Kageyama S, Ueda T, Yamauchi T, Tsuzuki M, Yonese J, Kawai T, Ida T
Department of Urology, Atami National Hospital.
Hinyokika Kiyo. 1994 Nov;40(11):1021-5.
We present a case report of a relapse to the mediastinal lymph node alone, 38 months after orchiectomy on surveillance for stage I typical seminoma. The patient, a 63-year-old man, was treated with high inguinal orchiectomy for left testicular tumor and close follow-up. After 38 months from the initial treatment, the chest X-ray film and CT scan revealed mediastinal tumor. Fine needle aspiration cytology performed under the bronchoscopy showed seminoma cells. Complete remission was achieved after three courses chemotherapy of cisplatin, vincristine, methotrexate, peplomycin and etoposide (COMPE). He has continued to be clinically disease-free 8 months after completion of the treatment. According to the available data in the literature, 94% of the recurrences was detected within 3 years after orchiectomy, and 92% involved retroperitoneal lymph node metastases. This is a rare case who had a late relapse in the mediastinum alone.
我们报告一例病例，患者为I期典型精原细胞瘤，接受睾丸切除术后进行监测，38个月后仅纵隔淋巴结复发。患者为一名63岁男性，因左侧睾丸肿瘤接受高位腹股沟睾丸切除术并密切随访。初始治疗38个月后，胸部X光片和CT扫描显示纵隔肿瘤。支气管镜下细针穿刺细胞学检查显示为精原细胞瘤细胞。采用顺铂、长春新碱、甲氨蝶呤、培普利霉素和依托泊苷（COMPE）进行三个疗程化疗后实现完全缓解。治疗完成8个月后，他临床上仍无疾病复发。根据文献中的现有数据，94%的复发在睾丸切除术后3年内被检测到，92%涉及腹膜后淋巴结转移。这是一例罕见的仅纵隔晚期复发的病例。
