Zhang Shi-Qiang, Wu Song, Yao Kai, Dong Pei, Li Yong-Hong, Zhang Zhi-Ling, Li Xian-Xin, Zhou Fang-Jian
Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.
Chin J Cancer. 2013 Mar;32(3):149-52. doi: 10.5732/cjc.012.10110. Epub 2012 Sep 10.
If a testicular cancer patient has a mass in the retroperitoneum, a metastasis is often the first suspicion, probably leading to improper diagnosis and overtreatment. Here we report a case of retroperitoneal schwannoma mimicking metastatic seminoma. A 29-year-old man, who had a history of seminoma, presented with a single retroperitoneal mass suspected to be a metastasis. Because the patient refused radiotherapy, 3 cycles of cisplatin, etoposide, and bleomycin were offered. Post-chemotherapy computed tomography scan revealed persistence of the retroperitoneal mass, with no change in tumor size or characteristics. Subsequently, retroperitoneal lymph node dissection was performed. The dissected tissue contained negative lymph nodes but a single mass in the attached fat. Pathology revealed retroperitoneal schwannoma, which was confirmed by immunohistochemistry. Thus, clinicians should be aware of retroperitoneal schwannoma and its distinction from metastatic seminoma to avoid misdiagnosis and ensure proper treatment.
如果睾丸癌患者腹膜后出现肿块，通常首先怀疑是转移瘤，这可能导致诊断不当和过度治疗。在此，我们报告一例腹膜后神经鞘瘤误诊为转移性精原细胞瘤的病例。一名有精原细胞瘤病史的29岁男性，出现一个腹膜后肿块，怀疑是转移瘤。由于患者拒绝放疗，给予了3个周期的顺铂、依托泊苷和博来霉素化疗。化疗后计算机断层扫描显示腹膜后肿块持续存在，肿瘤大小和特征无变化。随后进行了腹膜后淋巴结清扫术。切除的组织中淋巴结为阴性，但附着脂肪中有一个肿块。病理显示为腹膜后神经鞘瘤，免疫组化予以证实。因此，临床医生应了解腹膜后神经鞘瘤及其与转移性精原细胞瘤的区别，以避免误诊并确保正确治疗。
