Rhabdomyosarcoma arising in testicular teratoma

Somatic type malignancy arising de novo from testicular germ cell tumours is a rare occurrence, particularly sarcomatous malignancy. This case report is of a late presentation with disseminated rhabdomyosarcoma that had arisen from a large 110 mm diameter left testicular tumour (ignored by the patient for several months). Rhabdomyosarcoma had extensively overgrown background mature teratomatous elements within the primary, while ENA staging from the cervical nodes yielded just rhabdomyosarcoma. The diagnosis of rhabdomyosarcoma was confirmed with immuno-chemistry and electron microscopy. It highlights an unusual differential for a testicular tumour.