Masui M, Minakami H, Yuki T, Kotake T, Ito H, Nagao K
Department of Urology, Teikyo University School of Medicine.
Hinyokika Kiyo. 1993 Jun;39(6):581-5.
A case of testicular tumor occurring after orchiopexy is presented. The patient, a 21-year-old male, who had undergone bilateral orchiopexy 14 years before was admitted to our clinic on February 17 in 1992 because of left testicular tumor. Computed tomography showed left inguinal and paraaortic lymphnode metastases. Left high orchiectomy was performed. The tumor was histologically diagnosed to be mixed tumors of embryonal carcinoma, yolk sac tumor and choriocarcinoma. After two courses of chemotherapy consisting of cisplatin, etoposide and bleomycin (PEB regimen), LDH and tumor markers (HCG, HCG-beta) returned to the normal range. The size of retroperitoneal metastasis was significantly reduced and inguinal metastasis disappeared. Therefore retroperitoneal and left inguinal lymphadenectomy were performed. Pathological examination of the resected retroperitoneal and left inguinal lymphnodes revealed embryonal carcinoma and no residual tumor cells, respectively. Additionally, two courses of chemotherapy were performed after surgery. His postoperative course was uneventful and ten months of follow-up showed no evidence of recurrence.
本文报告一例睾丸固定术后发生睾丸肿瘤的病例。患者为21岁男性,14年前接受过双侧睾丸固定术,因左侧睾丸肿瘤于1992年2月17日入住我院。计算机断层扫描显示左侧腹股沟和腹主动脉旁淋巴结转移。行左侧高位睾丸切除术。肿瘤组织学诊断为胚胎癌、卵黄囊瘤和绒毛膜癌混合瘤。采用顺铂、依托泊苷和博来霉素组成的化疗方案(PEB方案)进行两个疗程化疗后,乳酸脱氢酶(LDH)和肿瘤标志物(人绒毛膜促性腺激素,β-人绒毛膜促性腺激素)恢复至正常范围。腹膜后转移灶大小显著缩小,腹股沟转移灶消失。因此,行腹膜后和左侧腹股沟淋巴结清扫术。切除的腹膜后和左侧腹股沟淋巴结病理检查分别显示为胚胎癌且无残留肿瘤细胞。此外,术后又进行了两个疗程的化疗。他术后恢复顺利,随访10个月无复发迹象。