M Rangarajan. A Rare Case Of Fungating Anaplastic Seminoma In An Undescended Testis. The Internet Journal of Third World Medicine. 2006 Volume 4 Number 1.
Undescended testes that are present lateral and superior to the external inguinal ring reside in the superficial inguinal pouch of Browne. The cryptorchid testis has a 5% chance of malignant transformation to seminoma (most common), embryonal carcinoma, teratoma or teratocarcinoma. The patient was a 65-year old man presenting with a non-healing malignant ulcer in the left inguinal area of 6 months duration (Figure 1).
The left hemiscrotum was empty and the right testis was normal. Ultrasonogram and CT scan were taken and left testis could not be identified. Malignant transformation of an undescended testis is well documented. Here, the tumor has invaded the skin and fungated, presenting as an ulcero-proliferative growth in the left inguinal area. This is very rare. Multiple wedge biopsies showed an anaplastic variant of seminoma. Wide excision of the lesion with inguinal node dissection and primary split skin grafting was done. Postoperative recovery was uneventful. The anaplastic type of seminoma, with an incidence of 7.5%, is more aggressive and potentially more lethal. It has the worst prognosis and has greater metastatic potential than the other types. The incidence of the undescended testicular tumor fungating is very remote. In tumors of the testis, anaplastic type of seminoma has the highest chance of fungation. In fact, there are no other similar reports that we could find in the literature. This patient had cryptorchidism since birth and this chronicity may have resulted in malignant transformation. This case is being reported for its rarity.
Prof. Muthukumaran Rangarajan GEM Hospital, 45-A, Pankaja Mill Road, Ramnathapuram, Coimbatore – 641045, India. Tel: 0091-422-2324105 Mobile: 0091-9842320672 Fax: 0091-422-2320879 E-mail: firstname.lastname@example.org