Pure Testicular Teratoma Testicular tumors are the most common solid tumors in men aged between 15 and 35 year and they account for 1-2% of all male malignancies (1). Cryptorchidism, infertility, trauma, exposure of the mother to exogenous estrogen during pregnancy and infections are the risk factors for testicular cancer. Although most of the tumors (90-95%) originate from germ cells, they may develop from different cell types. Gonadal germ cell tumors (GCTs) of the testis are divided into two

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... groups as seminomas and non-seminoma GTSs (NSGCTs) in which pure teratoma is a subtype of NSGCT (1,2). Pure teratoma is a rare condition accounting for 2-6% of all NSGCTs in adults. Pure form of teratoma is more common in children which constitutes 38% of testicular GCT and 3% of them in adults. They are detected more commonly in children with the incidence of the testicular GCT, 3% in adults and 38% in children, respectively (3). Besides, pure teratomas represent 95% of all ovarian GCTs (1,2). The behavior of testicular teratoma is often aggressive and depends on the patient age, but there is no relationship between the behavior of ovarian teratoma and age. A 29-year-old male presented to our urology clinic with the complaint of a painless testicular mass. A septated avascular cystic mass was observed on ultrasound (US) with twinkling artifacts suggesting calcifications on color Doppler US (Figure 1) . Testicular tumor markers, beta-human chorionic gonadotropin and alphafetoprotein, were normal before radical orchiectomy. Pathological investigation of the surgical specimen revealed pure cystic teratoma (Figure 2) . Computed tomography and positron emission tomography showed a spiculated pulmonary nodule in the left lung. In the light of this finding, the patient was referred to the uro-oncology clinic and received chemotherapy after detection of the metastatic pulmonary nodule. Teratomas consist of elements derived from more than one germ cell layer (endoderm, mesoderm and/or ectoderm). Histologically they are classified as mature, immature and malignant. Mature teratomas are well differentiated relative to the germ cell layers Figure 1. A) Axial ultrasound scan shows septated cystic mass (thick arrow) with internal echogenities suggesting microcalcifications (thin arrow) and B) twinkling artefacts at microcalcifications on the colour doppler ultrasound (arrows)