Kinebuchi Yoshiaki, Ogawa Teruyuki, Kato Haruaki, Igawa Yasuhiko, Nishizawa Osamu, Miyagawa Shin-Ichi
Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan.
Int J Urol. 2007 May;14(5):458-60. doi: 10.1111/j.1442-2042.2007.01757.x.
A 33-year-old man with a left testicular tumor was referred to Shinshu University Hospital for advanced therapy. Radiographic imaging revealed multiple metastases in the retroperitoneal lymph nodes (RPLN) and bilateral lungs, as well as tumor thrombus that extended from the left renal vein to the inferior vena cava (IVC) adjacent to the right atrium. After orchidectomy, a diagnosis of embryonal carcinoma was made with a clinical stage of T1N2M1bS3, which has a poor prognosis, based on the International Germ Cell Cancer Collaborative Group consensus. After eight courses of chemotherapy, the patient's tumor markers normalized and the lung metastases disappeared, but the RPLN and tumor thrombus remained. Retroperitoneal lymph node dissection and thrombectomy were performed using a veno-venous bypass (VVB). The pathological examination of the thrombus revealed a mature teratoma. The patient has been disease-free since surgery.
一名33岁的左侧睾丸肿瘤男性患者被转诊至信州大学医院接受进一步治疗。影像学检查显示腹膜后淋巴结(RPLN)和双侧肺部有多处转移,以及从左肾静脉延伸至右心房附近下腔静脉(IVC)的肿瘤血栓。睾丸切除术后,根据国际生殖细胞癌协作组的共识,诊断为胚胎癌,临床分期为T1N2M1bS3,预后较差。经过八个疗程的化疗,患者的肿瘤标志物恢复正常,肺部转移灶消失,但腹膜后淋巴结和肿瘤血栓仍然存在。采用静脉-静脉旁路(VVB)进行了腹膜后淋巴结清扫和血栓切除术。血栓的病理检查显示为成熟畸胎瘤。自手术以来,患者一直无病生存。