Mixed Germ cell Tumor of the Testis with Yolk sac and choriocarcinoma components: A case report.

Testicular cancer is one of the leading malignancies affecting young men, with germ cell tumors (GCTs) being the most prevalent type. Testicular mixed germ cell tumors (TMGCTs) are rare malignant tumors that are more common in men aged 20–40 years. TMGCTs comprise two or more types of germ cell tumors that primarily affect the testis. Early detection through imaging and tumor markers like alpha-fetoprotein (AFP) and beta-human chorionic gonadotropin (HCG) is crucial for favorable outcomes. We present a case of a 30-year-old male patient presenting with progressive right testicular swelling and pain. Scrotal ultrasound revealed a markedly enlarged and heterogeneous right testicle measuring 5.4 cm, with mixed echogenicity and cystic features, highly suspicious for malignancy. Tumor markers were significantly elevated, with AFP at > 2000 ng/mL, HCG at 2,25,000 mIU/mL and serum LDH at 705U/L, indicating a high-risk testicular tumor. The patient underwent a right high inguinal orchiectomy with right hemi- scrotectomy. Pathology confirmed a testicular mixed GCT composed of yolk sac tumor, and choriocarcinoma with vascular/lymphatic invasion. This case highlights the aggressiveness of these tumors and challenges in treatment. Early detection, facilitated by thorough clinical evaluation and the use of imaging and tumor markers, remains the cornerstone of management, significantly improving prognosis and survival outcomes.