Metastatic seminoma in a 77-year-old man with a regressed primary tumour and concurrent high-grade superficial bladder cancer
Journal of Clinical Urology
School of Medical and Health Sciences
Incidental retroperitoneal (RP) masses present a diagnostic challenge. Primary lesions of the retroperitoneum are uncommon and encompass a range of benign to malignant pathologies.1 Lymphoma constitutes the majority of primary cases.1 Primary tumours showing a predilection for metastatic RP lymphadenopathy include renal cell and testicular carcinoma.1 Testicular cancers are the most commonly occurring cancer in young men aged 15–44 years.2 Of these malignancies, germ cell tumours constitute approximately 98% of all cases.3 Seminoma accounts for 50–60% of germ cell tumours and are diagnosed at a median age of 36 years.4 Spontaneous regression of a primary testicular tumour has been referred to as the ‘burned-out phenomenon’ and has been reported in the literature for several decades.5,6 Due to the low incidence of testicular cancer in men older than 60 years of age, it is rarely reported among this population.7 Therefore, it is unlikely for an incidental RP mass in an elderly man to represent metastatic disease from a primary testicular tumour. However, we report a case of metastatic RP lymphadenopathy with complete spontaneous involution of the primary germ cell testicular seminoma in an elderly male with bladder cancer.