Murányi Mihály, Salah Morshed Ali, Tállai Béla, Benyó Mátyás, Flaskó Tibor
Department of Urology, University of Debrecen Medical School and Health Science Center, Nagyerdei krt. 98, Debrecen 4032, Hungary.
Case Rep Med. 2011;2011:164070. doi: 10.1155/2011/164070. Epub 2011 Sep 29.
Late relapse of a testicular cancer is an uncommon occurrence. We report a case of late relapse of a testicular tumour combined with a renal cancer and their successful removal with retroperitoneoscopy. The 36-year-old patient underwent left orchiectomy, retroperitoneal lymph node dissection, and chemotherapy, because of mixed tumor including teratoma and embryonal carcinoma. 18 years after the successful primary therapy elevated serum alpha-fetoprotein level had been confirmed, then MRI and PET-CT scans demonstrated a 30 mm left renal mass and 22 mm retroperitoneal lymph node above the bifurcation of the left common iliac artery. We performed retroperitoneoscopic lymph node dissection and left renal tumour resection in the same session. The histology revealed embryonal carcinoma for the retroperitoneal lymph node and renal cell carcinoma for the left renal mass. We can conclude that late followup of patients with testicular tumour is important. Retroperitoneoscopy is feasible approach for the removal of retroperitoneal lymph node metastasis and resection of renal tumor.
睾丸癌的晚期复发并不常见。我们报告一例睾丸肿瘤晚期复发合并肾癌的病例，并通过后腹腔镜成功切除肿瘤。该36岁患者因混合性肿瘤（包括畸胎瘤和胚胎癌）接受了左侧睾丸切除术、腹膜后淋巴结清扫术及化疗。在成功的初始治疗18年后，血清甲胎蛋白水平升高得到确认，随后MRI和PET-CT扫描显示左肾有一个30毫米的肿块，左髂总动脉分叉上方有一个22毫米的腹膜后淋巴结。我们在同一次手术中进行了后腹腔镜淋巴结清扫术和左肾肿瘤切除术。组织学检查显示腹膜后淋巴结为胚胎癌，左肾肿块为肾细胞癌。我们可以得出结论，对睾丸肿瘤患者进行晚期随访很重要。后腹腔镜检查是切除腹膜后淋巴结转移灶和肾肿瘤的可行方法。
