Valentino William L, Cendrowski Kristina, Mandava Veena, Wei Justin
Riverside Community Hospital, 4445 Magnolia Avenue, Riverside, CA, 92501, USA.
HCA Healthcare, Nashville, TN, USA.
Radiol Case Rep. 2022 Jun 2;17(8):2732-2736. doi: 10.1016/j.radcr.2022.04.052. eCollection 2022 Aug.
Germ cell tumors are the most common nonhematologic malignancy of young men which often present with metastasis to the retroperitoneum, however a primary retroperitoneal mass should also be considered. The case presented herein reports a 42-year-old male presenting with a massive heterogenous retroperitoneal mass determined to be a mature cystic teratoma. Further investigation revealed a multifocal right testicular mass containing both a viable pure seminoma and a fibrous scar demonstrating germ cell neoplasia in situ thus representing the rare phenomenon of a "burned-out" mixed germ cell testicular tumor. When the radiologist is faced with a large retroperitoneal fat-containing mass, the differential includes a renal angiomyolipoma, liposarcoma, or germ cell tumor (whether primary or secondary). If pathology reveals a germ cell tumor, it is imperative to perform a thorough evaluation of the gonads, as it is much more common for a retroperitoneal germ cell tumor to be a metastasis from the gonads, rather than primary in origin.
生殖细胞肿瘤是年轻男性最常见的非血液系统恶性肿瘤，常伴有腹膜后转移，但也应考虑原发性腹膜后肿块。本文报告的病例为一名42岁男性，其腹膜后有一个巨大的异质性肿块，经诊断为成熟囊性畸胎瘤。进一步检查发现右侧睾丸有一个多灶性肿块，其中既有存活的纯精原细胞瘤，又有显示原位生殖细胞瘤变的纤维瘢痕，从而代表了罕见的“消退型”混合性生殖细胞睾丸肿瘤现象。当放射科医生面对一个含有大量脂肪的腹膜后肿块时，鉴别诊断包括肾血管平滑肌脂肪瘤、脂肪肉瘤或生殖细胞肿瘤（原发性或继发性）。如果病理检查显示为生殖细胞肿瘤，则必须对性腺进行全面评估，因为腹膜后生殖细胞肿瘤更常见的是性腺转移瘤，而非原发性肿瘤。
