Solitary bone metastasis from testicular tumor is rare. In literature, only few cases of isolated bone metastasis at first presentation have been reported, and none of them have been treated with extended surgery of the pelvic bone. Case Presentation: We report the case of a 33-year-old man with an iliac bone osteolytic metastasis as the first presentation of a non-seminomatous germ-cell testis tumor (NSGCT), treated with post-chemotherapy en bloc resection of residual tumor in the left iliac bone (Type I + II internal hemipelvectomy). After a 72-month follow-up, the patient has been asymptomatic, with no signs of local recurrence or metastasis and negative serum tumor markers. Conclusions: In selected cases, testicular NSGCT with iliac bone metastasis and normal or normalizing tumor markers can be treated, in association with chemotherapy, by extended surgery, including bone resection, to obtain gain in survival and maintain limb function.

Keywords:
Testicular tumor, Bone metastasis, En bloc resection, Internal hemipelvectomy
1.
Albers P, Albrecht W, Algaba F, Bokemeyer C, Cohn-Cedermark G, Fizazi K, et al: Guidelines on testicular cancer: 2015 update. Eur Urol 2015; 68: 1054–1068.
2.
Oechsle K, Bokemeyer C, Kollmannsberger C, Mayer F, Berger LA, Oing C, et al: Bone metastases in germ cell tumor patients. J Cancer Res Clin Oncol 2012; 138: 947–952.
3.
Jamal-Hanjani M, Karpathakis A, Kwan A, Mazhar D, Ansell W, Shamash J, et al: Bone metastases in germ cell tumours: lessons learnt from a large retrospective study. BJU Int 2013; 112: 176–181.
4.
Chargari C, MacDermed D, Védrine L: Symptomatic solitary skull bone metastasis as the initial presentation of a testicular germ cell tumor. Int J Urol 2010; 17: 100.
5.
Uygun K, Karagol H, Kocak Z, Cicin I, Yalcin O, Caloglu M, et al: Isolated bone metastasis in testicular germ cell tumors: a case report and review of the literature. Onkologie 2006; 29: 93–95.
6.
Benedetti G, Rastelli F, Fedele M, Castellucci P, Damiani S, Crinò L: Presentation of nonseminomatous germ cell tumor of the testis with symptomatic solitary bone metastasis. A case report with review of the literature. Tumori 2006; 92: 433–436.
7.
Bosco P, Bihrle 3rd W, Malone MJ, Silverman ML: Primary skeletal metastasis of a nonseminomatous germ cell tumor. Urology 1994; 43: 564–566.
8.
Lee JK, Kim SH, Kim JH, Kim IY, Kim TS, Jung S, et al: Metastatic spinal cord compression of testicular yolk sac tumor. Childs Nerv Syst 2002; 18: 171–174.
9.
Samanta DR, Bose C, Krishnappa R, Mishra S, Mohanty S, Upadhyay A, Senapati SN: Mixed germ cell tumor of testis with isolated scapular metastasis: a case report and review of the literature. Case Rep Urol 2015; 2015: 205297.
10.
Oosteruis JW, Looijenga LH: Testicular germ-cell tumours in a broader perspective. Nat Rev Cancer 2005; 5: 210–222.
11.
Chaganti RSK, Houldsworth J: Genetics and biology of adult human male germ cell tumors. Cancer Res 2000; 60: 1475–1482.
12.
Shao QD, Yan X, Sun JY, Xu TM: Internal hemipelvectomy with reconstruction for primary pelvic neoplasm: a systematic review. ANZ J Surg 2015; 85: 553–560.
© 2018 S. Karger AG, Basel
2018
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