Matsumoto H, Nakane H, Aoki A, Naito K, Imate Y, Ohkami K, Isoyama R
Department of Urology, Yamaguchi University School of Medicine.
Hinyokika Kiyo. 2000 Jul;46(7):505-8.
We report a case of synchronous presentation of thyroid cancer and testicular seminoma with lymph node metastasis. A 37-year-old man presented with right scrotal swelling and multiple lymph node swelling. We performed right radical orchiectomy, and histological examination revealed a seminoma of the testis. After systemic work-up for staging, we diagnosed the patient with multiple lymph node metastasis of the seminoma, and administered three cycles of bleomycin, etoposide, and cisplatin (BEP) therapy. Although the chemotherapy was very effective for the retroperitoneal and left cervical lymph node metastases, the right cervical tumor did not change. Retroperitoneal lymphadenectomy combined with right cervical lymph node dissection and hemi-thyroidectomy were performed on September 8, 1998. Pathological examination of the thyroid revealed papillary thyroid cancer and its right cervical lymph node metastasis. There was no evidence of viable cancer cells from either of the primary cancers in the retroperitoneal lymph node. Unresponsiveness to chemotherapy for metastatic lesions from testicular cancer might be a useful clue to detect primary tumors of other origins.
我们报告一例甲状腺癌与睾丸精原细胞瘤同时出现并伴有淋巴结转移的病例。一名37岁男性出现右侧阴囊肿大及多处淋巴结肿大。我们实施了右侧根治性睾丸切除术，组织学检查显示为睾丸精原细胞瘤。在进行全身分期检查后，我们诊断该患者为精原细胞瘤多处淋巴结转移，并给予三个周期的博来霉素、依托泊苷和顺铂（BEP）治疗。尽管化疗对腹膜后和左侧颈部淋巴结转移非常有效，但右侧颈部肿瘤并无变化。1998年9月8日进行了腹膜后淋巴结清扫术联合右侧颈部淋巴结清扫术及甲状腺半切除术。甲状腺病理检查显示为甲状腺乳头状癌及其右侧颈部淋巴结转移。腹膜后淋巴结中未发现来自任何一种原发性癌症的存活癌细胞。对睾丸癌转移灶化疗无反应可能是检测其他原发肿瘤的有用线索。
