Extragonadal nonseminomatous germ cell tumor with retroperitoneal and hepatic hilum involvement: a case report
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Keywords
Germ Cell Tumors, Extragonadal Neoplasms, Nonseminomatous Germ Cell Tumors, Retroperitoneal Space, Human Chorionic Gonadotropin, beta Subunit
Abstract
Extragonadal germ cell tumors (EGGCTs) are rare entities characterized by atypical anatomical locations, aggressive clinical behavior, and significant diagnostic challenges. Early recognition is essential to ensure appropriate management and improve patient outcomes. Objective: To describe the diagnostic approach and therapeutic management of a case of extragonadal nonseminomatous germ cell tumor with retroperitoneal and hepatic hilum involvement. Case presentation: a 43-year-old male presented with progressive abdominal pain, unintentional weight loss, and retroperitoneal lymphadenopathy. Laboratory studies revealed markedly elevated beta-human chorionic gonadotropin (β-hCG) and lactate dehydrogenase (LDH) levels, with normal alpha-fetoprotein (AFP). Imaging studies, including testicular ultrasonography and computed tomography, excluded the presence of a primary testicular tumor. Based on clinical, biochemical, and radiological findings, a diagnosis of extragonadal nonseminomatous germ cell tumor was established and subsequently confirmed by histopathological examination. Conclusion: This case highlights the importance of considering extragonadal germ cell tumors in the differential diagnosis of retroperitoneal masses in the absence of identifiable testicular lesions. An integrated approach combining tumor markers, imaging studies, and histopathological confirmation is essential for accurate diagnosis and appropriate therapeutic planning.
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Copyright (c) 2025 MD Juan Sebastian Quijano Constain, MD Juan Gabriel Romero, MD Eduar Wilmar Idrobo
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