[Burn out bilateral testicular tumor]. / Tumor testicular bilateral "quemado" ("burn out").

UNLABELLED: Differentiating a primary retroperitoneal seminoma from a metastatic testicular tumor with an occult testicular primary or a burned out testicular cancer remains difficult. We present a case of a burned out tumor. The patient had a retroperitoneal seminoma with ultrasonically and pathologically demonstrated abnormalities in both testes, but without evidence of tumor. The patient received chemotherapy and underwent surgery of the residual retroperitoneal mass and bilateral orchiectomy. All surgical specimens were negative for testis cancer. CONCLUSION: Primary extragonadal germ cell tumors in the retroperitoneum are a rare entity. The presence of a retroperitoneal tumor with ultrasonographical abnormalities in testicular evaluation should be considered as a metastases of a burned out testicular cancer, and biopsy is mandatory. Surgical evaluation and orchiectomy should be evaluated in a individual setting.

Tumor testicular bilateral “quemado” (“burn out”) / Burn out bilateral testicular tumor

Es difícil diferenciar entre tumor de células germinales retroperitoneal primario y enfermedad metastásica de un tumor gonadal indetectado o que ha regresado espontáneamente. Presentamos un caso clínico de “burn out” o tumor quemado, es decir un tumor retroperitoneal seminomatoso, metastásico con importantes alteraciones testiculares bilaterales tanto ecográficas como anatomopatológicas, pero sin evidenciar tumor. Pese a las controversias que detallamos, nuestra opción terapéutica fue la extirpación de la masa residual tras la quimioterapia asociada a orquiectomía bilateral en el mismo acto. Concluimos que ante un tumor retroperitoneal, la existencia de alteraciones ecográficas en los testículos, pese a una palpación normal, debe hacer pensar en un “Síndrome de burn out”, siendo obligatoria la biopsia testicular bilateral. La exploración quirúrgica de los mismos e incluso la orquiectomía son opciones a valorar en función de cada paciente (AU)

Differentiating a primary retroperitoneal seminoma from a metastatic testicular tumor with an occult testicular primary or a burned out testicular cancer remains difficult. We present a case of a burned out tumor. The patient had a retroperitoneal seminoma with ultrasonically and pathologically demonstrated abnormalities in both testes, but without evidence of tumor. The patient received chemotherapy and underwent surgery of the residual retroperitoneal mass and bilateral orchiectomy. All surgical specimens were negative for testis cancer. Conclusion: Primary extragonadalgerm cell tumors in the retroperitoneum are a rare entity. The presence of a retroperitoneal tumor with ultrasonographical abnormalities in testicular evaluation should be considered as a metastases of a burned out testicular cancer, and biopsy is mandatory. Surgical evaluation and orchiectomy should be evaluated in a individual setting (AU)