睾丸未成熟畸胎瘤的全椎体整块切除术：在生长畸胎瘤综合征导致椎体转移加剧的情况下实现长期生存。
Total en bloc spondylectomy in testicular immature teratoma: Long-term survival amidst vertebral metastasis escalated by growing teratoma syndrome.
作者信息
Tamaki Masahiro, Maruno Kouhei, Hazama Tatsuya, Takahashi Toshifumi, Yamada Yuya, Nakashima Masakazu, Kikkawa Kazuro, Ito Noriyuki
机构信息
Department of Urology Japanese Red Cross Wakayama Medical Center Wakayama-shi Wakayama Japan.
出版信息
IJU Case Rep. 2024 Nov 22;8(1):60-63. doi: 10.1002/iju5.12810. eCollection 2025 Jan.
INTRODUCTION
We present a rare case of long-term survival following metastasectomy for lumbar metastasis with growing teratoma syndrome.
CASE PRESENTATION
An 18-year-old man presented with left scrotal mass and lumbago. Alpha-fetoprotein was elevated to 648.8 ng/mL, while human chorionic gonadotropin and lactate hydrogenase were normal. Pathology of left inguinal orchiectomy revealed immature teratoma, and computed tomography confirmed a single metastasis in the second lumbar vertebra. After two courses of bleomycin, etoposide, cisplatin chemotherapy, alpha-fetoprotein decreased, but computed tomography confirmed an enlarged lumbar metastasis. A vertebral biopsy demonstrated teratoma with a dominant mature component, and growing teratoma syndrome was suspected. Following additional etoposide, cisplatin chemotherapy, and normalization of alfa-fetoprotein, total spondylectomy was performed. Vertebral pathology proved mature teratoma. After adjuvant chemotherapy, he has been recurrence-free for 17 years.
CONCLUSION
Spondylectomy of a single metastatic vertebra contributed to long-term survival in a testicular teratoma case.
引言
我们报告一例罕见的经腰椎转移瘤切除术及生长性畸胎瘤综合征治疗后长期存活的病例。
病例报告
一名18岁男性因左侧阴囊肿物及腰痛就诊。甲胎蛋白升高至648.8 ng/mL，而人绒毛膜促性腺激素和乳酸脱氢酶正常。左侧腹股沟睾丸切除术病理显示为未成熟畸胎瘤，计算机断层扫描证实第二腰椎有单个转移灶。经过两个疗程的博来霉素、依托泊苷、顺铂化疗后，甲胎蛋白下降，但计算机断层扫描证实腰椎转移灶增大。椎体活检显示畸胎瘤以成熟成分占主导，怀疑为生长性畸胎瘤综合征。在追加依托泊苷、顺铂化疗及甲胎蛋白恢复正常后，进行了全脊椎切除术。椎体病理证实为成熟畸胎瘤。辅助化疗后，他已无复发存活17年。
结论
在一例睾丸畸胎瘤病例中，单个转移椎体的全脊椎切除术有助于长期存活。
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