Embil J M, Weinerman B H, Pascoe E A
Department of Medicine, University of Manitoba, Winnipeg.
Can J Surg. 1994 Apr;37(2):165-7.
Late recurrence of nonseminomatous germ cell tumours of the testis is rare. The authors report on a 35-year-old man treated initially for embryonal cell carcinoma of the testis with metastases, who presented 12 years later with an increasing serum alpha-fetoprotein level and a biopsy-proven embryonal cell cancer in the hilus of the left lung. Because the tumour was highly resistant to two separate courses of cis-platinum-based chemotherapy and one course of radiotherapy, surgical resection for salvage was carried out. The patient was free of disease 3.5 years after the second operation. The possible reasons for the occurrence of this highly resistant metastatic testicular cancer are discussed. They include a second primary tumour and malignant degeneration of the original tumour. In this patient the latter cause was the most plausible.
睾丸非精原细胞性生殖细胞肿瘤的晚期复发很少见。作者报告了一名35岁男性，最初因睾丸胚胎性细胞癌伴转移接受治疗，12年后出现血清甲胎蛋白水平升高，经活检证实左肺门有胚胎性细胞癌。由于肿瘤对两疗程顺铂为主的化疗和一疗程放疗高度耐药，遂进行挽救性手术切除。第二次手术后3.5年患者无疾病。讨论了这种高度耐药转移性睾丸癌发生的可能原因。包括第二原发性肿瘤和原发肿瘤的恶性变。在该患者中，后一种原因最有可能。
