Iwamura Hiromichi, Hatakeyama Shingo, Fukushi Ken, Sato Tendo, Kojima Yuta, Murasawa Hiromi, Ishimura Hirofumi, Yoneyama Takahiro, Koie Takuya, Kamimura Noritaka, Morobashi Satoko, Kijima Hiroshi, Ohyama Chikara
The Departments of Urology, Hirosaki University Graduate School of Medicine.
Hinyokika Kiyo. 2013 Mar;59(3):189-93.
A 35-year-old man with an intra-abdominal testicular tumor arising from the right unresolved intraabdominal testis is reported. At 10 years old, left orchidopexy was successfully performed for bilateral undescended testes. However, the right testis was not detected during the operation, and it was diagnosed as vanishing testis. Twenty-five years later, he was referred to our hospital with the complaint of right lower abdominal pain. Computed tomography revealed huge pelvic tumors and bulky para-aortic lymph node swellings. Histopathologic examination of the needle biopsy specimen obtained from the pelvic tumor revealed seminomatous germ cell tumor. Taking the results with a tumor marker study into consideration, the patient was tentatively diagnosed with non-seminomatous germ cell tumor NSGCT (stage IIB) arising from the unresolved intra-abdominal testis or extragonadal germ cell tumor. He received 3 courses of bleomycin, etoposide, cisplatin (BEP), and 4 courses of VP-16, ifosfamide, cisplatin (VIP). After chemotherapy, we performed tumorectomy and retroperitoneal lymphadenectomy because tumor markers were normalized and 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET)-CT revealed normalization. We identified the pelvic tumor as an intra-abdominal testicular tumor arising from right unresolved intra-abdominal testis. Pathological examination revealed no residual tumor cells. There has been no recurrence 17 months after surgery.
报告了一名35岁男性，其腹腔内睾丸肿瘤起源于右侧未降入阴囊的腹腔内睾丸。患者10岁时，因双侧隐睾成功进行了左侧睾丸固定术。然而，手术中未发现右侧睾丸，诊断为睾丸消失。25年后，他因右下腹痛转诊至我院。计算机断层扫描显示盆腔有巨大肿瘤及腹主动脉旁淋巴结肿大。对盆腔肿瘤穿刺活检标本进行组织病理学检查，结果显示为精原细胞瘤性生殖细胞肿瘤。综合肿瘤标志物研究结果，该患者初步诊断为源于未降入阴囊的腹腔内睾丸或性腺外生殖细胞肿瘤的非精原细胞瘤性生殖细胞肿瘤（NSGCT，IIB期）。他接受了3个疗程的博来霉素、依托泊苷、顺铂（BEP方案）以及4个疗程的依托泊苷、异环磷酰胺、顺铂（VIP方案）化疗。化疗后，由于肿瘤标志物恢复正常且2-[18F]氟-2-脱氧-D-葡萄糖正电子发射断层扫描（FDG-PET）-CT显示肿瘤消退，我们进行了肿瘤切除术和腹膜后淋巴结清扫术。我们确定盆腔肿瘤为源于右侧未降入阴囊的腹腔内睾丸的腹腔内睾丸肿瘤。病理检查未发现残留肿瘤细胞。术后17个月无复发。
