Resnick Matthew J, Canter Daniel, Brucker Benjamin M, Kutikov Alexander, Guzzo Thomas J, Wein Alan J
Division of Urology, University of Pennsylvania Medical Center, Philadelphia, PA, USA.
Nat Clin Pract Urol. 2008 Jul;5(7):397-401. doi: 10.1038/ncpuro1133. Epub 2008 Jun 3.
A previously healthy 51-year-old man with two children sustained a minor testicular trauma and subsequently sought medical care for persistent discomfort.
Physical examination, scrotal ultrasonography, Doppler ultrasound evaluation of testicular blood flow, scrotal MRI, measurement of serum tumor markers and testosterone levels, CT of the chest, abdomen and pelvis, intraoperative frozen section analysis and final pathologic analysis.
Bilateral testicular seminoma (clinical stage I).
The patient initially underwent radical left orchiectomy with intraoperative frozen section analysis, which returned equivocal results. Final pathologic analysis revealed a 2.5 cm left testicular seminoma without vascular invasion. After careful discussion, he ultimately underwent radical right orchiectomy; pathologic analysis revealed a 2.7 cm right seminoma with vascular invasion. Testosterone replacement therapy was initiated. After further discussion, the patient elected to undergo adjuvant abdominal radiotherapy to a total of 25 Gy. The patient showed no evidence of disease over a post-treatment follow-up period of 24 months.
一名既往健康的51岁男子育有两个孩子，遭受了轻微的睾丸创伤，随后因持续不适寻求医疗护理。
体格检查、阴囊超声检查、睾丸血流的多普勒超声评估、阴囊MRI、血清肿瘤标志物和睾酮水平测定、胸部、腹部和骨盆CT、术中冰冻切片分析及最终病理分析。
双侧睾丸精原细胞瘤（临床I期）。
患者最初接受了根治性左睾丸切除术及术中冰冻切片分析，结果不明确。最终病理分析显示左睾丸有一个2.5厘米的精原细胞瘤，无血管侵犯。经过仔细讨论，他最终接受了根治性右睾丸切除术；病理分析显示右睾丸有一个2.7厘米的精原细胞瘤，伴有血管侵犯。开始进行睾酮替代治疗。经过进一步讨论，患者选择接受总计25 Gy的辅助腹部放疗。在24个月的治疗后随访期内，患者未出现疾病迹象。
