1. Hypertestosteronemia and Infertility from a Mediastinal Extragonadal Germ Cell Tumor 
Georgios K. Dimitriadis, MD, MSc, PhDc, Gregory Kaltsas, MD, PhD, Tarek Ghobara, MSc, Bidisa Sinha, MD, Eftychia E. Drakou, MD, Kishore Gopalakrishnan, MD, Christos Kosmas, MD, PhD, Stephen D. Keay, MD, Dimitris K. Grammatopoulos, PhD, Harpal S. Randeva, MD, PhD 
The American Journal of Medicine 
Volume 130, Issue 6, Pages e261-e263 (June 2017)
DOI: /j.amjmed
Copyright © 2017 Elsevier Inc. Terms and Conditions

2. Figure 1
Whole-body, contrast-enhanced computed tomography reveals a 7 × 6 × 5-cm mass of the anterior mediastinum without evidence of further disease dissemination in the thorax and abdomen.
The American Journal of Medicine  , e261-e263DOI: ( /j.amjmed )
Copyright © 2017 Elsevier Inc. Terms and Conditions

3. Figure 2
Fatty and nodular tissue from an extratesticular germ cell tumor of the anterior mediastinum infiltrating the thymus gland. Histopathologic examination of the excised mediastinal tissue revealed a mixed primarily seminomatous (95%) with minor teratomatous (5%) component germ cell tumor in the background thymic tissue.
The American Journal of Medicine  , e261-e263DOI: ( /j.amjmed )
Copyright © 2017 Elsevier Inc. Terms and Conditions

4. Figure 3
Hematoxylin–eosin staining showing germ cells infiltrating the background thymus and granuloma. Immunohistochemistry was positive for PLAP, CD117, OCT3/4, and CAM 5.2(dot-like), and negative for aFP, CD30 (ruling out yolk sac and embryonal carcinoma origin), CD56, TTF-1, and CK5 (ruling out metastases, lung primary, and thymoma).
The American Journal of Medicine  , e261-e263DOI: ( /j.amjmed )
Copyright © 2017 Elsevier Inc. Terms and Conditions

5. Figure 4
Testosterone levels in relation to interventions throughout disease clinical course. Normotestosteronemia: 9-26 nmol/L. Hypotestosteronemia: <9 nmol/L. Hypertestosteronemia: >26 nmol/L.
The American Journal of Medicine  , e261-e263DOI: ( /j.amjmed )
Copyright © 2017 Elsevier Inc. Terms and Conditions