Ioannidis Orestis, Malliora Anastasia, Christidis Panagiotis, Loutzidou Lydia, Anestiadou Elissavet, Symeonidis Savvas, Ouzounidis Nikolaos, Foutsitzis Vassilis, Mantzoros Ioannis, Angelopoulos Stamatios
4th Academic Department of General Surgery, Aristotle University of Thessaloniki, General Hospital of Thessaloniki "G. Papanikolaou", Thessaloniki, Greece.
Discoveries (Craiova). 2022 Jun 30;10(2):e149. doi: 10.15190/d.2022.8. eCollection 2022 Apr-Jun.
Testicular cancer is the solid tumor with the greatest incidence in men between 15 and 44 years old. Its main histological type is germ cell tumor, that is divided into seminomatous and non-seminomatous tumors. Seminoma, consisting 55% of testicular cancer, manifests in the fourth decade of men's life and a rare type of it is the anaplastic seminoma (5% to 15% of testicular seminoma). Diagnosis is based on clinical examination, testicular ultrasound, magnetic resonance imaging, tumor markers measurement and pathological examination, while treatment of choice is radical orchiectomy, with or without retroperitoneal lymphadenectomy, potentially followed by radiotherapy or chemotherapy. We present the case of a 36-year-old male patient, whose father suffered from anaplastic seminoma and visited the hospital due to a painless hydrocele. The testicle was swollen and hard on palpation, while cytological examination of the drained fluid detected neoplasm, potentially seminoma. Tumor markers measurement, as well as abdominal and pelvic computerized tomography scans, were evaluated and the patient was staged as IIA, according to the American Joint Commission on Cancer. Radical orchiectomy with high ligation of the seminal vesicle was performed and the pathological examination showed anaplastic testicular seminoma. Postoperatively, four cycles of chemotherapy with bleomycin, etoposide and platinum (BEP) were performed and no signs of recurrence were present after 1 year. In conclusion, anaplastic seminoma has a good prognosis and is suggested to be treated with radical orchiectomy, with or without retroperitoneal lymphadenectomy, potentially followed by radiotherapy or chemotherapy.
睾丸癌是15至44岁男性中发病率最高的实体瘤。其主要组织学类型是生殖细胞肿瘤，分为精原细胞瘤和非精原细胞瘤。精原细胞瘤占睾丸癌的55%，在男性生命的第四个十年出现，其中一种罕见类型是间变性精原细胞瘤（占睾丸精原细胞瘤的5%至15%）。诊断基于临床检查、睾丸超声、磁共振成像、肿瘤标志物测量和病理检查，而首选治疗方法是根治性睾丸切除术，可伴有或不伴有腹膜后淋巴结清扫术，之后可能进行放疗或化疗。我们报告一例36岁男性患者，其父亲患有间变性精原细胞瘤，该患者因无痛性鞘膜积液前来就诊。触诊时睾丸肿大且质地坚硬，引流液的细胞学检查发现肿瘤，可能为精原细胞瘤。评估了肿瘤标志物测量结果以及腹部和盆腔计算机断层扫描，根据美国癌症联合委员会的标准，该患者分期为IIA期。进行了根治性睾丸切除术并高位结扎输精管，病理检查显示为间变性睾丸精原细胞瘤。术后进行了四个周期的博来霉素、依托泊苷和顺铂（BEP）化疗，1年后无复发迹象。总之，间变性精原细胞瘤预后良好，建议采用根治性睾丸切除术治疗，可伴有或不伴有腹膜后淋巴结清扫术，之后可能进行放疗或化疗。
