PMC9803560_01
FDG-PET/CT scanning revealed a testicular mass, with maximal SUV of 6.9 (arrow): (a) transverse image and (b) CT of the testicular mass.
CRIONM2022-3326761.001.jpg
PMC9803560_01_CRIONM2022-3326761.001.jpg
fig1
A PET-CT scan exhibited multiple hypermetabolic areas described as pulmonary nodules and retroperitoneal adenopathies, compatible with metastatic lesions (Figure 1), as well as an enlargement in the right testicle, which was not clinically manifest.
Skin (a) and lung biopsies (b) performed three months before admission (400x, H&E).
CRIONM2022-3326761.002.jpg
PMC9803560_01_CRIONM2022-3326761.002.jpg
fig2
A skin biopsy was performed, resulting in leukocytoclastic vasculitis and intimal hyperplasia (Figure 2(a)). A lung biopsy showed alveolar hemorrhage with fibrinoid necrosis and transmural infiltrates, suggestive of vasculitis (Figure 2(b)).
(a) Germ cell tumor neoplasm with solid and lobular pattern and fibrous septae (40x, H&E). (b) Tumor cells are large with pale cytoplasm. (c) The nuclei are round with one prominent central nucleoli. (d) A prominent lymphocytic infiltrate is present (400x, H&E).
CRIONM2022-3326761.003.jpg
PMC9803560_01_CRIONM2022-3326761.003.jpg
fig3
A radical right orchiectomy was performed, with a final pathology report of a stage IIIC (TxNxM1bS1) germ cell tumor with beta-hGC levels > 1,000 IU/L consistently with the diagnosis of nonseminomatous germ cell tumor (NSGCT) (Figure 3).