Kayada K, Yamaguchi O, Irisawa C, Muraki O
Department of Urology, Fukushima Medical College.
Hinyokika Kiyo. 1996 Aug;42(8):613-6.
Multiple tumors of mediastinum, retroperitoneum and lung were detected in a 40-year-old man presented with lumbago and lower abdominal pain. As biopsy specimen taken from the cervical lymph node suggested germ-cell tumor and his testes were normally palpable, the initial diagnosis was an extragonadal germ-cell tumor. However, since ultrasonography of his left testis showed a small high echoic lesion (5 mm) assumed to be a burned-out tumor, orchiectomy was performed. Histological findings confirmed scar tissue as burned-out tumor and also revealed some malignant cells lining the seminiferous tubules that were thought to be the carcinoma-in-situ of the testis. After chemotherapy of etoposide and cisplatinum he achieved a partial response which has been maintained for 7 months. Examinations for burned-out tumor or carcinoma-in-situ of the testis should be made for the patients with an extragonadal germ cell tumor who have normally palpable testes.
一名40岁男性因腰痛和下腹部疼痛就诊,检查发现其纵隔、腹膜后和肺部有多个肿瘤。由于取自颈部淋巴结的活检标本提示为生殖细胞肿瘤,且其睾丸触诊正常,初步诊断为性腺外生殖细胞肿瘤。然而,因其左侧睾丸超声检查显示一个小的高回声病变(5毫米),推测为消退型肿瘤,遂行睾丸切除术。组织学检查结果证实瘢痕组织为消退型肿瘤,同时还发现一些衬于生精小管的恶性细胞,考虑为睾丸原位癌。接受依托泊苷和顺铂化疗后,他获得了部分缓解,且已维持7个月。对于睾丸触诊正常的性腺外生殖细胞肿瘤患者,应进行消退型肿瘤或睾丸原位癌的检查。