Sakurai Hiromichi, Kawai Koji, Onozawa Mizuki, Inoue Takamitsu, Miyazaki Jun
The Department of Urology, International University of Health and Welfare Narita Hospital.
Hinyokika Kiyo. 2023 Jun;69(6):157-162. doi: 10.14989/ActaUrolJap_69_6_157.
The patient was a 27-year-old male. In December 2020, he was diagnosed with a primary extragonadal germ cell tumor of the retroperitoneum with inferior vena caval (IVC) involvement. After 3 courses of bleomycin, etoposide and cisplatinum and 3 courses of paclitaxel, ifosfamide and cisplatin, the serum human chorionic gonadotropin (hCG) level remained abnormally low. He was referred to our department after follow-up for 2 months. Since the hCG level continued to decrease during follow-up, we decided to perform marker-positive surgery. He underwent retroperitoneal lymph node dissection. We also resected a part of the IVC wall and tumor in the IVC. The serum hCG level was normalized at 5 days after surgery. Pathological examination revealed only necrotic tissue. Immunohistochemistry showed hCG positive in the necrotic tissue.
该患者为一名27岁男性。2020年12月,他被诊断为原发性腹膜后性腺外生殖细胞肿瘤,累及下腔静脉(IVC)。在接受3个疗程的博来霉素、依托泊苷和顺铂以及3个疗程的紫杉醇、异环磷酰胺和顺铂治疗后,血清人绒毛膜促性腺激素(hCG)水平仍异常低。随访2个月后他被转诊至我科。由于随访期间hCG水平持续下降,我们决定进行标记物阳性手术。他接受了腹膜后淋巴结清扫术。我们还切除了部分IVC壁及IVC内的肿瘤。术后5天血清hCG水平恢复正常。病理检查仅显示坏死组织。免疫组化显示坏死组织中hCG呈阳性。