Paraneoplastic lympic-hypothalamic encephalitis in testicular mixed germinal cells tumor. Unpublished case report

The paraneoplastic syndrome is a distant secondary response due to the presence of a neoplasia; it represents a challenge in the primary disease diagnosis. Testicular germ cell neoplasms are classified into seminomatosous and non-seminomatous, and the presence of a pluripotential component may lead to a rare mixed tumor that is associated with hormonal and immunological disorders (paraneoplastic syndromes). In this paper we present the case of a 17-year-old patient with no relevant history, who began with behavioral alterations up to depersonalization, especially violent. During the disease progression there was gynecomastia and hypothalamic-pituitary syndromes. In this article we discuss limbic-hypothalamic encephalitis in the context of mixed germ cell tumors, and the changes in violent behavior that led to the diagnosis after testicular trauma. The diagnosis was confirmed by onconeuronal markers, the hormone profile and histopathology.