case_images: PMC11291199_01
case_images: The post-op specimen measures 9x8x4.5 cm and shows grey-red to grey-brown inelastic tissue. Cross-section displays grey-red and grey-white areas with necrotic and hardened regions. Diagnosed as a malignant germ cell tumor (left retroperitoneal), consistent with choriocarcinoma of epithelial origin per immunohistochemical staining.
case_images: fonc-14-1427341-g001.jpg
case_images: PMC11291199_01_fonc-14-1427341-g001.jpg
case_images: f1
case_images: Figure 1 ). Further ultrasound evaluation of the reproductive system detected a solid mass within the left testis, most likely a homologous germ cell tumor. To investigate the cause of the abdominal pain, a CT scan of the whole abdomen on 2 March revealed ( Figure 3 ): 1) a new hyperdense shadow in the abdominal cavity indicative of potential hemorrhage, necessitating clinical correlation; 2) a notably increased number of lung nodules compared to previous scans, and 3) a fresh abdominopelvic effusion.
case_images: On March 1, 2023, an abdominal CT scan revealed irregular mixed-density masses in the retroperitoneum and left abdominal cavity, measuring 66 mm x 82 mm and 46 mm x 44 mm, respectively. These masses surrounded the abdominal aorta, extended below the bifurcation, and affected the left psoas major muscle and ureter definition. Heterogeneous enhancement in the mass with migrating vascular shadows was observed, along with multiple lymph nodes in the left abdominal cavity and a nodular omentum. Additionally, multiple intensifying nodules were noted in the right hepatic lobe during the arterial phase, with isodensity in the portal and delayed phases. No fluid was present in the abdominal cavity, but enlargement of retroperitoneal lymph nodes and multiple nodules in both lungs were suspected to be metastatic.
case_images: fonc-14-1427341-g002.jpg
case_images: PMC11291199_01_fonc-14-1427341-g002.jpg
case_images: f2
case_images: No fluid was present in the abdominal cavity, but enlargement of retroperitoneal lymph nodes and multiple nodules in both lungs were suspected to be metastatic ( Figure 2 ).
case_images: A full abdominal CT scan on 2 March revealed: 1) a new hyperdense shadow in the abdominal cavity indicative of potential hemorrhage, necessitating clinical correlation; 2) a notably increased number of lung nodules compared to previous scans, and 3) a fresh abdominopelvic effusion.
case_images: fonc-14-1427341-g003.jpg
case_images: PMC11291199_01_fonc-14-1427341-g003.jpg
case_images: f3
case_images: To investigate the cause of the abdominal pain, a CT scan of the whole abdomen on 2 March revealed ( Figure 3 ): 1) a new hyperdense shadow in the abdominal cavity indicative of potential hemorrhage, necessitating clinical correlation; 2) a notably increased number of lung nodules compared to previous scans, and 3) a fresh abdominopelvic effusion.