Heik S C, Kuck K H, Chen C, Hossfeld D K, Krebber H, Kupper W
Abteilung Kardiologie, Universitäts-Krankenhaus Eppendorf, Hamburg.
Dtsch Med Wochenschr. 1992 Dec 22;117(51-52):1962-4. doi: 10.1055/s-2008-1062537.
Two years after the removal of an embryonic testicular tumour from a now 26-year-old man, his general health deteriorated and a holosystolic murmur was heard over the tricuspid valve area. A chest X-ray film demonstrated lung metastases. Biochemical tests were within normal limits, but the human chorionic gonadotrophin level was elevated to 81,030 mU/ml. Echocardiography revealed mild tricuspid regurgitation and a floating mass between the right atrium and ventricle, in contact with the tricuspid valve. The described findings did not support the diagnosis of embolus or inflammatory vegetation. Because of the danger of embolization and obstruction of the pulmonary outflow tract the mass was removed surgically. Enzyme-histological examination identified the tissue as a metastasis of the testicular tumour. The patient's condition at first improved, but he soon died of bleeding from the lung which was infiltrated by trophoblast-containing metastases of the testicular tumour.
一名26岁男性在胚胎性睾丸肿瘤切除两年后，全身健康状况恶化，在三尖瓣区可闻及全收缩期杂音。胸部X线片显示有肺转移。生化检查结果在正常范围内，但人绒毛膜促性腺激素水平升高至81,030 mU/ml。超声心动图显示轻度三尖瓣反流，右心房和心室之间有一漂浮肿物，与三尖瓣接触。上述检查结果不支持栓子或炎性赘生物的诊断。由于存在肺流出道栓塞和梗阻的危险，遂通过手术切除了肿物。酶组织学检查确定该组织为睾丸肿瘤转移灶。患者病情起初有所改善，但很快死于肺部出血，肺部被含滋养层的睾丸肿瘤转移灶浸润。
