Bone metastasis is a rare entity in germ cell tumor of testis and is a poor prognostic site. It is usually associated with synchronous metastasis at other sites. Till now very few cases of isolated bone metastasis of germ cell tumor of testis have been reported but none have reported scapular metastasis. We are reporting a case of nonseminomatous germ cell tumor of right testis that was operated eight months ago and now presented with isolated scapular metastasis. Histopathology of the scapular tissue revealed rhabdomyosarcoma or poorly differentiated synovial sarcoma. Immunohistochemistry with serum markers concluded it to be metastatic germ cell tumor. To the best of our knowledge this is the first reported case of scapular metastasis of testicular germ cell tumor. This case is being reported here due to dilemmatic way of presentation and also to emphasize that histopathology may sometimes misguide and immunohistochemistry is necessary in such cases.

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A 60-year-old male presented with a mild tender, irregular, fixed mass of size 10cm×8cm at right chest wall at infra clavicular area of six month duration. The mass was hard in consistency, overlying skin was free [Table/ Fig-1]. Both the breasts were normal. He had no evidence of supraclavicular or axillary lymphadenopathy. Remainder of physical examination was unremarkable. He had no history of surgery in the past and denied any previous neoplasia or family history of cancer. Contrast enhanced MRI of thorax showed in homogenously enhancing infiltrating expansile mass involving right chest parietal plane, anterosuperior aspect embedding pectoral muscle plane with rib erosion. Another mass was present at left internal mammary area [ ABSTRACTCarcinoma of male breast constitutes 1% of total breast malignancy. Carcinoma arising from ectopic breast tissue in male is an extremely rare entity and can be misdiagnosed. Ectopic breast tissue may be supernumerary or aberrant one. Despite morphologic difference, ectopic breast tissue presents characteristics analogous to orthoptic breast in terms of functional and pathologic degeneration. Most of the ectopic breast tissue occurs in thoracic or abdominal portion of milk line. If found in a location outside the milk line, it proves a diagnostic dilemma. We are reporting a case of 60-year-old male who presented with a fixed mass of size 10cm×8cm, in right chest wall infraclavicular area of 6 months duration. Histopathology of the mass revealed invasive duct carcinoma. He had no evidence of malignant or occult primary lesion in the bilateral mammary glands. Due to the paucity of the literature, incidence of ectopic male breast cancer and its management is not well understood. There is high probability of misdiagnosis of this disease. To the best of our knowledge this is the first described case of ectopic male breast cancer in the chest wall, not along the milk line, which is being reported here for documentation.carcinoma originating in an ectopic breast tissues at right anterior chest wall. He received three cycle of TAC {Docetaxel, Adriamycin, Cyclophophamide} and after three cycles of chemotherapy there was partial response and was inoperable for which he was advised three more cycles of chemotherapy, but he was lost for follow up.

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