Germ cell tumors in male patients without gonadal involvement: computed tomography/magnetic resonance imaging findings and diagnostic workflow

Extragonadal germ cell tumors (EGCTs) represent 1% to 5% of all germ cell tumors (GCTs) (1). Morphological type includes mature/immature teratoma, seminoma, yolk sac tumor, embryonal carcinoma, choriocarcinoma and mixed gonadal GCTs. Their anatomic distribution varies widely and includes the mediastinum, sacrococcygeal region, neck, retroperitoneum and other rare anatomic sites. Diagnosis of EGCTs is made on the basis of histological findings and excluding the presence of a testicular/ovarian involvement. Laboratory is pivotal for diagnosis of EGCTs, often demonstrating high levels of human chorionic gonadotropin (β-HCG) and/or α-fetoprotein (α-FP). The prognosis of patients with EGCTs is variable for the possible occurrence of aggressive behavior and distant metastasis (2). We describe computed tomography (CT) and magnetic resonance (MR) imaging findings of EGCTs reporting a case series of three male patients with different disease’s locations that underwent contrast-enhanced CT with or without positron emission tomography (PET) and/or MR examinations. The diagnostic workflow of all patients is also illustrated.