The “burnt-out” testicular (Azzopardi) tumor

Excerpt

In males, primary germ cell tumors typically present as a testicular mass [1]. On a few occasions, the primary testicular tumor can regress leaving behind only residual testicular scarring, despite the presence of widespread metastatic disease. This scenario represents a “burnt-out” testicular tumor, also known eponymously as an “Azzopardi tumor” (Fig. 1) [2]. In 1961, Azzopardi et al. reported a series of 17 cases of young men who died of metastatic germ cell tumors, in whom the primary testicular lesion was a fibrous scar with minimal or no viable neoplastic tissue, when examined pathologically [2]. These scars often contained calcium, and it was theorized that the primary tumor had infarcted due its propensity for local vascular invasion, with the resulting necrotic area forming a matrix conducive to calcium deposition [2]. When the “burnt-out” appearance is identified sonographically, it should prompt evaluation of the chest, abdomen, and pelvis for metastatic deposits (Fig. 2).

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