Santucci Jordan, Stapleton Peter, West Jack, Huang Siyu, Lawrentschuk Nathan, Brown Stephen, Forsyth Robert, Sathianathen Niranjan
Grampians Health, Ballarat, VIC, Australia.
Cabrini Institute, Malvern, VIC, Australia.
Urol Case Rep. 2025 Aug 25;62:103175. doi: 10.1016/j.eucr.2025.103175. eCollection 2025 Sep.
We report a 43-year-old man with de novo metastatic testicular seminoma complicated by paraplegia from spinal cord compression due to retroperitoneal lymphadenopathy. Urgent retroperitoneal biopsy confirmed seminoma and, after the patient declined neurosurgical intervention, systemic chemotherapy was promptly initiated prior to delayed orchidectomy. Post-chemotherapy orchidectomy histology revealed minimal viable tumour and serial imaging showed a residual retroperitoneal mass with low-grade uptake on FDG-PET. The mass was deemed unresectable, and surveillance was favoured over immediate salvage. This case highlights the importance of timely diagnosis, multidisciplinary care, and guideline-informed flexibility in managing advanced seminoma with rare complications such as spinal cord compression.
我们报告了一名43岁的男性，患有新发转移性睾丸精原细胞瘤，并因腹膜后淋巴结病导致脊髓压迫而并发截瘫。紧急腹膜后活检确诊为精原细胞瘤，在患者拒绝神经外科干预后，在延迟睾丸切除术前迅速开始全身化疗。化疗后睾丸切除组织学检查显示存活肿瘤极少，系列影像学检查显示腹膜后有残留肿块，FDG-PET上摄取较低。该肿块被认为无法切除，因此更倾向于监测而非立即进行挽救性治疗。本病例强调了在管理伴有脊髓压迫等罕见并发症的晚期精原细胞瘤时，及时诊断、多学科护理以及遵循指南的灵活性的重要性。
