PMC3033347_01
Histology: (a) Testicular tumor demonstrating vascular invasion by undifferentiated teratoma. (b) Urethral tumor demonstrating undifferentiated teratoma. (c) Urethral tumor demonstrating positive staining for CD30 in immunohistochemistry.
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F1
Lymphovascular involvement was noted, with widespread blood vessel involvement seen (Figure 1a). Histology of the urethral mass confirmed a metastatic malignant undifferentiated teratoma (Figure 1b). Immunochemistry was positive for placental alkaline phosphatase and CD30 (Figure 1c).
CT Scans: (a) Pre-chemotherapy computed tomography (CT) scan of the thorax demonstrating bilateral widespread pulmonary metastasis. (b) Post-chemotherapy CT scan of the thorax demonstrating resolution of the pulmonary metastasis.
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F2
A staging computed tomography (CT) scan revealed extensive disease within the thorax with multiple bilateral pulmonary metastases measuring up to 3 cm in both lungs (Figure 2a). A reassessment CT scan of the chest and abdomen (Figure 2b) four weeks after completion of chemotherapy indicated excellent response to treatment.
MRI Scans: (a) Pre-chemotherapy T2 sagittal thin penile MRI slices demonstrating the penile metastasis within the corpora. (b) Post-chemotherapy T2 sagittal thin penile MRI slices showing the resolving penile lesion.
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F3
Within the penile shaft, 3 cm proximal to the glans penis, a soft tissue mass was confirmed measuring 2 cm in long axis, involving both the penile corpora (Figure 3a). A repeat MRI of the pelvis six weeks after completion of chemotherapy indicated partial resolution of the penile (Figure 3a) and bony lesions. A further repeat MRI scan of the penis performed 14 weeks later confirmed further resolution of the penile metastasis, which is now a fibrotic scar-like 9 mm lesion (Figure 3b).