Mediastinal, Endobronchial, and Pleural Metastases of immature Testicular Teratoma

This is the report of a 32 year old man presenting with dyspnea and chest pain that was hospitalized with findings of right massive pleural effusion. He had undergone orchiectomy one year previously and diagnosed as testicular teratoma. Thoracal computed tomography showed a necrotic mass occupying right upper and middle lobes, having variable internal echos, and regular contours, right-sided pleural effusion and another mass in anterior mediastinum. Bronchoscopy revealed a vegetal mass partly obstructing the intermediate bronchus. Biopsies of the endobronchial lesion and of the plevra were reported to indicate a metastasis of an immature testicular teratoma. Serum alpha-fetoprotein and pleural effusion alpha­fetoprotein and Cal9-9 levels were high. Dyspnea was relieved partially by repeated thoracentesis. The patient considered to be at stage IV, expired 13 months after the initial diagnosis. We reported this case as rare, having endobronchial, pleural, mediastinal metastases of immature testicular teratoma.