Fabre Elodie, Jira Hassan, Izard Vincent, Ferlicot Sophie, Hammoudi Yacine, Theodore Christine, Di Palma Mario, Benoit Gerard, Droupy Stephane
Service d'Urologie, CHU Bicêtre, Bicêtre, France.
BJU Int. 2004 Jul;94(1):74-8. doi: 10.1111/j.1464-410X.2004.04904.x.
To report the natural history of 'burned-out' testicular tumour (a testicular tumour that has regressed spontaneously with no treatment and that generally presents at the stage of metastases).
We report five cases of burned-out testicular tumours to illustrate the clinical, radiological and histopathological features, and discuss the hypothesis of natural history of these neoplasms.
The findings in the five patients tended to indicate that metastatic progression appears to induce spontaneous regression of the previous tumour site. Patients explored for extragonadal germ cell tumour present with various clinical features depending on the site of the metastases.
Despite the controversial hypotheses of the origin of these tumours, extragonadal germ cell tumours should be considered to be metastases of a 'burned-out' primary testicular tumour that must be investigated. When a primary testicular tumour is detected, the testis must be removed, and standard chemotherapy yields good long-term results. The hypothesis of an immunological reaction against the tumour inducing the spontaneous necrosis of the primary tumour and possibly the metastases should be considered. Immunological screening should be proposed in patients to investigate this interesting model of spontaneous tumour regression.
报告“消退型”睾丸肿瘤（一种未经治疗而自发消退且通常在转移阶段出现的睾丸肿瘤）的自然病程。
我们报告5例消退型睾丸肿瘤病例，以阐述其临床、放射学及组织病理学特征，并讨论这些肿瘤自然病程的假说。
5例患者的研究结果倾向于表明，转移进展似乎会促使先前肿瘤部位自发消退。因性腺外生殖细胞肿瘤接受检查的患者，其临床特征因转移部位而异。
尽管这些肿瘤的起源假说存在争议，但性腺外生殖细胞肿瘤应被视为“消退型”原发性睾丸肿瘤的转移灶，必须对此进行调查。当检测到原发性睾丸肿瘤时，必须切除睾丸，标准化疗可产生良好的长期效果。应考虑针对肿瘤的免疫反应导致原发性肿瘤甚至转移灶自发坏死这一假说。应建议对患者进行免疫筛查，以研究这种有趣的自发肿瘤消退模式。
