Pure embryonal carcinoma of testis presenting with extensive metastasis

Abstract

Embryonal carcinoma is a type of non-seminomatous germ cell tumor. Pure embryonal carcinoma of testis occurs only in 3-4% cases. We present a case of 34-year-old man with aggressive clinical course. At the time of presentation, he had left testicular swelling along with supraclavicular mass with extensive metastasis to retroperitoneum, liver, and lung. On gross pathological examination, specimen showed tumor replacing entire testis with involvement of rete testis, epididymis, and spermatic cord. It is observed that many patients with a tumor composed predominantly of embryonal carcinoma have metastasis at the time of diagnosis. Embryonal carcinoma is an aggressive tumor due to its tendency to early hematogenous spread emphasizing its need for early detection and treatment. The estimation of serum tumor marker levels is not conclusive in these cases. We are presenting this case for its rarity, and advanced stage of disease with clinical and histomorphological features.

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

“…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].…”

“…two-thirds of cases, lymph node and distant metastasis are detected at the moment of diagnosis [2]. The main reason for embryonal carcinoma's aggressiveness is the tendency of early hematogenous invasion [3]. The median survival time was 5 months and 1, 2 and 5 year survival rates of 41%, 34% and 34%, respectively [7].The case was a 36-year-old male, who applied to the clinic with complaints of pain and swelling in the left testis and chilling-shivering.…”

“…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].…”

“…66% of embryonal carcinoma cases and cases with embryonal carcinoma component [4]. These tumors follow an aggressive course because of the early hematogenous invasion of embryonal carcinoma [3]. For this reason, early diagnosis and treatment of embryonal carcinoma cases are very important [3].…”

“…These tumors follow an aggressive course because of the early hematogenous invasion of embryonal carcinoma [3]. 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].…”