Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2010 Feb;73(2):88-92. doi: 10.1016/S1726-4901(10)70007-1.
Gastric cancer is one of the most common malignancies in the world. The routes of metastasis include direct extension, lymphatics, and peritoneal or hematogenous spread. Testicular metastasis is rare. We present here a 23-year-old gastric cancer patient who first presented with right-side testis swelling and pain. Diagnosis of metastatic adenocarcinoma was made after right-side orchiectomy. Gastric adenocarcinoma with ascites and peritoneal seeding was found after esophagogastroscopy and abdominal computed tomography. The patient received chemotherapy consisting of docetaxel 36 mg/m(2) and cisplatin 30 mg/m(2) on day 1 and day 8, plus oral tegafur/uracil 300 mg/m(2)/day and leucovorin 90 mg/day on day 1 to day 14 in a 21-day cycle, and he had a partial response to the chemotherapy. Metastatic tumors, especially gastric adenocarcinoma, should be considered in the differential diagnosis of patients presenting with testicular mass and they may respond well to chemotherapy.
胃癌是世界上最常见的恶性肿瘤之一。转移途径包括直接蔓延、淋巴转移和腹膜或血行播散。睾丸转移较为罕见。我们在此报告一例 23 岁胃癌患者，最初表现为右侧睾丸肿胀和疼痛。右侧睾丸切除术术后诊断为转移性腺癌。胃镜和腹部 CT 检查发现胃癌合并腹水和腹膜种植。患者接受了化疗，方案为多西他赛 36mg/m(2)和顺铂 30mg/m(2)，第 1 天和第 8 天给药，同时口服替加氟/尿嘧啶 300mg/m(2)/天和亚叶酸钙 90mg/天，每 21 天为一个周期，化疗后部分缓解。对于出现睾丸肿块的患者，应考虑转移性肿瘤，特别是胃癌，这些肿瘤可能对化疗有良好的反应。
