PMC4932489_01
Abdominal CT scan, revealed irregular mass with central necrosis (White arrow) in mid posterior aspect of abdomen, displacing and compressing the adjacent structures (Black arrows).
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Abdominal CT scan showed; soft tissue mass lesion lobulated and irregular with central necrosis in the mid posterior aspect of the abdomen, displacing and compressing adjacent structures measuring about 8 x 7 cm, (Fig. 1).
Testicular examination revealed firm mass in the left testis (black arrow).
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In surgery unit the diagnosis was reviewed when a firm left testis mass was discovered (Fig. 2).
Testicular ultrasound showed two heterogeneous masses (black arrows). At the lower pole of left testis.
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This showed two heterogeneous masses at the lower pole of left testis each is about 2 x 2 cm in size (Fig. 3).
A duodenal biopsy (high power) showed intestinal mucosa, with attached malignant tumor composed of sheets and cords of atypical cells with large pleomorphic nuclei (black arrow).
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Focally the tumor was forming tubules and clefts like spaces (Fig. 4).
Immune stains of the duodenal biopsy showed PLAP (placental Alkaline Phosphatase) positive (yellow arrow).
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Alkaline Phosphatase) positive (Fig. 5). AFP (alpha-Fetoprotein), Melan A (melanocyte differentiation antigen), LCA (Leukocyte common antigen), CD117 (c-kit proto-oncogene), all are negative.
Left testis histopathology result was seminoma with nests & cords of pleomorphic hyperchromatic malignant cells (black arrows).
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The testis Histopathology finding was seminoma (Fig. 6): with no lymphatic or perinural invasion, with free surgical margins.
A year following surgery Abdominal CT scan, showed no tumor residue in the retroperitoneum. (Black arrow).
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His abdominal CT scan showed no tumor residue in the retroperitoneum (Fig. 7).