Testicular carcinoma metastatic to the neck is rare. Even more rare is a finding of choriocarcinoma as a neck mass without any sign of a primary testicular tumor, as only a few cases have been reported in the literature. We describe a new case that occurred in a 29-year-old man who presented with a neck mass. Fine-needle aspiration biopsy identified the tumor as a malignant epithelial neoplasm. Radiologic findings indicated the presence of a systemic metastasis of a tumor to the chest and abdomen, as well as the neck. Findings on an incisional biopsy of the neck mass were consistent with a choriocarcinoma. The testicles were normal on palpation and ultrasonography. The patient was diagnosed with metastatic choriocarcinoma with an unknown primary, and he was started on chemotherapy. On the second day of treatment, which was 25 days after his referral to our clinic, he died of respiratory insufficiency.
Carcinoma of the testicle is the most common malignancy in men between the ages of 15 and 34 years.1 This malignancy usually presents as an enlargement of the testicle or as a mass in the testicle.2 Germ cell tumors account for 98% of all testicular malignancies.1 Choriocarcinoma is a rare, highly malignant tumor of the testes, and it usually occurs as a component of mixed germ cell tumor.3