睾丸绒毛膜癌。以隐匿性胃肠道失血为表现的不寻常病例。

Testicular choriocarcinoma. An unusual presentation as occult gastrointestinal blood loss.

作者信息

Stokes E W, Perkins C

机构信息

Department of Medicine, William Beaumont Army Medical Center, El Paso, Texas 79920-5001.

出版信息

J Adolesc Health Care. 1989 Mar;10(2):146-50. doi: 10.1016/0197-0070(89)90106-x.

DOI:10.1016/0197-0070(89)90106-x

PMID:2784429

Abstract

Choriocarcinoma is the rarest testicular germ cell tumor, occurring in less than 1% of cases. Gastrointestinal bleeding is not uncommon in cases of testicular choriocarcinoma and reflects metastatic disease. Typically, the patient presents with marked upper or lower gastrointestinal tract bleeding. A young adult male with metastatic testicular choriocarcinoma presented as a near-syncopal episode, with a hematocrit of 22% and hemoccult-positive stool. Endoscopy revealed a solitary bleeding lesion along the greater curvature of the stomach. His presentation suggested chronic, rather than acute, gastrointestinal blood loss. This case may represent the first case of testicular choriocarcinoma in which chronic gastrointestinal blood loss was the presenting manifestation of metastatic disease.

摘要

绒毛膜癌是最罕见的睾丸生殖细胞肿瘤，发病率不到1%。睾丸绒毛膜癌患者出现胃肠道出血并不罕见，这反映了转移性疾病。通常情况下，患者表现为明显的上消化道或下消化道出血。一名患有转移性睾丸绒毛膜癌的年轻成年男性表现为近乎晕厥发作，血细胞比容为22%，粪便潜血阳性。内镜检查发现胃大弯处有一个孤立的出血病灶。他的表现提示为慢性而非急性胃肠道失血。该病例可能是首例以慢性胃肠道失血为转移性疾病表现的睾丸绒毛膜癌病例。