Yamashita Maiko, Sakai Takanari, Yamashita Shinichi, Fujishima Fumiyoshi, Goto Takuro, Sato Takuma, Kawasaki Yoshihide, Kawamorita Naoki, Tanaka Takaki, Ito Akihiro
Department of Urology Tohoku University Graduate School of Medicine Sendai Miyagi Japan.
Department of Urology Hachinohe City Hospital Hachinohe Aomori Japan.
IJU Case Rep. 2023 Apr 29;6(4):226-229. doi: 10.1002/iju5.12593. eCollection 2023 Jul.
In testicular cancer, late relapse of teratoma with somatic-type malignancy is rare and associated with a poor survival. A case of retroperitoneal lymph node metastasis of teratoma with somatic-type malignancy 18 years after initial treatment for testicular cancer is reported.
A 46-year-old man had a 15-mm-sized mass in the para-aortic region 18 years after initial treatment for testicular cancer, without elevated serum alfa-fetoprotein or human chorionic gonadotropin levels. Laparoscopic retroperitoneal lymph node dissection was performed. The pathological findings showed teratoma with somatic-type malignancy, and the findings of primary testicular cancer reported a yolk sac tumor, not teratoma.
Late relapse of teratoma with somatic-type malignancy was resected by laparoscopic retroperitoneal lymph node dissection. Therefore, long-term follow-up should be considered if patients with small retroperitoneal masses did not undergo retroperitoneal lymph node dissection, and early detection and surgical resection for relapse might be effective.
在睾丸癌中,畸胎瘤伴体细胞型恶性肿瘤的晚期复发罕见且预后不良。本文报告1例睾丸癌初次治疗18年后发生畸胎瘤伴体细胞型恶性肿瘤的腹膜后淋巴结转移病例。
一名46岁男性在睾丸癌初次治疗18年后,腹主动脉旁区域出现一个15毫米大小的肿块,血清甲胎蛋白或人绒毛膜促性腺激素水平未升高。进行了腹腔镜腹膜后淋巴结清扫术。病理结果显示为畸胎瘤伴体细胞型恶性肿瘤,而原发性睾丸癌的结果报告为卵黄囊瘤,而非畸胎瘤。
通过腹腔镜腹膜后淋巴结清扫术切除了畸胎瘤伴体细胞型恶性肿瘤的晚期复发灶。因此,对于未进行腹膜后淋巴结清扫术的腹膜后小肿块患者,应考虑长期随访,复发时的早期检测和手术切除可能有效。