睾丸切除术后48年精原细胞瘤复发：最长的晚期复发及治疗情况
Recurrence of seminoma 48 years after orchiectomy: Longest late recurrence and treatment.
作者信息
Miyazaki Shinya, Ogura Ryota, Ohashi Munehiro, Shimizu Teruki, Taga Hideto, Ueda Takashi, Okumi Masayoshi, Hongo Fumiya, Ukimura Osamu
机构信息
Department of Urology Kyoto Prefectural University of Medicine Kyoto City Kyoto Japan.
Department of Urology Kyoto Tanabe Central Hospital Kyotanabe-city Kyoto Japan.
出版信息
IJU Case Rep. 2025 Jan 30;8(2):166-169. doi: 10.1002/iju5.70000. eCollection 2025 Mar.
INTRODUCTION
Although not frequent, the recurrence of seminoma later than 5-10 years after orchiectomy has been reported. We report a case of recurrence of seminoma 48 years after orchiectomy, with metastasis to the para-aorta that was treated with chemotherapy.
CASE PRESENTATION
An 83-year-old man had an incidentally enlarged para-aortic lymph node noted on computed tomography. Needle biopsy revealed metastasis from a seminoma that had been treated with orchiectomy at age 35. Chemotherapy was introduced but discontinued after the first course due to side effects. However, a decrease in fluorodeoxyglucose accumulation on positron emission tomography was observed, with no subsequent re-enlargement of the tumor.
CONCLUSION
Chemotherapy was introduced for an elderly patient with the longest known late relapse. Dose reduction should be considered in cases with good prognosis, considering factors such as age.
引言
虽然并不常见，但有报道称精原细胞瘤在睾丸切除术后5至10年以上复发。我们报告一例睾丸切除术后48年精原细胞瘤复发的病例，其转移至腹主动脉旁，接受了化疗。
病例介绍
一名83岁男性在计算机断层扫描时偶然发现腹主动脉旁淋巴结肿大。针吸活检显示为精原细胞瘤转移，该患者35岁时曾接受睾丸切除术。开始进行化疗，但由于副作用在第一个疗程后停药。然而，正电子发射断层扫描显示氟脱氧葡萄糖摄取减少，肿瘤随后未再增大。
结论
对一名已知晚期复发时间最长的老年患者采用了化疗。考虑到年龄等因素，预后良好的病例应考虑减少剂量。
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