Tani Masaru, Nakata Wataru, Yamamichi Gaku, Tsujimura Go, Hirao Motohiro, Tsujimoto Yuichi, Nin Mikio, Hiramatsu Naoki, Tsujihata Masao
The Department of Urology, Osaka Rosai Hospital.
The Department of Gastroenterology, Osaka Rosai Hospital.
Hinyokika Kiyo. 2020 Feb;66(2):53-57. doi: 10.14989/ActaUrolJap_66_2_53.
The patient was a 43-year-old man. At 30 years of age, he underwent high-inguinal orchiectomy for a right testicular tumor and was diagnosed with seminoma pT1N0M0. The patient had been followed without additional treatment and had dropped out 7 years after surgery. At 43 years of age, abdominal ultrasonography performed for screening revealed a swollen 4 cm-wide intra-abdominal lymph node, and he was referred to our department. Abdominal contrast-enhanced computed tomography (CT) showed a mass with a 5 cm-wide contrast effect that contacted the anterior surface of the inferior vena cava from the duodenum to the aortic bifurcation. Histological examination by trans-duodenal ultrasound-guided fineneedle aspiration suggested late recurrence of seminoma. After receiving three courses of BEP (bleomycin, etoposide, and platinum) therapy, the patient underwent laparoscopic lymphadenectomy. Pathological examination showed no residual tumor, and the patient was free of recurrence at 13 months after surgery.
患者为一名43岁男性。30岁时，他因右侧睾丸肿瘤接受了高位腹股沟睾丸切除术，被诊断为精原细胞瘤pT1N0M0。此后对该患者进行随访，未进行额外治疗，患者在术后7年失访。43岁时，为进行筛查而进行的腹部超声检查发现一个4厘米宽的腹内肿大淋巴结，随后他被转诊至我科。腹部增强计算机断层扫描（CT）显示一个肿块，有5厘米宽的造影增强效应，从十二指肠至主动脉分叉处与下腔静脉前表面相连。经十二指肠超声引导下细针穿刺活检的组织学检查提示精原细胞瘤晚期复发。在接受三个疗程的BEP（博来霉素、依托泊苷和顺铂）治疗后，患者接受了腹腔镜淋巴结切除术。病理检查显示无残留肿瘤，患者在术后13个月时无复发。
