5% of germ cell tumors are extra-gonadal, occurring primarily outside of testis (see link below to germ cell tumors), in particular within mediastinum
Risk Factors
Fam hx
Undescended testicle
Typical age 15-30
2nd peak >60 for seminomas
Symptoms
Firm, usually painless nodule or mass
Typically unilateral
If metastatic disease, can have symptoms based on site of spread: back pain, sob, chest pain, gynecomastia (from elevated bHCG), headache/other neurologic, etc
Physical Exam Findings
Focal
Firm nodules/enlargement
Usually non-tender
Tests
Imaging with US of testes; CT for extent of disease
Alpha fetoprotein (AFP); beta-HCG as serum tumor markers