Medical School Pathology: Pathophysiology of Germ Cell Tumors of the Testis

[@hannahmich7342]

I happen to have been born with a undescended testis on my right side. At age ten surgery was done to bring this testis down into the scrotum. After the surgery I remained in the hospital for a week and clearly something more was done to me besides this simple surgery but nothing was ever directly said to me. My abdominal scar was very large and people treated me different. About the third day in the children’s ward a women came into my ward and pointed to the young sleeping child in the bed next to me. She said they had saved me from becoming a girl but pointing to this child they couldn’t save him. I was in shock and confused and said nothing. She just turned around a exited the ward. Shortly after two men rolled into the ward and loaded the child up and gathered his few belonging and went to surgery. Needless to say this event and what had transpired after the surgery upset me. I never spoke of this to anyone until I was an adult. My mind was full of fears that this child was being punished as I had noticed he had very similar surgery as me accept he was cut open on both sides of his lower abdomen. I had heard her say they were going to make this child a girl? I’m sure that is what she said. As a ten year old my young mind raced thinking that someone could even make or turn a person into a girl? To tell you the truth my mind just tried to block the whole thing out and I never spoke of it until and broke down and told my future wife many years later. I’ve always had gender dysphoria and never acted on it but starting in my early twenties I started to feel as I I were pregnant. I told my wife and she made a joke out of it. Sexually I wasn’t well developed but I was sort of male enough to marry and we got along very well and are still married after many many years. The undescended testis never grew always remaining very very small. The other testis was also small but worked well enough to maintain a marriage while at the same time leaving me to deal with dysphoria, something I actively suppressed. Year passed and we even had a child while I still had to deal with feelings of gender dysphoria. At age 45 I felt a lump and the undescended testis doubled in size overnight. I studied biology in college and had a good background that I realized I needed to see a doctor. The doctor wasn’t upset and said to come back in three weeks and see what happens. We live in a small community in northern Minnesota and this was the only Clinic in the area. Week after week I came back and I even asked for a blood test to see if I could have a teratoma. The doctor laughed at me and said he was not going to do the alphafeto protein test I requested. He said I did not have cancer. Several week later he broke down and sent me to a radiologist for a ultrasound. When I walked into the exam room the doctor was very stressed out. She clearly didn’t want to be here doing this test. The moment she started I could see the mass was huge. Infact it passed all the was into my abdomen, it was that large. My first words was this is a tumor. She said oh no it was just fluid and that was her expert option. As I turned to face her I looked out a door way into the next room and caught the profile of a man pulling back from the door jamb. The doctor and the nurse were in direct line of sight of him. Very confusing. I just covered myself up and exited the room. When I saw my regular doctor again he read the report stating this was nothing more than just fluid. Several weeks later this was becoming very painful and I demanded this be surgically removed. He told me I was over reacting but would contact a surgeon. Weeks later the surgeon saw me and said he could take it out till after Christmas and that turned out to be February. This all started in July of 1996 and now it was February of 1997. While I was wide awake he cut into my lower abdomen and a 10 cm malignant germ teratoma pop out of the wound. The surgeon signaled the nurse to put me under and I spoke up and said not to do that. I said I do not panic. After he finished he said he found holes or pockets in my lower abdomen from my childhood surgeries were several things were surgically removed. We do not know what was done there. Later imaging found a massive 17.5 cm mass in my upper abdomen. None of these doctors spoke to me for many weeks but a surgeon did drive down from duluth Minnesota to tell me he was putting together a treatment plan to bring this cancer under control. Months of horrid chemo and then he had contacted a surgeon at the Mayo Clinic. The truth was he didn’t think I would survive two months. Fast forward to June of 1997 and major surgery at the Mayo Clinic. Six hours of surgery produced a massive teratoma. It wasn’t malignant, just the most well developed one they had ever seen. Limbs, skin, bone tissue and so on. This thing was in me my whole life and I never knew it. Clearly doctors found other bits in me as a child and never passed this data on to me. Oh that alphafeto protein test that I requested the first weeks I started to see the first doctor were done after the first surgery was done the following February, was 10200. A HCG test also indicated cancer. I was at least stage three cancer. In the last twenty some years I’ve had some surgery repairs and horrid nerve pain in my limbs. I went back to work eights months later but had to deal with nerve pain most of twenty year but gradually that even went away. I still have gender dysphoria but the feeling of being pregnant is gone. I have thought of transitioning with estrogen but my endocrinologist suggested that in as much as my cancer was related to ovarian cancer that may not be a good idea. She suggest I have a receptor for ovarian and breast cancer. In all I’ve had over twenty surgeries for various things. I took a early retirement and with four months had four by passes. I had to retire in order to retain post retirement medical from the company I worked for. I did go back to work five years ago with another company to makeup losses I took retiring early.

[@sannpwintaung1224]

Thank you sir great explanation

[@abcdefg1876]

Please do a lecture on Tumors of the ovary , i'm a big fan , thanks for your dedication ❤️

[@PathologyCentral]

Ovarian tumors are tough... and interesting! I'm a little overwhelmed with teaching, but will put this on the list, along with carcinomas of the colon!

[@abcdefg1876]

@@PathologyCentral thank you for taking the time to reply to me personally prof. ❤️ will wait impatiently ❤️

[@PathologyCentral]

@@abcdefg1876 You bet!

[@sotnat9834]

We are just animals, I'm survivor of 50% embryonal carcinoma & 50% teratoma, I was in a lot of pain in my left ball and left groin area my left was getting bigger and bigger and pain a lot in touch when I was 37 in 2009 without metastasis.