Abstract
Testicular cancer represents 1% of all malignant tumors in men. About 95% of testicular cancers are germ cell tumors (GCTs). These can be divided into nonseminomatous GCTs (NSGCTs) and seminomas. NSGCTs include teratomas, yolk sac tumors, embryonal carcinomas, choriocarcinomas, and mixed tumors. Only 2–6% of testicular teratomas are pure teratomas. Pure teratomas can be subdivided into prepubertal and postpubertal. The prognosis is significantly different between these two age groups. Different from teratomas in ovary, the immaturity in a teratoma is not an indication of their biologic behavior; the age of the patient is of greater importance. Malignant transformation of teratoma occurs in only 3–6% of testicular GCTs. The most frequent transformed histologic types consist of rhabdomyosarcoma, adenocarcinoma, and primitive neuroectodermal tumors. We report a rare case of pure postpubertal testicular teratoma with a secondary somatic malignancy that was an incidental finding in a patient presenting with lower back pain and testicular torsion.
Highlights
Primary testicular tumors are rare, but they are the most common solid malignancy in men 20–35 years of age [1]
Malignant transformation of teratoma is rare, occurring in only 3–6% of Testicular germ cell tumors (TGCTs). e most frequent transformed histologic types consist of rhabdomyosarcoma, adenocarcinoma, and primitive neuroectodermal tumors [6]. ey are more aggressive than teratomas without malignant transformation, usually metastatic at presentation, and have a high recurrence rate. e main therapy for localized disease is surgical resection because they are resistant to radiation and systemic chemotherapy
We report a rare case of pure postpubertal testicular teratoma with a secondary somatic malignancy that was an incidental nding in a patient presenting with lower back pain and testicular torsion
Summary
Primary testicular tumors are rare, but they are the most common solid malignancy in men 20–35 years of age [1]. Postpubertal teratomas are de ned by the WHO as typically part of mixed germ cell tumors and rarely pure neoplasms, almost always malignant and usually present at a metastatic site [4, 5]. Malignant transformation of teratoma is rare, occurring in only 3–6% of TGCTs. e most frequent transformed histologic types consist of rhabdomyosarcoma, adenocarcinoma, and primitive neuroectodermal tumors [6]. We report a rare case of pure postpubertal testicular teratoma with a secondary somatic malignancy that was an incidental nding in a patient presenting with lower back pain and testicular torsion. Patient is a 38-year-old white male with a past medical history signi cant only for schizophrenia, currently on Abilify. He presented to the emergency department at the University of
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