Metastatic Seminoma in the Duodenum: Diagnosis with Endoscopy Followed by Successful Treatment

Morinaga, Maki; Osada, Taro; Kon, Kazuyoshi; Kato, Jun; Konishi, Masae; Shibuya, Tomoyoshi; Sakamoto, Naoto; Nagahara, Akihito; Yao, Takashi; Fujime, Μakoto; Watanabe, Sumio

doi:10.2169/internalmedicine.53.3014

Cited by 6 publications

(5 citation statements)

References 13 publications

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“…If GCT is diagnosed preoperatively, even if no obvious primary can be pointed out, chemotherapy will be preceded according to the guidelines [13]. Chemotherapy was markedly effective for metastatic duodenal GCTs, and there are several reports of progress without surgery [14][15][16]. It is not clear whether chemotherapy is successful for primary duodenal cancers with the characteristics of an embryonal carcinoma, as in our case.…”

Section: Discussionmentioning

confidence: 90%

Primary Duodenal Carcinoma with Embryonal Carcinoma Features in a Young Man

Yamamoto

Washimi

Murakawa

et al. 2021

Case Rep Gastroenterol

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We present the case of a 35-year-old man with intractable nausea, vomiting, and severe anemia. A computed tomography (CT) scan of the chest, abdomen, and pelvis showed a circumferential lesion thickening of up to 3.5 cm at the level of the third portion of the duodenum. No aortocaval, retroperitoneal lymphadenopathy, nor secondary lesion was observed. Esophagogastroduodenoscopy (EGD) revealed a circumferential mass within the third portion of the duodenum. Histopathology of biopsy materials from the duodenal mass showed it most likely to be a poorly differentiated adenocarcinoma. The patient underwent a subtotal stomach-preserving pancreaticoduodenectomy with regional lymph node dissection. Histologically, tumor cells with basophilic cytoplasm and pleomorphic nuclei showed a solid pattern, and expressed CD30 and SALL4 immunohistochemically, leading to a diagnosis of embryonal carcinoma-like tumor. No other primary tumor could be identified, and the location of the tumor, mainly on the mucosal surface, suggested a duodenal origin. The UICC TNM staging was T3N2M0, stage IIB. This is a rare case of primary duodenal carcinoma with features of embryonal carcinoma.

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Section: Discussionmentioning

confidence: 90%

Primary Duodenal Carcinoma with Embryonal Carcinoma Features in a Young Man

Yamamoto

Washimi

Murakawa

et al. 2021

Case Rep Gastroenterol

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“…Metastatic seminoma to the duodenum has been previously described in a young patient who was successfully treated by chemotherapy 19 . Primary retroperitoneal seminoma has also been reported in a 43‐year old patient who was successfully treated with surgical excision followed by chemotherapy 20 .…”

Section: Discussionmentioning

confidence: 93%

“…18 Metastatic seminoma to the duodenum has been previously described in a young patient who was successfully treated by chemotherapy. 19 Primary retroperitoneal seminoma has also been reported in a 43-year old patient who was successfully treated with surgical excision followed by chemotherapy. 20 Erroneous classification of extragonadal seminoma (metastatic or primary) as an adenocarcinoma is a pitfall that has been previously reported 21 and the misdiagnosis adversely influences the treatment outcome.…”

Section: Discussionmentioning

confidence: 97%

Upper gastrointestinal bleed as the initial presentation of seminoma involving the duodenum in an elderly patient with 9 year follow up: A case report and literature review

Zhao

Cheng

Khalil

2023

Diagnostic Cytopathology

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Germ cell tumors are the most common malignancies in males between 20 and 40 years. However, primary extragonadal germ cell tumors are rare and account for 2%-5% of all germ cell neoplasms in adults. Extragonadal germ cell tumors are characterized by their midline locations including pineal and suprasellar regions, mediastinum, retroperitoneum and sacrococcyx. These tumors have also been reported in rare locations such as prostate, bladder, vagina, liver and scalp. Extragonadal germ cell tumors can be primary but may also represent metastases from primary gonadal germ cell tumors. In this report we describe a case of a duodenal seminoma in a 66-yearold male with no history of testicular tumors, who presented with upper gastrointestinal bleed as the initial manifestation. He was effectively treated with chemotherapy and continues to progress well clinically, with no episodes of recurrence.

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“…The treatment in patients with metastasized testicular seminoma to the GI tract usually comprises of chemotherapy and/or surgical resection. The response rate to chemotherapy in such patients is approximately 60% [ 5 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

Small Bowel Metastasis as a Presentation of Testicular Seminoma

Muhanna

Nimri

Almomani

et al. 2021

Cureus

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Testicular germ cell tumors account for 95% of testicular cancers in men with approximately 71,000 patients being diagnosed with testicular cancer every year. The overall survival of testicular germ cell tumors is approximately 95%. However, the prognosis becomes less favorable when distant metastasis is present. Gastrointestinal (GI) tract metastasis occurs in less than 5% of patients with non-seminomatous tumors, and in less than 1% in patients with pure seminomas. GI metastasis usually involves the colon, esophagus, and stomach with the most common symptoms of GI metastasis being diarrhea, nausea, vomiting, and obstruction. We discuss the case of a 42-year-old male patient with GI manifestations as the first presentation of testicular seminoma with metastasis to the small bowel. Computed tomography of the abdomen and pelvis revealed a small bowel mass, and the diagnosis was confirmed with histopathologic examination of endoscopic biopsy samples. The patient subsequently underwent chemotherapy treatment with close surveillance. Clinicians should maintain a high index of suspicion in the differential diagnosis of abdominal pain in young male patients, especially when associated with symptoms like unexplained weight loss, constitutional symptoms, and testicular pain or swelling. Metastasis to the GI tract from the testis should be promptly diagnosed and managed, as the overall survival rates can significantly decrease with the delay of diagnosis.

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Metastatic Seminoma in the Duodenum: Diagnosis with Endoscopy Followed by Successful Treatment

Cited by 6 publications

References 13 publications

Primary Duodenal Carcinoma with Embryonal Carcinoma Features in a Young Man

Primary Duodenal Carcinoma with Embryonal Carcinoma Features in a Young Man

Upper gastrointestinal bleed as the initial presentation of seminoma involving the duodenum in an elderly patient with 9 year follow up: A case report and literature review

Small Bowel Metastasis as a Presentation of Testicular Seminoma

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