De Oliveira Pedro Simões, De Oliveira Tiago Ribeiro, Pereira Sérgio, Martinho David, Lopes Tomé
Hospital de Santa Maria, Urology Department, Lisbon.
Arch Ital Urol Androl. 2018 Mar 31;90(1):68-69. doi: 10.4081/aiua.2018.1.68.
To present a case of a bilateral synchronous testicular seminoma in a young male clinical stage IIB.
A 37 years old man presented a bilateral testicular mass with elevated tumoral markers. Histology of frozen section revealed bilateral seminoma and bilateral radical orchiectomy was performed.
Enhanced chest and abdominopelvic staging CT scan revealed a lymphadenopathy of 30 mm within the inter-aortocava nodal chain (stage IIB). Patient received three cycles of BEP. Three months later 18F-FDG PET showed no evidence of hypermetabolic activity and serum tumoral markers were normal.
Bilateral testicular germ cell tumors are a rare disease. Management of this tumors is controversial. Bilateral radical orchiectomy is the standard of care, nevertheless, in order to preserve fertility and androgen production, an organsparing surgery can be attempted in selected cases. Although prognosis is good, with overall survival rates similar to patients with unilateral disease, life-long close follow-up may be advocated due to relapse risk.
报告一例年轻男性临床IIB期双侧同步性睾丸精原细胞瘤病例。
一名37岁男性出现双侧睾丸肿块且肿瘤标志物升高。冰冻切片组织学检查显示双侧精原细胞瘤，遂行双侧根治性睾丸切除术。
增强胸部及腹盆腔分期CT扫描显示主动脉腔静脉间淋巴结链有一个30mm的淋巴结肿大（IIB期）。患者接受了三个周期的BEP方案化疗。三个月后，18F-FDG PET检查未发现高代谢活性迹象，血清肿瘤标志物正常。
双侧睾丸生殖细胞肿瘤是一种罕见疾病。对此类肿瘤的治疗存在争议。双侧根治性睾丸切除术是标准治疗方法，不过，为了保留生育能力和雄激素分泌，在特定病例中可尝试保留器官手术。尽管预后良好，总体生存率与单侧疾病患者相似，但鉴于复发风险，可能主张进行终身密切随访。
