Yamashita Shinichi, Ogata Yukihiko, Kawamura Sadafumi, Tochigi Tatsuo, Tateno Hiroo, Kuwahara Masaaki
Department of Urology, Miyagi Cancer Center.
Nihon Hinyokika Gakkai Zasshi. 2005 Jan;96(1):21-4. doi: 10.5980/jpnjurol1989.96.21.
Late relapse of testicular tumor is rare. We report a case of recurrence of seminoma at left inguinal lymph node 18 years after initial treatment. A 63-year-old man had a left orchiectomy for left testicular tumor (T1N0M0) in February 1985, with no past history of scrotal or inguinal surgery. Histological examination revealed seminoma (pT1), and prophylactic radiotherapy (34.2 Gy) to para-aortic and left hemi-pelvic regions was perfomed. In November 2003, the patient presented with left inguinal swelling, and was referred to our hospital with suspicion of metastasis to left inguinal lymph nodes. Serum markers (AFP, hCG, hCGbeta and LDH) were normal. Computerized tomography (CT) showed three masses in the left inguinal region, but no other abnormal mass was detected at chest, abdomen or pelvis. Lymphoidectomy of the left inguinal region was perfomed in January 2004, and the mass revealed to be metastasis of seminoma by histological examination.
睾丸肿瘤的晚期复发很罕见。我们报告一例精原细胞瘤在初始治疗18年后于左侧腹股沟淋巴结复发的病例。一名63岁男性于1985年2月因左侧睾丸肿瘤(T1N0M0)接受了左侧睾丸切除术,既往无阴囊或腹股沟手术史。组织学检查显示为精原细胞瘤(pT1),并对腹主动脉旁和左侧半盆腔区域进行了预防性放疗(34.2 Gy)。2003年11月,患者出现左侧腹股沟肿胀,因怀疑左侧腹股沟淋巴结转移被转诊至我院。血清标志物(甲胎蛋白、人绒毛膜促性腺激素、人绒毛膜促性腺激素β亚基和乳酸脱氢酶)均正常。计算机断层扫描(CT)显示左侧腹股沟区有三个肿块,但胸部、腹部或盆腔未发现其他异常肿块。2004年1月对左侧腹股沟区进行了淋巴结切除术,组织学检查显示肿块为精原细胞瘤转移。