Stroosma Otto B, Delaere Karl P J
Department of Urology, Atrium Medical Centre, Heerlen, The Netherlands.
BJU Int. 2008 May;101(9):1101-5. doi: 10.1111/j.1464-410X.2007.07360.x. Epub 2008 Jan 8.
To review previous reports of carcinoid (an endocrine tumour mostly of the gastrointestinal tract) tumours of the testis.
Carcinoid tumours of the testis are rare and can be divided into primary carcinoid (group 1), testicular metastasis from another location (group 2) and carcinoid within a testicular teratoma (group 3). A case of testicular carcinoid within our clinic prompted us to review previous reports; all the cases found were assessed for patient and tumour characteristics, diagnostic tools used, treatment and prognosis.
In all, 62 cases were assessed and divided into groups 1 (44 patients), 2 (six) and 3 (12), respectively. Seven patients in group 1 developed metastases. A wide variety of diagnostic tools was used to search for other tumour sites. All patients were treated with orchidectomy. Three patients with a primary carcinoid were treated with adjuvant chemotherapy (two) or radiotherapy (one), with unknown results. All but one of the nine patients who died were known to have metastasis, either from a primary testicular carcinoid or testicular metastases from an intestinal carcinoid.
When a testicular carcinoid tumour is discovered, other tumour sites should be excluded. The most useful diagnostic tools for this purpose seem to be urinary 5-hydroxyindoleacetic acid measurement, somatostatin receptor scintigraphy, computed tomography and video-capsule endoscopy. Localized testicular carcinoid tumours have an excellent prognosis after orchidectomy.
回顾既往关于睾丸类癌(一种主要起源于胃肠道的内分泌肿瘤)的报道。
睾丸类癌罕见,可分为原发性类癌(第1组)、其他部位转移至睾丸的类癌(第2组)以及睾丸畸胎瘤内的类癌(第3组)。我们诊所的一例睾丸类癌病例促使我们回顾既往报道;对所有发现的病例评估患者及肿瘤特征、所用诊断工具、治疗及预后情况。
共评估62例病例,分别分为第1组(44例患者)、第2组(6例)和第3组(12例)。第1组中有7例患者发生转移。使用了多种诊断工具来查找其他肿瘤部位。所有患者均接受了睾丸切除术。3例原发性类癌患者接受了辅助化疗(2例)或放疗(1例),结果未知。已知死亡的9例患者中,除1例之外,均发生转移,或是原发性睾丸类癌转移,或是肠道类癌转移至睾丸。
发现睾丸类癌肿瘤时,应排除其他肿瘤部位。用于此目的最有用的诊断工具似乎是尿5-羟吲哚乙酸测定、生长抑素受体闪烁扫描、计算机断层扫描和视频胶囊内镜检查。局限性睾丸类癌肿瘤睾丸切除术后预后良好。