Gastrointestinal tract metastasis in patients with germ-cell tumor of the testis

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Abstract
A study of the incidence and clinical course of testicular germ-cell tumor metastatic to the gastrointestinal tract is presented. Gastrointestinal tract metastasis occurred in 25 cases, 5% of all patients evaluated with germ-cell tumor of the testis. Although embryonal carcinoma was the dominant component in all cases, elements of choriocarcinoma were found in 20 cases and HCG was positive in 22 cases. Metastasis occurred most commonly by direct invasion from adjacent tumor. The most frequent site of gastrointestinal involvement was the proximal small intestine. Involvement of the duodenum was noted in seven cases. The most common gastrointestinal tract manifestations were intestinal obstruction and gastrointestinal bleeding. Although a variety of therapeutic modalities were tried, the average length of survival from the time of diagnosis of gastrointestinal metastasis to death was six months.