Giant testicular tumour with major choriocarcinoma component.

Giant testicular tumour, with volume greater than 10 times a normal testicle, is a rare presentation of testicular cancer. This is of particular note in nations where public health campaigns and high literacy rates generally lead to early detection and cure. We present a 22 year old male, with 14 month history of increasing scrotal swelling. Orchidectomy revealed a mixed germ cell tumour (choriocarcinoma 40%, teratoma 30%, and yolk sac 30%), 250 x 150 × 150mm in size. This case details the largest testicular tumour recorded in Australia, and one of the largest mixed germ cell tumours globally.

Paraneoplastic bullous pemphigoid - A sign of clear cell renal carcinoma.

Paraneoplastic bullous pemphigoid is a rare paraneoplastic syndrome. Rash is pruritic, with erythematous eruption of large subepidermal bullae over skin and often mucosal surfaces. We present an 84y woman with a three week history of erythematous rash, and 48hrs of bullae. A left clear cell renal cell carcinoma was identified on CT imaging during the presentation. Subsequent removal of the tumour resulted in resolution of bullous pemphigoid symptoms. This first-of-kind case and successful result strengthens the association between renal cell carcinoma and paraneoplastic bullous pemphigoid, arguing for a high degree of clinical suspicion in unexplained presentations of bullous pemphigoid.