Testicular Teratoma with Metastatic Somatic Malignant Transformation: A Rare Case Report
M. Belaghzal *
Department of Urology, Mohammed VI University Hospital, Tangier, Morocco.
Y. Retal
Department of Urology, Mohammed VI University Hospital, Tangier, Morocco.
Z. Bakkali Aissaoui
Department of Urology, Mohammed VI University Hospital, Tangier, Morocco.
A. Khallouk
Department of Urology, Mohammed VI University Hospital, Tangier, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Background: Somatic malignant transformation (SMT) in testicular teratomas is a rare phenomenon and is associated with relative resistance to chemotherapy, making therapeutic management particularly challenging.
Case Report: A 69-year-old man presented with a large left testicular mass associated with para-aortic lymphadenopathy. Radical orchiectomy revealed a teratoma with somatic malignant transformation, including adenocarcinomatous, sarcomatous, and neuroectodermal components.
Following BEP chemotherapy (bleomycin, etoposide, and cisplatin), the persistence of a residual lymph node mass led to a retroperitoneal lymph node dissection (RPLND). Histopathological examination revealed a pure residual teratoma.
Conclusion: This case highlights the prognostic value of histological analysis of residual masses and emphasizes the central role of surgery in metastatic forms with somatic malignant transformation.
Keywords: Testicular neoplasms, teratoma, somatic malignant transformation, germ cell tumor, retroperitoneal lymph node dissection, neoplasm metastasis