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A subsequent FDG-PET/CT [Figure 1] showed a hypermetabolic 8 cm �� 7 cm retroperitoneal mass with a maximum standardized uptake value (SUVmax) of 22 and mild asymmetric FDG activity in the right testis with SUVmax: 4.46. Subsequent radical resection of the retroperitoneal mass was complicated by left renal vein injury due to tumor invasion. The estimated blood loss was 2 L and the left renal vein was ligated to stop bleeding. The final pathology revealed that the mass had characteristics consistent with seminoma with margin click here determine whether the tumor was primary or metastatic. An FDG-PET/CT 2 weeks after surgery [Figure 2] showed postoperative changes without convincing evidence of residual disease or metastases, Chlormezanone as well as interval improvement of the asymmetric mild FDG activity seen before within the testis. Figure 1 (a) 18 fluoro-2-deoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) maximum intensity projection image showing intensely hypermetabolic retroperitoneal mass maximum standardized uptake value ([SUVmax]: 22) and mild asymmetric FDG ... Figure 2 (a) 18 fluoro-2-deoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) maximum intensity projection image weeks after surgery. (b) Axial hybrid PET/CT of the region that previously showed high FDG activity in the retroperitoneal mass. ... Discussion Primary retroperitoneal seminoma is a rare entity that accounts for approximately 2% of all seminomas.[1] The origin of extragonadal retroperitoneal germ cell tumors is controversial. One of the theories suggests that the tumors originate embriologically from displaced germ cells situated along the midline of the body.[2] Another explanation suggests that these tumors are metastatic lesions from spontaneously regressed (burned-out) testicular carcinomas.[3,4] This is why in some cases, in spite of negative imaging, elective orchiectomy is part of the treatment plan of these patients, with most of the cases AZD5363 datasheet showing no significant evidence of the primary malignancy after pathology. In our case, pathology was unable to determine whether the tumor was primary or metastatic. The patient's scrotal ultrasound did not show evidence of testicular masses or other abnormalities. It is true that the staging FDG-PET/CT showed a mild diffuse testicular asymmetry, but the findings were not consistent with malignancy. In addition, the surveillance follow-up scan postresection of the retroperitoneal mass showed spontaneous improvement. Although primary retroperitoneal seminoma has been previously described in the literature,[5,6] to the best of our knowledge, this is the first case in which a primary retroperitoneal seminoma was characterized by FDG-PET/CT.