Burned-out testicular tumor with retroperitoneal lymph node metastasis: a case report

Abstract

Introduction: A burned-out seminoma of the testis is an exceptionally rare clinical entity, with few reports found in the literature.

Case presentation: A case of burned-out tumor of the testis in a 31-year-old man is reported. The tumor presented as a retroperitoneal mass with histological characteristic of a seminoma. The testes on clinical examination were normal, and a suspicious lesion in the scrotum was only identified after ultrasound. Incision of the abdominal mass was decided, followed by orchectomy. Histological examination of the testis revealed a suspicious lesion with characteristics of spontaneous regression of germ cell tumors.

Conclusion: We describe one of very few cases worldwide, where spontaneous regression of a primary testicular tumor occurred after demonstration of retroperitoneal lymph node metastasis, a phenomenon known as burned-out seminoma, which is hard to recognize and incompletely characterized by physicians.

Figure 1

Computed tomography scan showing a 7 cm retroperitoneal tumor on the left side of the aorta, compressing the left renal vein.

Figure 2

Retroperitoneal mass with seminomatous germ cells (hematoxylene-eosine, ×40).

Figure 3

Retroperitoneal mass with positive immunoreactivity to PLAP (placental alkaline phosphatase, ×40).

Figure 4

Testicular scar, with seminomatous germ cell neoplasia (hematoxylene-eosine ×60).

Figure 5

Well-demarcated nodular scar with large aggregates of Leydig cells in the surrounding atrophic testis (hematoxylene - eosine ×40).