Kitano Hiroyuki, Sentani Kazuhiro, Goto Keisuke, Sekino Yohei, Yamanaka Ryoken, Nagasaka Keiji, Shigematsu Yoshinori, Kobayashi Kanao, Hayashi Tetsutaro, Yasui Wataru, Teishima Jun
Department of Urology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3 Minamiku, Hiroshima City, Hiroshima 734-8551 Japan.
Department of Molecular Pathology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Int Cancer Conf J. 2020 Aug 9;9(4):240-243. doi: 10.1007/s13691-020-00437-z. eCollection 2020 Oct.
Primary adenocarcinoma of the rete testis is an extremely rare tumor with a poor prognosis. Herein, we report a case of primary adenocarcinoma of the rete testis accompanied by elevated serum carbohydrate antigen 19-9 (CA19-9) antigen levels in a 44-year-old man who presented with left scrotal swelling. Para-aortic lymph node swelling was observed on the computed tomography scan. Germ cell tumor markers were within the normal range, but serum CA19-9 antigen levels were high. Radical orchiectomy was performed, and histological examination revealed primary adenocarcinoma of the rete testis with no evidence of other primary carcinomas. The patient underwent three lines of chemotherapy, although no reports suggest the use of gemcitabine and oxaliplatin (GEMOX) in a patient with adenocarcinoma of the rete testis. Unfortunately, he developed metastasis at multiple sites and passed away due to adenocarcinoma 13 months after undergoing orchiectomy. Some reports suggest that CA19-9 antigen levels are elevated in patients with adenocarcinoma of the rete testis, although it has not been clarified whether elevated CA19-9 antigen levels reflect the progression of adenocarcinoma of the rete testis. In this case, as CA19-9 antigen levels increased with progression, CA19-9 might be a marker for primary adenocarcinoma of the rete testis. GEMOX chemotherapy as a line of treatment in primary adenocarcinoma of the rete testis has not been reported. Therefore, further studies must evaluate the efficacy of the aforementioned chemotherapy regimen.
睾丸网原发性腺癌是一种极其罕见且预后较差的肿瘤。在此，我们报告一例44岁男性睾丸网原发性腺癌病例，该患者因左侧阴囊肿大就诊，血清糖类抗原19-9（CA19-9）抗原水平升高。计算机断层扫描显示腹主动脉旁淋巴结肿大。生殖细胞肿瘤标志物在正常范围内，但血清CA19-9抗原水平较高。实施了根治性睾丸切除术，组织学检查显示为睾丸网原发性腺癌，无其他原发性癌的证据。尽管尚无关于在睾丸网腺癌患者中使用吉西他滨和奥沙利铂（GEMOX）的报道，但该患者接受了三线化疗。不幸的是，他出现了多处转移，在接受睾丸切除术后13个月因腺癌去世。一些报告表明，睾丸网腺癌患者的CA19-9抗原水平会升高，尽管CA19-9抗原水平升高是否反映睾丸网腺癌的进展尚未明确。在本病例中，随着病情进展CA19-9抗原水平升高，CA19-9可能是睾丸网原发性腺癌的一个标志物。尚未有关于GEMOX化疗作为睾丸网原发性腺癌一线治疗方案的报道。因此，进一步的研究必须评估上述化疗方案的疗效。
