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- Title
A Nonseminomatous Germ Cell Tumor Presenting as a Mixed Cryoglobulinemic Vasculitis.
- Authors
Cojuc-Konigsberg, Gabriel; Comte Natera, Isabel; López Graciano, Blanca E.; Mosqueda López, Luis Gerardo; Rojo Ávila, José Alonso; Martínez, Braulio; Ramírez-Sandoval, Juan C.
- Abstract
Background. Mixed cryoglobulinemia syndrome (MCS) is a rare entity with a variety of causes but has not been associated with testicular germ cell tumors. We present here a case of a patient with a nonseminomatous germ cell tumor (NSGCT) presenting as a type III mixed cryoglobulinemic vasculitis. Case Presentation. A 58-year-old male exhibited typical clinical features of vasculitis, including weakness, fatigue, palpable purpura, multiple mononeuropathy, and a low C4 level. An MCS diagnosis was confirmed by the presence of cryoglobulins (6%) with polyclonal IgM and IgG components and biopsy proven leukocytoclastic vasculitis. Concomitantly, a stage IIIC (TxNxM1bS1) germ tumor with marked elevation of serum beta-human chorionic gonadotropin (2764 mUI/mL) was diagnosed. An aggressive treatment was needed, including methylprednisolone pulses, plasmapheresis, rituximab, followed by orchiectomy, and chemotherapy (bleomycin/etoposide/cisplatin). After tumor resection and treatment, cryoglobulins decrease to 0%, suggesting a paraneoplastic origin of the vasculitis. Conclusion. To the best of our knowledge, this is the first case of MCS possibly attributable to a NSGCT. This case further elaborates on the presentation of mixed cryoglobulinemia vasculitis and adds to the published literature on the topic.
- Subjects
LEUKOCYTOCLASTIC vasculitis; VASCULITIS; GERM cell tumors; FATIGUE (Physiology); TUMOR surgery; TUMOR treatment
- Publication
Case Reports in Oncological Medicine, 2022, p1
- ISSN
2090-6706
- Publication type
Case Study
- DOI
10.1155/2022/3326761