Service d'immunorhumatologie, CHU Lapeyronie, 34000 Montpellier, France. pit
Joint Bone Spine. 2011 Dec;78(6):644-5. doi: 10.1016/j.jbspin.2011.05.012. Epub 2011 Jul 2.
We report a first case of primitive mediastinal seminoma revealed by bone metastasis without testicular tumor. In a 24-year-old patient with a 6-month history of isolated right hip pain, having normal X-ray and blood tests, we discovered a clinically silent chest mass being diagnosed as seminoma on needle biopsy. Etoposide-ifosfamide-cisplatin chemotherapy was chosen because of the presence of multiple lesions and its lesser toxicity. Germ cell tumors are a rare cause of bone metastases and need to be known to rheumatologists because of their excellent prognosis when recognized and treated early. We discuss new diagnostic (CT, MRI and PET-Scan) and treatment (chemotherapy and radiotherapy) strategies applied to our patient.
我们报告了首例无睾丸肿瘤而仅有骨转移的原始纵隔精原细胞瘤。在一名 24 岁男性患者中，他右侧髋关节疼痛 6 个月，X 线和血液检查均正常，我们发现了一个临床无症状的胸部肿块，经针吸活检诊断为精原细胞瘤。由于存在多个病变，且毒性较小，我们选择了依托泊苷-异环磷酰胺-顺铂化疗。生殖细胞瘤是骨转移的罕见原因，由于早期发现和治疗可获得极好的预后，因此需要让风湿病学家了解。我们讨论了应用于我们患者的新的诊断（CT、MRI 和 PET 扫描）和治疗（化疗和放疗）策略。
