GERM-CELL TUMOR AS A DIAGNOSTIC PITFALL OF METASTATIC CARCINOMA

Aim-Testicular germ cell tumours may present as metastases in cervical lymph nodes, yet the primary tumours remain clinically occult. The ai m of the study is to alert pathologists and clinicians to this uncommo n but important presentation and highlight the clues and the diagnosti c adjuncts to its correct diagnosis. Methods-The clinical, cytological , histological, and immunohistochemical features of two patients with germ cell tumour initially presenting as cervical lymphadenopathy were described and analysed. Results-Both patients were young adult males, who were found tol have metastatic undifferentiated carcinoma on fine needle aspiration of the enlarged cervical lymph nodes. The tumour ce lls it both cases were positive for placental alkaline phosphatase (FL AP) and negative for epithelial membrane antigen (EMA). Conclusions-Cl inicians and pathologists should be aware of the possibility of germ c ell tumour when encountering a young adult male with metastatic poorly differentiated carcinoma. Positivity for FLAP and negativity for EMA are helpful adjuncts in arriving at the correct diagnosis.