extragonadal germ cell tumor and male infertility

background: over recent decades a possible decrease in sperm quality and an increase in the incidence of testicular cancer have been reported in many populations. some recent findings, as cohort studies, showed an increased risk of testicular cancer in men with abnormal semen analysis. case: a 30 years old man referred to our clinic with chief compliant of infertility for 3 years. spermogram revealed azoospermia and right extratesticular intrascrotal mass was detected by ultrasound examination. right inguinal surgical approach showed intact small sized atrophic right testis and an intrascrotal mass. in microscopic examination of the mass mixed germ cell tumor with teratoma, yolk sac and embryonal components were reported. conclusion: extragonadal germ cell tumors, like their testicular counterparts are associated with primary germ cell defects. the higher incidence of antecedent infertility suggests that either congenital or acquired primary germ cell defect contributes to defective spermatogenesis and therefore, there is higher risk of cancer development in incompletely migrated germ cells. we recommend complete evaluation of cancer in patients with infertility and azoospermia.