case_images: PMC10725136_01
case_images: A representative image from the original testicular tumor, showing the ENET (left side of the image) adjacent to the teratoma (right side of the image). The ENET comprised 80% of the total mass and is shown here to have a vaguely nested growth pattern composed of small round blue cells. A pseudorosette is denoted by the arrow. The teratoma comprised only 20% of the total mass and is shown to contain mature epithelial (asterisks) and cartilaginous tissue (cross). (40x Magnification).. Abbreviation: ENET, embryonic-type neuroectodermal tumor.
case_images: 10.1177_23247096231218145-fig1.jpg
case_images: PMC10725136_01_10.1177_23247096231218145-fig1.jpg
case_images: fig1-23247096231218145
case_images: He underwent radical orchiectomy and pathology showed embryonic-type neuroectodermal tumor, which had arisen from a 6.1-cm teratoma (Figure 1).
case_images: Axial (left) and coronal (right) computed tomographic images of the thorax with contrast demonstrating a large left upper lobe mass. There is mediastinal invasion in addition to hemodynamically significant compression of the left main pulmonary artery and near-occlusion of the left mainstem bronchus.
case_images: 10.1177_23247096231218145-fig2.jpg
case_images: PMC10725136_01_10.1177_23247096231218145-fig2.jpg
case_images: fig2-23247096231218145
case_images: About 15 months after initial diagnosis, surveillance imaging was concerning for disease progression with chest x-ray demonstrating a new lesion. A computed tomography (CT) thorax was performed for better characterization (Figure 2).
case_images: A representative image of the core biopsy of the left mediastinal mass. This mass showed a metastasis of the embryonic-type neuroectodermal tumor arising from a testicular teratoma. This section shows nests of tumor cells (arrows) with surrounding bands of immature neuropil (asterisks). The tumor cells are variably sized and contain hyperchromatic nuclei with minimal to moderate eosinophilic cytoplasm. The morphologic features in this biopsy resemble those seen in the original tumor. No teratoma component was identified in this biopsy. (400x Magnification).
case_images: 10.1177_23247096231218145-fig3.jpg
case_images: PMC10725136_01_10.1177_23247096231218145-fig3.jpg
case_images: fig3-23247096231218145
case_images: Axial (left) and coronal (right) computed tomographic images of the thorax with contrast demonstrating significant interval decrease in previously visualized left upper lobe mass. This mass is now seen encasing the left mainstem bronchus and the segmental branches of the left pulmonary artery with no hemodynamically significant compression. Interval decrease of mediastinal invasion.
case_images: 10.1177_23247096231218145-fig4.jpg
case_images: PMC10725136_01_10.1177_23247096231218145-fig4.jpg
case_images: fig4-23247096231218145
case_images: After 4 cycles of treatment, follow-up chest imaging showed presence of mass, but interval decrease in size (Figure 4).