Transformación somática en tumor de células germinales: reporte de 2 casos

Background

We describe herein 2 cases of germ cell tumors with somatic malignant transformation (SMT), a rare phenomenon with a low survival rate.

Case 1

A 53-year-old man had a one-month progression of pain and hardening in the left testis. He was diagnosed with a tumor and underwent radical orchiectomy (RO). The histopathology report stated: teratoma with SMT into neurogenic sarcoma and rhabdomyosarcoma. The patient developed retroperitoneal disease and was treated with chemotherapy. The retroperitoneal tumor progressed and grew and so surgical exploration was carried out, identifying an unresectable tumor. A biopsy was taken and the result was a high-grade fusiform rhabdomyosarcoma extending to the greater omentum.

Case 2

A 45-year-old man was a user of NSAIDs. He underwent RO and retroperitoneal tumorectomy in 2004 that reported germ cell tumor at both sites. He received chemotherapy and adjuvant radiotherapy. In 2014 he was referred to our institution and a PET-CT scan identified a 3 × 4 cm intercaval-aortic tumor. Tumor markers were normal. Tumorectomy of 80% of the tumor (R2) was performed, reporting fusocellular sarcoma. Three cycles of doxorubicin/ifosfamide and radiotherapy were administered. The patient remained under surveillance with a 16 mm intercaval-aortic tumor. He presented with upper gastrointestinal bleeding and died.

Conclusions

SMT of germ cell tumors is rare and insufficiently understood.