Sarcoid-like granulomatosis and testicular germ cell tumor: the 'Great Imitator'

Oncology. 2011;81(5-6):319-24. doi: 10.1159/000334239. Epub 2011 Dec 15.

Abstract

Objectives: Only a few case reports and small case series of patients with sarcoidosis or sarcoid-like reaction and testicular germ cell tumors (GCT) have been reported in the literature. We performed a retrospective study of patients with testicular GCT managed at the Centre Léon-Bérard, who presented granulomatosis.

Methods: We performed a computerized search to identify all male patients with both a diagnosis of sarcoidosis or granuloma and testicular tumors seen at the Centre Léon-Bérard between 1992 and 2008.

Results: A total of 13 patients were identified among the 1,182 patients with testicular tumors. The median age at diagnosis of testicular GCT was 25.5 years. Six patients had stage I disease, 2 patients had stage IIb and 5 patients had stage III. Sarcoid-like granulomatosis was found in 9 patients at the time of initial diagnosis and in 4 patients during follow-up. Sarcoidosis presented mainly as pulmonary disease without severe organ involvement, with a benign evolution.

Conclusion: We advise caution in the interpretation of clinical and histological findings in these patients. Sarcoid-like granulomatosis, a condition that can be combined with testicular cancer, should always be considered in the differential diagnosis of metastatic testicular tumors.

MeSH terms

  • Adult
  • Diagnosis, Differential
  • Follow-Up Studies
  • Granuloma, Respiratory Tract / diagnosis
  • Granuloma, Respiratory Tract / pathology*
  • Humans
  • Male
  • Neoplasm Staging / methods
  • Neoplasms, Germ Cell and Embryonal / diagnosis
  • Neoplasms, Germ Cell and Embryonal / pathology*
  • Retrospective Studies
  • Sarcoidosis, Pulmonary / diagnosis
  • Sarcoidosis, Pulmonary / pathology*
  • Testicular Neoplasms / diagnosis*
  • Testicular Neoplasms / pathology
  • Young Adult