Journal of Indian Association of Pediatric Surgeons
Journal of Indian Association of Pediatric Surgeons
                                                   Official journal of the Indian Association of Pediatric Surgeons                           
Year : 2020  |  Volume : 25  |  Issue : 1  |  Page : 62--63

Testicular mixed germ cell tumor in a newborn child: A rare case

Mahmood Dhahir Al-Mendalawi 
 Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq

Correspondence Address:
Prof. Mahmood Dhahir Al-Mendalawi
P.O. Box 55302, Baghdad Post Office, Baghdad

How to cite this article:
Al-Mendalawi MD. Testicular mixed germ cell tumor in a newborn child: A rare case.J Indian Assoc Pediatr Surg 2020;25:62-63

How to cite this URL:
Al-Mendalawi MD. Testicular mixed germ cell tumor in a newborn child: A rare case. J Indian Assoc Pediatr Surg [serial online] 2020 [cited 2022 May 28 ];25:62-63
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I read with great interest the case report by Singh et al.[1] published in the April–June 2019 issue of the Journal of Indian Association of Pediatric Surgeons. The authors described a case of testicular mixed germ cell tumor (MGCT) with yolk sac and immature teratoma component in an Indian newborn.[1] I presume that the rarity of that neoplasm and its aggressive nature should alert the authors to consider defective immune status in the studied newborn. Among defective immune states, human immunodeficiency virus (HIV) infection has prime importance. It is explicit that individuals infected with HIV are more vulnerable to various types of neoplasms compared with immunocompetent individuals. The increased vulnerability has been attributed to various factors, including suppressed immunity, associated infection with oncogenic viruses, and prolonged life expectancy due to the use of antiretroviral treatment.[2] Among neoplasms, testicular germ cell tumor has been reported in HIV-infected individuals.[3],[4] In India, HIV infection is an important health threat. Although no recent data are yet present on the exact pediatric HIV seroprevalence in India, the available data pointed out that the prevalence of HIV infection among pregnant women was reported to be substantial (1.03%).[5] I presume that the vertically acquired HIV infection would have to be seriously considered in the studied newborn. The HIV states of the studied neonate and mother were regrettably not determined as the contemplated laboratory protocol did not include HIV testing. This is obvious as the authors mentioned that the “routine blood investigations were within normal limits, including complete blood counts, renal function test, and liver function test.”[1] Hence, defining HIV status in the studied newborn through the diagnostic workup of blood CD4 lymphocyte count and viral overload measurements was solicited. If that workup was to disclose HIV reactivity, the case in question could be surely considered a novel case report of the youngest patient with HIV-associated testicular MGCT in the literature.

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1Singh AP, Tanger R, Mishra D, Ansari M, Gupta AK, Shukla AK. Testicular mixed germ cell tumor in a newborn child: A rare case. J Indian Assoc Pediatr Surg 2019;24:144-6.
2Valencia Ortega ME. Malignancies and infection due to the human immunodeficiency virus. Are these emerging diseases? Rev Clin Esp 2018;218:149-55.
3Hentrich MU, Brack NG, Schmid P, Schuster T, Clemm C, Hartenstein RC. Testicular germ cell tumors in patients with human immunodeficiency virus infection. Cancer 1996;77:2109-16.
4Munver R, Donehower RC, Kronz JD, Polascik TJ. HIV infection presenting as an unusually large pure yolk sac tumor of the testis. J Urol 2000;164:1653-4.
5Sibia P, Mohi MK, Kumar A. Seroprevalence of human immunodeficiency virus among antenatal women in one of the institute of Northern India. J Clin Diagn Res 2016;10:QC08-9.