ArticleFrontiers in oncology2026
A pure intertubular testicular seminoma mimicking a burned-out tumor: a case report.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: In men presenting with metastatic seminoma and no discrete intratesticular mass, multiparametric MRI (mpMRI) findings such as atrophy, heterogeneity, calcifications, and focal low-signal areas are often interpreted as a regressed ("burned-out") testicular primary. Rare non-mass-forming patterns, however, may produce similar indirect features and complicate primary-site attribution. Case presentation: A 37-year-old man presented with abdominal pain and a 7-8-cm retroperitoneal mass; biopsy confirmed seminoma. Scrotal ultrasound demonstrated right testicular atrophy with diffuse parenchymal heterogeneity and a punctate calcification, without a focal lesion. Testicular mpMRI showed marked heterogeneity with a poorly defined subcapsular T2-hypointense pseudonodular area, heterogeneous enhancement with focal relative hypoperfusion, and regions of increased apparent diffusion coefficient-an appearance considered compatible with a burned-out tumor. Right inguinal orchiectomy performed prior to systemic therapy revealed diffuse viable seminoma with an exclusive intertubular growth pattern, associated germ cell neoplasia Conclusion: This radiologic-pathologic correlation illustrates that diffuse viable intertubular seminoma with fibro-sclerotic remodeling can mimic burned-out tumor on mpMRI. In metastatic seminoma, subtle ipsilateral testicular abnormalities on ultrasound/mpMRI should prompt orchiectomy to secure definitive primary-site pathology and avoid misclassification as regression or extragonadal disease.
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