Hasegawa Tomomi, Maeda Kosaku, Kamata Naoki, Okita Yutaka
Division of Cardiovascular, Thoracic, and Pediatric Surgery, Department of Cardio-Pulmonary and Vascular Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
Pediatr Surg Int. 2006 Jun;22(6):570-2. doi: 10.1007/s00383-006-1694-8. Epub 2006 May 13.
Teratomas in an undescended testis are rare in infants. This report was the youngest case of immature teratoma originating in intra-abdominal undescended testis. A 3-month-old infant with cryptorchism was seen because of an asymptomatic palpable mass in the right abdomen. Ultrasonography and computed tomography revealed a multicystic large tumor with focal calcifications in the right side and serum tumor markers within normal limits. Complete resection of the tumor was performed and the histopathological diagnosis was made as immature teratoma of the right testis. Because retroperitoneal lymph nodes metastasis was observed in 3-month follow-up postoperatively, retroperitoneal lymphadenectomy and chemotherapy including bleomycin, etoposide, and cisplatin were performed. Presently, the infant has been free of recurrence for 3 years. We suggest that nonpalpable testis should undergo a careful evaluation and prompt resolution and that the subsequent finding of an intra-abdominal mass should make us think on the possibility of intra-abdominal testicular germ cell tumor. Postoperative adjuvant chemotherapy in combination with complete resection of the tumor is necessary for pediatric immature teratomas originating in intra-abdominal undescended testis.
隐睾中的畸胎瘤在婴儿中很少见。本报告是起源于腹腔内隐睾的未成熟畸胎瘤最年轻的病例。一名3个月大的隐睾婴儿因右侧腹部可触及无症状肿块前来就诊。超声检查和计算机断层扫描显示右侧有一个多房性大肿瘤，伴有局灶性钙化，血清肿瘤标志物在正常范围内。对肿瘤进行了完整切除，组织病理学诊断为右侧睾丸未成熟畸胎瘤。由于术后3个月的随访中观察到腹膜后淋巴结转移，因此进行了腹膜后淋巴结清扫术，并采用了包括博来霉素、依托泊苷和顺铂在内的化疗。目前，该婴儿已无复发3年。我们建议，对于不可触及的睾丸应进行仔细评估并及时处理，随后发现腹腔内肿块时应考虑腹腔内睾丸生殖细胞肿瘤的可能性。对于起源于腹腔内隐睾的小儿未成熟畸胎瘤，术后辅助化疗联合肿瘤完整切除是必要的。
