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Abdominal contrasted TC scan showed the four pancreatic neuroendocrine tumors that are indicated with the arrows.
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F1
The abdominal contrast computerized tomography (CT) documented the presence of four hyper-vascular focal lesions, of <1 centimeter and localized at the pancreatic body and tail, which were suggestive for neuroendocrine tumors (NET) (Figure 1).
Gallium-68 labeled somatostatin receptor PET-CT showed uptake in 3 Gallium-68 labeled somatostatin receptor PET-CT showed an uptake in 3 nodules in the pancreas.
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F2
A Gallium-68 labeled somatostatin receptor PET-CT an showed uptake in 3 nodules in the pancreas (Figure 2).
Showed the patient's family tree. None of the patient's male relatives had history of testicular mass.
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F3
Figure 3 shows the index pedigree.
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PMC6582702_05
Hematoxylin and eosin (HE) staining of testis intra-tubular germ cell neoplasia (200X magnification) composed by the yolk sac tumor, with mainly anastomosing channels that focally expand to form variably sized cysts lined by primitive tumor cells with varying amounts of clear, glycogenated cytoplasm (mycrocistic or reticular pattern, panel A) and of the mature teratoma, with different type of mature tissue such as squamous epithelium with keratinization (panel B shows a dermoid cyst).
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F4
The histological examination showed an intratubular germ cell neoplasia (IGCNU), consisting of a mature teratoma and yolk sac tumor, with signs of pre-invasive lesion, such as presence of peri-neoplastic, placental alkaline phosphatase (PLAP) and CD117 positive seminiferous tubules, with basal nuclei and abundant clear cytoplasm (Figure 4).
PMC6582702_06
PMC6582702_07