Katayama Hiromichi, Aoki Hiroshi, Taguchi Katsuyuki, Sakurada Yuu, Sato Tomonori, Takahashi Masahiro, Shibuya Rie, Naganuma Hiroshi, Ishidoya Shigeto
Division of Urology, Sendai City Hospital, Sendai, Japan.
Division of Pathology, Sendai City Hospital, Sendai, Japan.
Urol Case Rep. 2016 Sep 30;9:48-50. doi: 10.1016/j.eucr.2016.08.012. eCollection 2016 Nov.
We report a histologically pure stage 1 seminoma with an elevated human chorionic gonadotropin (hCG). A 38 year-old man was referred for the evaluation of the left testicular swelling. He showed an elevated serum hCG level of 25,265 mIU/ml with normal a fetoprotein and lactate dehydrogenase. Imaging showed heterogeneous tumor without any metastatic lesions. We conducted 4 courses of chemotherapy before detecting hCG nadir. The final pathological report showed pure seminoma with syncytiotrophoblastic cells but no choriocarcinoma components. The patient remains disease free until present time. The case raised several questions regarding diagnosis and treatment strategy for bulky testicular seminoma.
我们报告一例组织学上为纯1期精原细胞瘤且人绒毛膜促性腺激素（hCG）升高的病例。一名38岁男性因左侧睾丸肿大前来评估。他的血清hCG水平升高至25,265 mIU/ml，甲胎蛋白和乳酸脱氢酶水平正常。影像学检查显示肿瘤不均匀，但无任何转移病灶。在检测到hCG最低点之前，我们进行了4个疗程的化疗。最终病理报告显示为纯精原细胞瘤伴合体滋养层细胞，但无绒毛膜癌成分。该患者至今仍无疾病复发。该病例引发了关于巨大睾丸精原细胞瘤的诊断和治疗策略的几个问题。
