Ng Yau Hong, Ho Henry Sun Sien, Kumar Naresh Satyanarayan
Department of Orthopaedic Surgery, National University Hospital, Singapore, Singapore.
BMJ Case Rep. 2013 Apr 17;2013:bcr2013008863. doi: 10.1136/bcr-2013-008863.
This is the first-reported case of an isolated thoracic spine relapse of a stage 1 testicular seminoma more than 1 year after surgery and radiotherapy. We report a 38-year-old gentleman, who underwent radical orchidectomy and adjuvant retroperitoneal irradiation for a pure testicular seminoma, presenting with acute cord compression from an isolated T8 relapse 14 months after the index surgery. Decompressive laminectomy with instrumentation was performed with adjuvant chemoradiotherapy. The patient gained full neurological recovery and has remained disease-free for 4 years. Testicular seminomas rarely relapse in the spine after treatment with surgery and radiotherapy, and it is usually the lumbar spine that is involved. Spinal relapse also commonly presents with pain rather than acute cord compression. This case report discusses the unique behaviour of testicular seminomas and their presentation in vertebral relapse. We also present a summary of the available literature on isolated thoracic spine relapse of testicular seminomas.
这是首例报告的1期睾丸精原细胞瘤在手术和放疗1年多后出现孤立性胸椎复发的病例。我们报告一名38岁男性，他因单纯睾丸精原细胞瘤接受了根治性睾丸切除术和辅助性腹膜后照射，在初次手术后14个月因孤立性T8复发出现急性脊髓压迫。进行了减压椎板切除术并植入器械，并辅助放化疗。患者神经功能完全恢复，且已无病生存4年。睾丸精原细胞瘤在手术和放疗后很少在脊柱复发，且通常累及腰椎。脊柱复发也通常表现为疼痛而非急性脊髓压迫。本病例报告讨论了睾丸精原细胞瘤的独特表现及其在椎体复发中的情况。我们还总结了关于睾丸精原细胞瘤孤立性胸椎复发的现有文献。
