Introduction. Seminomas are the most common testicular tumors. Initial
therapy includes orchiectomy with resection of local lymph nodes, followed
by adjuvant radiotherapy. Testicular tumors usually metastasize to
retroperitoneal and mediastinal lymph nodes, lungs, liver, spleen,
gastrointestinal tract, and adrenal glands. Bone metastases from testicular
tumors are very rare, while seminoma metastasis to the bone marrow is a
curiosity, without any references in the scientific literature. Case Report.
A 66-year-old patient, previously treated for follicular non-Hodgkin
lymphoma, was admitted due to complaints of malaise, abdominal and back
pain, and hepatosplenomegaly. After examination and radiologically verified
enlarged retroperitoneal lymph nodes, the patient was referred to a
hematologist. Based on the patient?s medical history, a relapse of lymphoma
was suspected, and bone marrow biopsy was performed. The hematoxylin-eosin
staining of the biopsy sample showed diffuse large cell infiltrates with
bright cytoplasm, polygonal nuclei and prominent nucleoli. By
immunohistochemical staining, the cells showed positivity for cluster of
differentiation 10, cluster of differentiation 117, octamer binding
transcription factor 3/4, placental alkaline phosphatase, and cytokeratin
8/18, after which the diagnosis of seminoma metastasis to the bone marrow
was made. Shortly after the histopathological diagnosis was made, the
patient died. Conclusion. A seminoma is a testicular tumor with a favorable
prognosis. Due to suppression of hematopoiesis, bone marrow metastases
generally lead to the worst prognosis. The outcome of our patient highlights
the importance of timely diagnosis and therapy, which would increase the
chances of survival.