Suspicion of primary testicular germ cell tumor regressed completely before metastasis

We report a very rare case of an intratesticular, hard, palpable mass strongly suspicious for spontaneous and complete regression of a germ cell tumor (GCT) in the absence of metastasis. The patient was a 47-year-old male with a mass in his right, slightly atrophic testis. He had known about the hard mass for 20 years; it had remained asymptomatic and unchanged in size. Whereas serum tumor makers were all negative and no extragonadal malignancy was proven on computed tomography, ultrasound revealed microcalcification in the mass, indicating malignant potential. Right high orchiectomy was done to determine the definite diagnosis and therapy. Pathological examination of the surgical specimen demonstrated distinctive morphology highly suggestive of spontaneous GCT regression to the entire scar. In testicular oncology, this seems to be the first case demonstrating the interesting nature that has been discussed only for retroperitoneal GCT with burned-out testicular malignancy.