Tumors originating in the space delineated by the posterior sheath of the peritoneum and the posterior abdominal wall, extending from the diaphragm to the upper rim of the pelvis, are classified as retroperitoneal. Retroperitoneal GCTs account for approximately 1 to 2% of all GCTs. Approximately
70% of tumors are found in children under the age of 10 years, and one-half of these are diagnosed in children under the age of 1 year.50 Childhood tumors are mostly benign. Retroperitoneal GCTs in adult males are mostly malignant.62
The nature of primary malignant retroperitoneal GCTs in adult males is a matter of controversy. A significant number of patients diagnosed with retroperitoneal GCTs are subsequently found to have testicular GCTs, suggesting that many (if not all) retroperitoneal tumors are metastases from a primary testicular neoplasm.61,62 Histopathologic examination of testes of patients diagnosed with retroperitoneal GCTs will almost invariably disclose some abnormalities, such as hyalinization of seminiferous tubules, extensive fibrosis, or calcification, suggesting that the presumptive testicular primary GCTs might have involuted following the metastasis of tumor cells to retroperitoneal space, where a new tumor is formed. Some retroperitoneal tumors develop many years after orchiectomy for a testicu-lar tumor, further giving credence to the belief that most retroperitoneal GCTs are actually metastases.63
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