Testicular Choriocarcinoma Clinical Presentation

Updated: Apr 04, 2017
  • Author: Michael B Williams, MD, MS; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Presentation

History

Unlike classic seminoma or mixed germ cell tumors (GCTs), pure choriocarcinoma is more likely to manifest as symptoms of metastatic disease and is the most common element observed in brain metastases. In male patients with metastatic foci from an unknown primary, the possibility of testicular choriocarcinoma should be kept in the differential diagnosis. [7]

The local tumor itself may be small and may not cause symptoms.

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Physical

The local tumor in choriocarcinoma may be small or nonpalpable, whereas most testicular GCTs cause scrotal swelling and a palpable mass. Testicular pain, with or without radiating pain to the groin and abdomen, is possible but is more consistent with epididymitis.

Widely metastatic testicular GCTs, including choriocarcinoma, may also manifest as a "burned-out" local testis lesion that consists of fibrous scar with absent or minute amounts of viable tumor.

Physical examination findings from lung, liver, and/or brain metastases may be more pronounced than an abnormal finding on testicular examination.

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