Gohji K, Goto A, Takenaka A, Arakawa S, Matumoto O, Hikosaka K, Kamidono S
Department of Urology, Kobe University School of Medicine, Japan.
J Urol. 1989 Jan;141(1):133-6. doi: 10.1016/s0022-5347(17)40620-3.
We report a case of an extragonadal germ cell tumor from the retrovesical region associated with Klinefelter's syndrome. The patient presented with symptoms of macroscopic hematuria and micturition pain. An x-ray and digital examination were suspicious for prostatic carcinoma. However, needle biopsy of the tumor revealed embryonal cell carcinoma. Serum alpha-fetoprotein was 10,700 ng. per ml. Preoperatively, combined cytotoxic chemotherapy was administered and the antineoplastic effect was excellent. Serum alpha-fetoprotein rapidly returned to the normal range and the tumor volume decreased. Although the preoperative diagnosis was extragonadal germ cell tumor of the prostate, surgery revealed that the tumor originated from the retrovesical region. Orchiectomy and resection were performed. The resected tissue was mostly necrotic with a few viable cells of embryonal cell carcinoma, no metastatic lesions were detected in the lymph nodes and no masses were noted in the testes. Postoperatively, the patient was treated with cytotoxic chemotherapy. His condition has remained good with no clinical evidence of recurrence of the disease.
我们报告一例来自膀胱后区域的性腺外生殖细胞肿瘤，该患者患有克兰费尔特综合征。患者表现为肉眼血尿和排尿疼痛症状。X线和直肠指检怀疑为前列腺癌。然而，肿瘤穿刺活检显示为胚胎性癌。血清甲胎蛋白为每毫升10700纳克。术前给予联合细胞毒性化疗，抗肿瘤效果良好。血清甲胎蛋白迅速恢复至正常范围，肿瘤体积缩小。尽管术前诊断为前列腺性腺外生殖细胞肿瘤，但手术发现肿瘤起源于膀胱后区域。行睾丸切除术及肿瘤切除术。切除组织大部分坏死，有少数胚胎性癌存活细胞，淋巴结未检测到转移灶，睾丸未发现肿块。术后，患者接受细胞毒性化疗。他的病情一直良好，无疾病复发的临床证据。
