case_images: PMC6582702_01
case_images: PMC6582702_02
case_images: Abdominal contrasted TC scan showed the four pancreatic neuroendocrine tumors that are indicated with the arrows.
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case_images: PMC6582702_02_fendo-10-00365-g0001.jpg
case_images: F1
case_images: The abdominal contrast computerized tomography (CT) documented the presence of four hyper-vascular focal lesions, of <1 centimeter and localized at the pancreatic body and tail, which were suggestive for neuroendocrine tumors (NET) (Figure 1).
case_images: Gallium-68 labeled somatostatin receptor PET-CT showed uptake in 3 Gallium-68 labeled somatostatin receptor PET-CT showed an uptake in 3 nodules in the pancreas.
case_images: fendo-10-00365-g0002.jpg
case_images: PMC6582702_02_fendo-10-00365-g0002.jpg
case_images: F2
case_images: A Gallium-68 labeled somatostatin receptor PET-CT an showed uptake in 3 nodules in the pancreas (Figure 2).
case_images: Showed the patient's family tree. None of the patient's male relatives had history of testicular mass.
case_images: fendo-10-00365-g0003.jpg
case_images: PMC6582702_02_fendo-10-00365-g0003.jpg
case_images: F3
case_images: Figure 3 shows the index pedigree.
case_images: PMC6582702_03
case_images: PMC6582702_04
case_images: PMC6582702_05
case_images: Hematoxylin and eosin (HE) staining of testis intra-tubular germ cell neoplasia (200X magnification) composed by the yolk sac tumor, with mainly anastomosing channels that focally expand to form variably sized cysts lined by primitive tumor cells with varying amounts of clear, glycogenated cytoplasm (mycrocistic or reticular pattern, panel A) and of the mature teratoma, with different type of mature tissue such as squamous epithelium with keratinization (panel B shows a dermoid cyst).
case_images: fendo-10-00365-g0004.jpg
case_images: PMC6582702_05_fendo-10-00365-g0004.jpg
case_images: F4
case_images: The histological examination showed an intratubular germ cell neoplasia (IGCNU), consisting of a mature teratoma and yolk sac tumor, with signs of pre-invasive lesion, such as presence of peri-neoplastic, placental alkaline phosphatase (PLAP) and CD117 positive seminiferous tubules, with basal nuclei and abundant clear cytoplasm (Figure 4).
case_images: PMC6582702_06
case_images: PMC6582702_07