Primitive neuro ectodermal tumor arising in a testicular ter
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Teratomas make up about 4% of testicular germ cell tumors and follow a heterogeneous clinical progression.While some teratomas may be inert or only locally aggressive, 3–8% of the testicular teratomas have the potential for malignant transformation along endodermal, ectodermal, or mesodermal lines. There are rare cases of malignant transformation of teratomas to Primitive Neuro Ectodermal Tumor (PNET) reported in the literature. We report a rare case of mixed germ cell tumor with PNET metastasis and the role of adjuvant chemotherapy.

Case Report:
A 38-year-old man presenting with left testicular mass and extensive retroperitoneal lymphadenopathy underwent radical orchiectomy and specimen showed a germ cell tumor of primarily primitive neuroectodermal tumor mixed with mature teratoma. He then underwent RPLND, followed by adjuvant CAV (cyclophosphamide, doxorubicin, vincristine) and IE (ifosfamide, etoposide) alternating chemotherapy is given the high rate of recurrence and high rate of response to the PNET-specific chemotherapy...

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