Takagi Haruka, Hori Jun-Ichi, Morishita Shun, Makino Shogo, Otani Miyu, Kobayashi Shin, Wada Naoki, Kitta Takeya, Kakizaki Hidehiro
The Department of Renal and Urologic Surgery, Asahikawa Medical University.
Hinyokika Kiyo. 2024 Mar;70(3):77-80. doi: 10.14989/ActaUrolJap_70_3_77.
We present three cases of bilateral metachronous testicular tumors. The patient in case 1 had a history of left orchiectomy for undescended testis at the age of 19. The pathological findings revealed germ cell neoplasia in situ. Twenty-four years later (age=43), he was diagnosed with right testicular tumor with lymph node and lung metastasis (stage IIIc). Right orchiectomy was performed, and the pathological finding showed nonseminomatous germ cell tumor. He underwent chemotherapy, followed by lymph node dissection and lung metastasectomy. The patient in case 2 had a history of left orchiectomy for testicular tumor at the age of 41. The pathological finding of the left testis revealed seminoma (stage IA). Nineteen years later (age=60), he was diagnosed with right testicular tumor and underwent right orchiectomy. Herein, the pathological finding showed seminoma (stage IA). The patient in case 3 had a history of right orchiectomy for testicular tumor at the age of 25. The pathological findings revealed seminoma (stage IS), and he underwent adjuvant radiation of the para-aortic field without subsequent recurrence. Fourteen years later (age=39), he was diagnosed with left testicular tumor and underwent left orchiectomy. The pathological finding revealed seminoma (stage IB). The patient underwent adjuvant carboplatin monotherapy to prevent recurrence. Due to the long interval between the occurrence of bilateral metachronous testicular tumors (mean=19 years ; three cases), long-term observation is necessary to detect the possible occurrence of contralateral testicular tumors. Contralateral testicular biopsy might be considered at the time of orchiectomy for unilateral testicular tumor if associated with testicular atrophy and/or a history of undescended testis.
我们报告三例双侧异时性睾丸肿瘤。病例1患者19岁时因隐睾行左侧睾丸切除术。病理结果显示原位生殖细胞肿瘤。24年后(43岁),他被诊断为右侧睾丸肿瘤伴淋巴结和肺转移(Ⅲc期)。行右侧睾丸切除术,病理结果显示为非精原细胞性生殖细胞肿瘤。他接受了化疗,随后进行了淋巴结清扫和肺转移灶切除术。病例2患者41岁时因睾丸肿瘤行左侧睾丸切除术。左侧睾丸病理结果显示为精原细胞瘤(ⅠA期)。19年后(60岁),他被诊断为右侧睾丸肿瘤并接受了右侧睾丸切除术。在此,病理结果显示为精原细胞瘤(ⅠA期)。病例3患者25岁时因睾丸肿瘤行右侧睾丸切除术。病理结果显示为精原细胞瘤(ⅠS期),他接受了腹主动脉旁区域的辅助放疗,此后未复发。14年后(39岁),他被诊断为左侧睾丸肿瘤并接受了左侧睾丸切除术。病理结果显示为精原细胞瘤(ⅠB期)。该患者接受了辅助卡铂单药治疗以预防复发。由于双侧异时性睾丸肿瘤发生的间隔时间较长(平均19年;3例),需要长期观察以检测对侧睾丸肿瘤可能的发生情况。如果单侧睾丸肿瘤与睾丸萎缩和/或隐睾病史相关,在进行睾丸切除术时可考虑对侧睾丸活检。