CASE 712: GERMINOMA METASTASIS, Dr PHAN THANH HẢI, Dr LÝ VĂN PHÁI, Dr HUỲNH TRÁC LUÂN, Dr PHẠM HUỲNH BẢO TRÂN, MEDIC MEDICAL CENTER, HCMC, VIETNAM

A 42 year-old man with continuing pain in LLQ for one week and complained a light diarrhea and one lymph node at his left neck. He had no fever.

Laboratory findings noted raised beta 2 microglobulin.

Ultrasound detected hepatosplenomegaly and many lymph nodes in the abdomen, groins and neck that lead to think about an infiltration of lymphoma stage IV.

Full body MSCT detected a metastasized seminoma in right scrotum to the abdomen and mediastinum.

Chest X-RAY  noted nothing remarkable.

Microscopic and chemoimmunologic staining results of the left neck node were germinoma.

Based on evidences of  neck core biopsy and full body MSCT,  a scrotum ultrasound was done in revealing a tumor of the right testis, which was of size #74×36×66mm, vascularised , hypoechoic. The testis tumor metastasized pelvic and 2 groin lymph nodes and in the abdomen and mediastinum and the leftsideof the neck.

So at last it was a case of the germinoma tumor of the right testis that metastasized largely to the abdomen, groin, mediastinum and left neck lymph nodes. The clue of diagnosing for the case is performance of core biopsy of the neck lymph node.

Ultrasound could detect the case if taking notice of the scrotum of the patient.