Badawi Jasmin Katrin, Kittner Thomas, Manseck Andreas, Wirth Manfred Wirthamanfred
Department of Urology, University Hospital Carl Gustav Carus, Dresden, Germany.
Onkologie. 2005 Feb;28(2):98-100. doi: 10.1159/000082731.
Intracaval tumour thrombus developed per continuitatem from a primary testicular tumour is rare.
A patient with metastatic mixed non-seminomatous germ cell tumour of the testis extending into the inferior vena cava (IVC) is presented. He belonged to the intermediate-risk group according to the IGCCCG (International Germ Cell Cancer Collaborative Group) classification. The 26-year-old man underwent right inguinal orchiectomy. Computed tomography revealed the tumour thrombus as filling defect in the IVC extending nearly to the right renal vein. Duplex sonography detected a partial thrombosis of the IVC. Combination chemotherapy led to regression of pulmonal metastases and the intraluminal tumour thrombus. 5 months later, retroperitoneal lymphadenectomy was performed and the intraluminal thrombus was extracted by cavotomy. The thrombus originated from the ostium of the right testicularis vein in the IVC. Histological examination revealed no vital tumour tissue.
In patients with testicular cancer information about pathological processes of the IVC is important for therapeutic management. Testicular tumours seldom extend up the IVC.
由原发性睾丸肿瘤沿连续性发展形成的腔静脉内肿瘤血栓罕见。
本文介绍了一名患有转移性睾丸混合性非精原细胞瘤且肿瘤延伸至下腔静脉（IVC）的患者。根据国际生殖细胞癌协作组（IGCCCG）分类，他属于中危组。该26岁男性接受了右腹股沟睾丸切除术。计算机断层扫描显示肿瘤血栓为IVC内的充盈缺损，几乎延伸至右肾静脉。双功超声检测到IVC部分血栓形成。联合化疗使肺转移灶和腔内肿瘤血栓消退。5个月后，进行了腹膜后淋巴结切除术，并通过腔切开术取出腔内血栓。血栓起源于IVC内右睾丸静脉开口处。组织学检查未发现存活的肿瘤组织。
对于睾丸癌患者，了解IVC的病理过程对治疗管理很重要。睾丸肿瘤很少向上延伸至IVC。
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