10.1016/j.eucr.2023.102612
M3 - Article
AN - SCOPUS:85176728678
SN - 2214-4420
VL - 51
JO - Urology Case Reports
JF - Urology Case Reports
M1 - 102612
ER -