Department of Pediatric Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan.
J Pediatr Surg. 2009 Dec;44(12):2395-8. doi: 10.1016/j.jpedsurg.2009.08.024.
A major complication of retained testes is an occurrence of malignancy later in life. We, herein, report the case of a 2-year-old boy who presented with a huge yolk sac tumor with retroperitoneal lymph nodes metastasis that originated in a left intra-abdominal undescended testis. Computed tomography and magnetic resonance imaging showed a huge round tumor connecting to the left retroperitoneal lymph nodes with metastasis extending from the left pelvic region to the left renal hilum. The serum alpha-fetoprotein level was 36,528 ng/mL. The right abdominal tumor appeared to be a giant testis that had strangulated at the neck of the cord. The tumor had ruptured at the side of the left pelvic lymph node metastasis, and a yolk sac tumor was diagnosed from a histologic analysis of the resected specimens. Postoperative PEB chemotherapy was effective, and a complete surgical resection of the tumor was performed 3 months after the initial laparotomy. The pathologic findings showed fibrous tissue without any tumor cells. The patient has been doing well for 18 months after the radical operation. This case might be a coincidental association of a yolk sac tumor occurring in an undescended testis, which thus caused a delay in making an accurate diagnosis.
保留睾丸的一个主要并发症是日后发生恶性肿瘤。我们在此报告一例 2 岁男孩，因左侧腹腔内未降睾丸起源的巨大卵黄囊瘤伴腹膜后淋巴结转移而就诊。计算机断层扫描和磁共振成像显示一个巨大的圆形肿瘤与左侧腹膜后淋巴结相连，转移从左侧骨盆区域延伸至左肾门。血清甲胎蛋白水平为 36528ng/ml。右侧腹部肿瘤似乎是一个在精索颈部绞窄的巨大睾丸。肿瘤在左侧盆腔淋巴结转移侧破裂，对切除标本的组织学分析诊断为卵黄囊瘤。术后 PEB 化疗有效，在初次剖腹手术后 3 个月进行了肿瘤的完全手术切除。病理检查显示纤维组织中无任何肿瘤细胞。根治术后 18 个月，患者情况良好。这种情况可能是未降睾丸中的卵黄囊瘤偶然发生，导致准确诊断的延迟。
