Choyke P L, Hayes W S, Sesterhenn I A
Department of Diagnostic Radiology, National Institutes of Health, Bethesda, MD 20892.
Radiographics. 1993 Nov;13(6):1365-75; quiz 1377-8. doi: 10.1148/radiographics.13.6.8290730.
Primary extragonadal germ cell tumors (EGCTs) of the retroperitoneum are rarely encountered. In most cases, they arise from remnants of the genital ridge, whereas the majority of retroperitoneal germ cell tumors are metastases from primary testicular tumors. Differentiating between these primary and secondary tumors can be difficult because gonadal germ cell tumors can regress or develop slowly. Careful examination of the testes with ultrasound (US) is crucial for this determination, but asynchronous or metachronous lesions in both the testes and retroperitoneum can occur. Symptoms are often nonspecific, and diagnosis is frequently delayed. Serum markers such as beta-human chorionic gonadotropin and alpha-fetoprotein are often helpful in the diagnosis and follow-up of these tumors. Imaging techniques such as US and computed tomography play a major role in the localization and differentiation of primary and secondary retroperitoneal EGCTs. Treatment of EGCTs usually requires a combination of surgery, irradiation, and chemotherapy.
原发性腹膜后性腺外生殖细胞肿瘤（EGCTs）很少见。在大多数情况下，它们起源于生殖嵴的残余组织，而大多数腹膜后生殖细胞肿瘤是原发性睾丸肿瘤的转移灶。区分这些原发性和继发性肿瘤可能很困难，因为性腺生殖细胞肿瘤可能会消退或发展缓慢。用超声（US）仔细检查睾丸对于做出这一判断至关重要，但睾丸和腹膜后可能会出现不同步或异时性病变。症状通常不具特异性，诊断常常延迟。血清标志物如β-人绒毛膜促性腺激素和甲胎蛋白通常有助于这些肿瘤的诊断和随访。超声和计算机断层扫描等成像技术在原发性和继发性腹膜后EGCTs的定位和鉴别中起主要作用。EGCTs的治疗通常需要手术、放疗和化疗相结合。
