Giant seminoma of the testis (2.51 kg) in a setting of severe occupational and lifestyle exposures: a case report and pathophysiological insights.

We report a case of a giant testicular seminoma in a late 30s male with a two-year history of progressive left scrotal enlargement, who presented with a 22 × 14 × 12 cm mass weighing 2.51 kg. The patient had a significant occupational history of working as a barbecue vendor with daily exposure to high-temperature cooking oil fumes for 3 years, accompanied by extreme lifestyle disruption including approximately 20 working hours per day, less than 4 h of sleep, and heavy smoking and alcohol consumption. Although the exact timing of tumor initiation cannot be determined, these exposures may have contributed to tumor progression in a malignancy that likely had a prolonged preclinical phase. All serum tumor markers, including AFP, hCG, and LDH, were within normal limits. Radical orchiectomy was performed, and histopathology combined with immunohistochemistry (PLAP+, CD117+, SALL4+, D2-40+, CKpan-, CD30-) confirmed pure seminoma. This case highlights that in addition to classical risk factors such as cryptorchidism, chronic environmental exposure to carcinogens (e.g., polycyclic aromatic hydrocarbons from cooking fumes) and severe chronic sleep deprivation may represent potentially modifiable factors that warrant further investigation into their possible association with testicular germ cell tumors. Delayed diagnosis due to occupational neglect allowed the tumor to reach an exceptional size. Although causal associations remain to be established, preventive strategies that reduce exposure to environmental carcinogens, address occupational stress, ensure adequate sleep, and promote routine scrotal self-examination and timely medical consultation may be considered on general health grounds.