Ces Urol 2014, 18(2):138-143 | DOI: 10.48095/cccu2014017

Burned-out tumour of the testis with metastasis to the retroperitoneal lymph node

Karol Kajo¹, Michal Kajo¹, Katarína Macháleková¹, Július Palaj², Iveta Mečiarová³, Peter Zuzák⁴, Emil Tvrdík⁵

¹ Ustav patológie SZU a OUSA, s.r.o., Bratislava

² Klinika onkologickej chirurgie OUSA, s.r.o., a LF UK, Bratislava

³ Alpha medical patológia, s.r.o., Bratislava

⁴ Interná onkologická klinika OUSA a TU, Bratislava

⁵ sv. VINCENT, s.r.o., Prievidza

The term "burned-out tumour" refers to a rare clinical entity that represents a complete spontaneous regression of previously untreated testicular cancer with metastases in the retroperitoneum, mediastinum, lymph nodes, lung or liver. We describe the case of a 55-year-old patient with pain in the right lumbar region, in which the CT scan disclosed a tumour mass in the retroperitoneum (sized 70 x 55 x 90 mm), and ultrasonography revealed structural changes in the lower pole of the right testicle. First, the patient underwent a right-sided orchiectomy with histological finding of a scar in the testicle without distinct tumour changes, followed by radical resection of the retroperitoneal tumour, which histology proved to be a metastasis of seminoma in the lymph node. Consequently, the histology in the testis was re-evaluated and determined to be a completely regressed testicular tumour - "burned-out tumour." Subsequently, patient underwent adjuvant chemotherapy. The pathogenesis of "burned-out" tumours are comprises mainly of immunological factors, ischemia represents another, although less probable cause. Prognosis of "burned-out" tumours in cases of seminomatous germ cell tumours is comparable with those of primary testicular tumours.

Keywords: "burned-out" regression, seminoma, testis, tumour

Received: January 22, 2014; Accepted: February 6, 2014; Published: March 1, 2014