IntroductionTesticular tumors are a heterogeneous group of neoplasms exhibiting diverse histopathology and can be classified as seminomatous and non-seminomatous germ cell tumor types. Mixed germ cell tumors contain more than one germ cell component and various combinations have been reported. Here, we present a rare case of a mixed germ cell tumor composed of seminoma, choriocarcinoma and teratoma with a secondary somatic malignancy.Case presentationA 31-year-old Caucasian man presented with splenic rupture to our hospital. A right-sided testicular swelling had been present for 6 months and his alpha-fetoprotein, beta-human chorionic gonadotropin, and lactose dehydrogenase were increased. An ultrasound of his scrotum revealed an enlarged right testis with heterogeneous echogenicity. Multiple hypervascular lesions were noted in his liver and spleen. He underwent transcatheter embolization therapy of his splenic artery followed by splenectomy and right-sided orchiectomy. A computed tomography scan also showed metastasis to both lungs. During his last follow up after four cycles of cisplatin-based chemotherapy, the level of tumor markers had decreased, decreases in the size of his liver and pulmonary lesions were noted but new sclerotic lesions were evident in his thoracolumbar region raising concern for bony metastasis.ConclusionsPrognosis of testicular tumor depends mainly on the clinical stage, but emergence of a sarcomatous component presents a challenge in the treatment of germ cell tumors and the histological subtype of this component can be used as a guide to specific chemotherapy in these patients.

Soft tissue giant cell tumor of low malignant potential is a rare tumor located in superficial and deep soft tissue. Tumors with osteoclast-like giant cells have been reported in various sites as breast, salivary glands, lung, kidney and pancreas. These tumors are composed of evenly spaced multinucleated giant cells in a background of mononuclear component composed of round, oval or spindled cells. No atypia or significant mitotic activity is encountered. Immunohistochemical stains for TRAP, smooth muscle actin, desmin and cytokeratins are of great value for diagnosis. Nasal cavity represents a very unusual location for this type of tumors; soft tissue tumors must be included in the differential diagnosis of nasal obstruction. Due to the possibility of local recurrence, clinical follow-up is recommended.

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