CTICasesSterilized Mixed Germ Cell Tumor with Teratomatous Elements
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Imaging findings
Initial CT showed a small nodule on the right (a granuloma) and clean lung bases. A subsequent scan 10 months later revealed a new lesion in the left lower lobe.
Key takeaways
This case highlights a pitfall in pathology; the new lesion was initially misdiagnosed as a hamartoma but was later identified as a sterilized metastasis. The patient had undergone chemotherapy, which killed the germ cell line, leaving teratomatous elements. A melanin stain can distinguish sterilized germ cell tumors with teratomatous elements (positive) from hamartomas (negative).
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