Mixed Germ Cell Tumor of Testis with Isolated Scapular Metastasis: A Case Report and Review of the Literature.

Dipti Rani Samanta,Roopesh Krishnappa,Chaitali Bose,Ashish Upadhyay,Sulagna Mohanty,Saumyaranjan Mishra,Surendra Nath Senapati

doi:10.1155/2015/205297

Abstract

Bone metastasis is a rare entity in germ cell tumor of testis and is a poor prognostic site. It is usually associated with synchronous metastasis at other sites. Till now very few cases of isolated bone metastasis of germ cell tumor of testis have been reported but none have reported scapular metastasis. We are reporting a case of nonseminomatous germ cell tumor of right testis that was operated eight months ago and now presented with isolated scapular metastasis. Histopathology of the scapular tissue revealed rhabdomyosarcoma or poorly differentiated synovial sarcoma. Immunohistochemistry with serum markers concluded it to be metastatic germ cell tumor. To the best of our knowledge this is the first reported case of scapular metastasis of testicular germ cell tumor. This case is being reported here due to dilemmatic way of presentation and also to emphasize that histopathology may sometimes misguide and immunohistochemistry is necessary in such cases.

Highlights

Testicular tumor accounts for approximately 1% of all the tumors in male
For practical clinical purposes these germ cell tumors are classified into two major groups: seminomas and nonseminomatous germ cell tumors (NSGCT)
Hematogenous bone metastasis is uncommon in germ cell tumor

Summary

Introduction

Testicular tumor accounts for approximately 1% of all the tumors in male. It is the most common solid malignancy among the males in the age group of 15 to 35 years [1]. Mixed germ cell tumors are the second most common testicular germ cell tumor accounting for 40–50% of all primary germ cell tumors. Bone metastasis classifies patient into poor (nonseminomatous) or intermediate (seminomatous) prognostic group [2]. Is a case of mixed germ cell tumor of right testis with scapular metastasis. Histopathology report of scapular biopsy simulated rhabdomyosarcoma or poorly differentiated synovial sarcoma, immunohistochemistry and serum markers confirmed it as metastatic mixed germ cell tumor. This case is reported because of rarity of scapular metastasis from mixed germ cell tumor of testis and its confusing way of presentation

Case Report

Findings

Discussion