Combined Embryonal Cell Carcinoma and Granulomatous Orchitis of the Testis

Abstract

Testicular embryonal cell carcinoma is a germ cell tumor that can be poorly differentiated and quite aggressive. It is a fairly common carcinoma of the testis but is uncommonly found coexisting with the rare inflammatory process of granulomatous orchitis. This case study describes a male in his early 30s diagnosed with embryonal carcinoma of the right testis combined with granulomatous orchitis that was initially found with sonography. The main treatment options are an orchiectomy or chemotherapy. The patient in this case was treated with orchiectomy before the cancer could metastasize to distant organs.

Pure embryonal carcinoma of the testis in an adult male patient: case report

“…Widespread use of testicular USG today, the detection of small and non-palpable tumors significantly increased when compared to the past [3].The first imaging method to use when pain or a mass is detected in testis is scrotal USG. In embryonal carcinoma cases, generally well-circumscribed, hypoechoic, and heterogeneous lesions are characteristically observed in USG [5]. In the present case, an increase in point echogenicity in the right testicular parenchyma, miliary-type echogenicity, increase in liquids in left testis, miliary hyper-echogenicity, areas suspicious for local irregular hypo-echoic bilobular mass, and increase of vascularity of left testis were detected in scrotal USG.…”

“…Even though it is most frequently seen between the ages of 25 and 35 years, the average age is 31-32 years. It is rarely seen in infants and those older than 50 years [1][2][3][4][5]. The cases generally apply to the clinic with complaints of painfree testicular mass and (10%) hormonal symptoms [1][2][3]10].…”

“…Embryonal carcinoma is a non-seminomatous germ cell tumor and seen in only 1-5% [1][2][3][4][5][6][7][8]. In general, following the seminoma, it constitutes the second-most frequently (80%) seen tumor component of mixed germ cell tumors [2].…”

“…For this reason, early diagnosis and treatment of embryonal carcinoma cases are very important [3]. As in many testicular tumors, embryonal carcinoma is also detected by the patient or coincidentally in examination in form of pain-free or (less frequently) painful palpable mass [5][6][7][8][9][10]. When pain or mass is detected in testis, the first imaging method to be used is USG.…”

“…When pain or mass is detected in testis, the first imaging method to be used is USG. In USG, the embryonal carcinoma cases are characteristically seen in form of well-circumscribed, hypo-echoic, and heterogeneous lesions [5].…”