Ueda Takashi, Takada Ippei, Shimizu Teruki, Ito Saya, Fujihara Atsuko, Shiraishi Takumi, Nakamura Terukazu, Ukimura Osamu
Department of Urology Kyoto Prefectural University of Medicine Kyoto City Kyoto Japan.
Department of Urology Saiseikai Suita Hospital Suita Kyoto Japan.
IJU Case Rep. 2022 Apr 10;5(4):247-250. doi: 10.1002/iju5.12446. eCollection 2022 Jul.
Metastasis to the bone marrow is rare in testicular germ cell tumor patients. We report a case of a patient with a non-seminomatous testicular germ cell tumor who presented with bone marrow metastases after intensive chemotherapy.
A 36-year-old man was admitted to the hospital with pancytopenia. Previously, he had received intensive care for an advanced left testicular germ cell tumor. Although multidisciplinary treatments including several regimens of salvage chemotherapy, desperation retroperitoneal lymph node dissection, and focal radiotherapy were performed, the serum tumor marker alfa-fetoprotein was not normalized and there were no findings of relapse by several imaging modalities. Bone marrow aspirate, conducted to diagnose a cause of pancytopenia, revealed metastatic germ cell tumors in the bone marrow.
Bone marrow metastasis should be considered as a differential diagnosis in patients with germ cell tumors whose serum tumor makers are not normalized without any radiographic finding of recurrence.
骨髓转移在睾丸生殖细胞肿瘤患者中较为罕见。我们报告一例非精原性睾丸生殖细胞肿瘤患者，在接受强化化疗后出现骨髓转移。
一名36岁男性因全血细胞减少入院。此前，他因晚期左侧睾丸生殖细胞肿瘤接受了重症监护。尽管进行了包括多种挽救化疗方案、绝望性腹膜后淋巴结清扫术和局部放疗在内的多学科治疗，但血清肿瘤标志物甲胎蛋白未恢复正常，且多种影像学检查均未发现复发迹象。为诊断全血细胞减少的病因进行的骨髓穿刺显示骨髓中有转移性生殖细胞肿瘤。
对于血清肿瘤标志物未恢复正常且无任何影像学复发表现的生殖细胞肿瘤患者，应考虑骨髓转移作为鉴别诊断。
