shrinking seminoma

A 39-year-old man experiencing cranial nerve symptoms was referred to our neurosurgery department after a brain tumor was detected on computed tomography (CT) scans at a local hospital. Due to convulsive symptoms, the patient was admitted to our hospital for detailed examination. The patient was diagnosed with right testicular tumor, multiple brain metastases, multiple lung metastases and right kidney metastases, and was transferred to our urology department. Since the testicular tumor was staged as IIIC and identified as poor prognosis by the International Germ Cell Consensus classification (IGCCC), Bleomycin Etoposide Cisplatin (BEP) chemotherapy was initiated prior to surgery...

AIM: In advanced seminoma the management of residuals after completion of chemotherapy is controversial. Some centres routinely perform surgery for lesions > or =3 cm diameter, others recommend surgery solely if the residual fail to shrink or show even growth. This study prospectively investigates whether FDG PET can improve the prediction of viable tumour in post-chemotherapy seminoma residuals. MATERIALS AND METHODS: After an expansion of a previous study population, 54 patients from eight centres with metastatic seminoma and a CT-documented mass after chemotherapy were included in the study...

We report the case of a 33-year-old man presenting with a retroperitoneal seminoma secondary to a testicular tumor which had completely and spontaneously disappeared (burned-out or shrinking seminoma). Ultrasound only showed a fibrous scar in the right testis. A careful study of the testicles should be considered in all male retroperitoneal tumor, even if they are asymptomatic, to exclude an occult cancer or more rarely a spontaneously involuted tumor. Testicular ultrasonography is today the gold-standard technique and any parenchymal echostructure abnormality should be verified histologically...

We report 2 cases of testicular seminoma with unusual but dissimilar clinical presentations, which may represent different stages of spontaneous regression of a primary testicular seminoma, the so-called 'shrinking seminoma'. The aetiology of this phenomenon is discussed. These cases also illustrate that, like enlargement, reduction in the size of a testicle warrants investigation for malignancy.

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