Cáncer testicular bilateral sincrónico con discordancia histopatológica: revisión de la literatura

Introduction: Bilateral testicular tumors are very rare, representing between 1 % and 5 % of all testicular germ cell tumors (TGCT). The vast majority of primary bilateral TGCTs are metachronous, while synchronous tumors account for approximately 0.5 % to 1 % of all cases. Synchronous tumors mostly share the same histological pattern, predominantly seminoma, and synchronous bilateral TGCTs (SBTGCT) with discordant subtypes are extremely rare. Relevance & discussion: The atypical presentation of synchronous bilateral testicular carcinoma with metastatic histopathological discordance poses a therapeutic challenge. Historically, the pathogenesis behind the development of synchronous bilateral TGCTs has been a controversial and still undetermined topic. Apparently are result from separate oncological mechanisms and occur as the development of two independent primary tumors. Clinical case: A 19-year-old male presented with swelling in the left side of the neck. The biopsy reported an embryonal carcinoma, confirmed by ultrasound and tumor markers, revealing bilateral testicular tumors. A left radical orchiectomy was performed, resulting in a mixed germ cell tumor, followed by a right radical orchiectomy after chemotherapy, which yielded a teratoma. Conclusion: It is known that synchronous primary bilateral testicular germ cell tumors (TGCTs) typically present with similar histology; however, we discuss discordant histology presentations.