Abstract
Most patients with testicular germ cell tumor present with a painless scrotal mass. We report a 19-year-old patient who presented with neurological complains. Rapid clinical progression to coma was noted during the staging work up. A diagnosis of testicular mixed germ cell tumor with multiorgan metastasis (lymph node, lung, liver and brain) was made. Patients with brain metastasis should receive chemotherapy alone or combined with surgery or radiotherapy. Because the clinical symptoms deteriorated quickly, surgery was used upfront followed by chemotherapy and radiotherapy for the brain tumor. After the first stage of treatment, the clinical symptoms, tumor markers and imaging findings were improved. The residual brain tumor was eliminated by chemotherapy, and only sparse degenerated tumor cells were noted in the brain tissue. Longer follow up is required to assess the impact of our treatment strategy.
Highlights
The worldwide incidence of testis tumors is low (0.5-7.8 per 100,000 men) (1); testicular cancer is the most common solid tumor in men 15 to 34 years of age (2)
We report a case of widely metastatic testicular germ cell tumors (GCT) in a patient who presented with neurologic symptoms and rapid clinical progression to coma
Most testicular cancers are GCTs, which are classified as seminoma and non-seminomatous germ cell tumor (NSGCT)
Summary
The worldwide incidence of testis tumors is low (0.5-7.8 per 100,000 men) (1); testicular cancer is the most common solid tumor in men 15 to 34 years of age (2). Testicular tumor with brain metastasis is rare and portends a poor prognosis (5). We report a case of widely metastatic testicular GCT in a patient who presented with neurologic symptoms and rapid clinical progression to coma.
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