Ikeda H, Matsuyama S, Suzuki N, Takahashi A, Kuroiwa M, Nagashima K, Hirato J
Department of Surgery, Gunma Children's Medical Center, Japan.
Acta Paediatr Jpn. 1995 Aug;37(4):537-40. doi: 10.1111/j.1442-200x.1995.tb03372.x.
There is controversy concerning the treatment of stage I yolk sac tumor of the testis, particularly of those with histological factors that indicate a high risk of relapse. Usually orchiectomy alone is sufficient and adjuvant chemotherapy is unnecessary. Retroperitoneal lymphadenectomy is indicated for patients with persistently high alpha-fetoprotein. Once recurred, treatment at that time is thought to be curative. However, postoperative chemotherapy may be necessary for patients with a tumor expressing histological factors that predict possible relapse. In this paper we report on a case of a 2 year old boy whose tumor invaded the testicular veins. The patient suffered from recurrent disease but was successfully treated by chemotherapeutic regimens including cisplatin and retroperitoneal lymphadenectomy. The importance of the histological factors in making a decision on the treatment strategy for stage I testicular yolk sac tumor is discussed.
睾丸I期卵黄囊瘤的治疗存在争议，尤其是对于那些具有提示高复发风险组织学因素的患者。通常单纯睾丸切除术就足够了，无需辅助化疗。对于甲胎蛋白持续升高的患者，建议行腹膜后淋巴结清扫术。一旦复发，当时的治疗被认为是可治愈的。然而，对于肿瘤表达提示可能复发组织学因素的患者，术后化疗可能是必要的。在本文中，我们报告了一例2岁男孩，其肿瘤侵犯了睾丸静脉。该患者患有复发性疾病，但通过包括顺铂和腹膜后淋巴结清扫术在内的化疗方案成功治愈。本文讨论了组织学因素在决定I期睾丸卵黄囊瘤治疗策略中的重要性。
