Successful treatment of incidentally diagnosed retroperitoneal seminoma with primary external beam radiotherapy

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\n\tBackground:Germ cell tumours (GCTs) are the most common cancer in young men, typically arising from the testes. However, a small subset (1% to 2%) appears to originate in other locations and is referred to as primary extragonadal germ cell tumors (EGCTs but origin remains controversial.New thought is that these so called primary retroperitoneal seminomas uniformly represent metastases from an occult or regressed testicular primary tumour. \n\tMethod:We present case report of retroperitoneal seminoma in a 60 year old male patient who presented with bloody diarrhea. Endoscopic visualization of colon was normal but imaging confirmed incidental finding of a nodal mass in the abdomen. Biopsy report confirmed classic seminoma. A gonadal primary was not seen on testicular ultrasound. Staging imaging and PET did not identify any other sites of disease. \n\tConclusion: Our case confirms the excellent response to radiation as monotherapy in retroperitoneal seminoma with no known primary. In order to understand this rare neoplasm and serve our patients well more emphasis should be on research for developing novel immunohistochemistry and markers.

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