Rare scenarios in germ cell tumors: A case series.

Germ cell tumors are native to the testis, retroperitoneum, and mediastinum. Here, we report our experience on rare scenarios in this entity. The first patient presented with a primary mediastinal germ cell tumor with 2° hemophagocytosis. This dysregulated immune milieu portends a dismal outcome irrespective of treatment. Gastrointestinal involvement in germ cell tumor accounts for only 5% of cases. The Second case with duodenal involvement and hematemesis is believed to be due to contiguous infiltration of the retroperitoneal node. Another case with bleeding ileal intussusception was seen after high-dose chemotherapy in a relapsed non-gestational choriocarcinoma. Bone metastases are exceptional in seminomas and we report such a case as well. Our next patient had thrombotic cardiac involvement which is scarce in the literature. Last patient in this series is an 81-year-old man with sertoli leydig cell tumor. This rare disease in elderly should be differentiated from other entities as the management for each differs.