{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:41:50Z","timestamp":1787071310513,"version":"build-2736575974"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Germ cell tumors are native to the testis, retroperitoneum, and mediastinum. Here, we report our experience on rare scenarios in this entity. The first patient presented with a primary mediastinal germ cell tumor with 2\u00b0 hemophagocytosis. This dysregulated immune milieu portends a dismal outcome irrespective of treatment. Gastrointestinal involvement in germ cell tumor accounts for only 5% of cases. The Second case with duodenal involvement and hematemesis is believed to be due to contiguous infiltration of the retroperitoneal node. Another case with bleeding ileal intussusception was seen after high-dose chemotherapy in a relapsed non-gestational choriocarcinoma. Bone metastases are exceptional in seminomas and we report such a case as well. Our next patient had thrombotic cardiac involvement which is scarce in the literature. Last patient in this series is an 81-year-old man with sertoli leydig cell tumor. This rare disease in elderly should be differentiated from other entities as the management for each differs.<\/jats:p>","DOI":"10.4103\/ijc.ijc_1230_21","type":"journal-article","created":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T00:00:33Z","timestamp":1750982433000},"page":"162-168","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Rare scenarios in germ cell tumors: A case series"],"prefix":"10.4103","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3588-6334","authenticated-orcid":false,"given":"Lakshmi H.","family":"Kamala","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Regional Cancer Centre, Trivandrum, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geetha","family":"Narayanan","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Regional Cancer Centre, Trivandrum, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arun","family":"Vasudevan","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Regional Cancer Centre, Trivandrum, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neelima","family":"Radhakrishnan","sequence":"additional","affiliation":[{"name":"Department of Pathology, Regional Cancer Centre, Trivandrum, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,5,16]]},"reference":[{"key":"R1-20250627","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global cancer statistics. 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J Clin"},{"key":"R2-20250627","doi-asserted-by":"crossref","first-page":"117","DOI":"10.3960\/jslrt.49.117","article-title":"Primary mediastinal non-seminomatous germ cell tumor associated with hemophagocytic syndrome","volume":"49","author":"Sada","year":"2009","journal-title":"J Clin Exp Hematop"},{"key":"R3-20250627","doi-asserted-by":"crossref","first-page":"6668","DOI":"10.1172\/JCI139682","article-title":"Germ cell tumors and associated hematologic malignancies evolve from a common shared precursor","volume":"130","author":"Taylor","year":"2020","journal-title":"J Clin Invest"},{"key":"R4-20250627","doi-asserted-by":"crossref","first-page":"692","DOI":"10.4103\/2141-9248.141515","article-title":"Hemophagocytosis on bone marrow aspirate cytology: Single center experience in North Himalayan region of India","volume":"4","author":"Chandra","year":"2014","journal-title":"Ann Med Health Sci Res"},{"key":"R5-20250627","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1016\/S0090-4295(99)80366-5","article-title":"Successful management of intracardiac extension of tumor thrombus in a patient with advanced nonseminomatous germ cell testicular cancer","volume":"46","author":"Savarese","year":"1995","journal-title":"Urology"},{"key":"R6-20250627","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1159\/000474807","article-title":"Testicular carcinoma with inferior vena cava thrombosis extending into the right atrium treated with chemotherapy and anticoagulation","volume":"21","author":"Geffen","year":"1992","journal-title":"Eur Urol"},{"key":"R7-20250627","first-page":"371","article-title":"[Tumor thrombus arising from the superior vena cava and extending into the right atrium in a patient with advanced testicular germ cell tumor","volume":"55","author":"Miyake","year":"2009","journal-title":"Hinyokika Kiyo"},{"key":"R8-20250627","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1002\/1097-0142(19820801)50:3<548::AID-CNCR2820500327>3.0.CO;2-2","article-title":"Autopsy findings in 154 patients with germ cell tumors of the testis","volume":"50","author":"Bredael","year":"1982","journal-title":"Cancer"},{"key":"R9-20250627","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1016\/0090-4295(76)90374-5","article-title":"Metastases from testicular carcinoma. Study of 78 autopsied cases","volume":"8","author":"Johnson","year":"1976","journal-title":"Urology"},{"key":"R10-20250627","first-page":"160560","article-title":"Unusual presentation of testicular cancer with tumor thrombus extending to the inferior vena cava","author":"Dusaud","year":"2015","journal-title":"Case Rep Urol 2015"},{"key":"R11-20250627","first-page":"4789259","article-title":"Gastrointestinal involvement of testicular germ cell tumor","author":"Shogbesan","year":"2017","journal-title":"Case Rep Gastrointest Med 2017"},{"key":"R12-20250627","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1007\/BF01072468","article-title":"Gastrointestinal tract metastasis in patients with germ-cell tumor of the testis","volume":"23","author":"Chait","year":"1978","journal-title":"Dig Dis"},{"key":"R13-20250627","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1186\/1752-1947-2-294","article-title":"Testicular seminoma presenting with duodenal perforation: A case report","volume":"2","author":"Miocinovic","year":"2008","journal-title":"J Med Case Rep"},{"key":"R14-20250627","doi-asserted-by":"crossref","first-page":"218","DOI":"10.3389\/fendo.2019.00218","article-title":"Severe complications in testicular germ cell tumors: The choriocarcinoma syndrome","volume":"10","author":"Rejlekova","year":"2019","journal-title":"Front Endocrinol"},{"key":"R15-20250627","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1093\/annonc\/mdw648","article-title":"Impact of primary metastatic bone disease in germ cell tumors: Results of an International global germ cell tumor collaborative group G3 registry study","volume":"28","author":"Oing","year":"2017","journal-title":"Ann Oncol"},{"key":"R16-20250627","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1111\/bju.12218","article-title":"Bone metastases in germ cell tumours: Lessons learnt from a large retrospective study","volume":"112","author":"Jamal-Hanjani","year":"2013","journal-title":"BJU Int"},{"key":"R17-20250627","doi-asserted-by":"crossref","first-page":"311","DOI":"10.5858\/2007-131-311-AILALC","article-title":"An in-depth look at leydig cell tumor of the testis","volume":"131","author":"Al-Agha","year":"2007","journal-title":"Arch Pathol Lab Med"},{"key":"R18-20250627","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.1590\/s1677-5538.ibju.2018.0720","article-title":"Malignant leydig cell tumor in a 91-year-old man: Case report","volume":"45","author":"Justo","year":"2019","journal-title":"Int Braz J Urol"},{"key":"R19-20250627","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1097\/CAD.0b013e32835a3598","article-title":"Testicular and testicular adnexa tumors in the elderly","volume":"24","author":"Gigantinoa","year":"2013","journal-title":"Anticancer Drugs"}],"container-title":["Indian Journal of Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijc.ijc_1230_21","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:44:26Z","timestamp":1787067866000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijc.ijc_1230_21"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":19,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/ijc.ijc_1230_21","relation":{},"ISSN":["0019-509X","1998-4774"],"issn-type":[{"value":"0019-509X","type":"print"},{"value":"1998-4774","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"assertion":[{"value":"2021-10-13","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-03-01","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}