A Case of Metachronous Testicular Tumor Developing Twenty Years after Treatment of Retroperitoneal Extragonadal Germ Cell Tumor

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  • Tobiume Motoi
    The Department of Urology, Japan Organization of Occupational Health and Safety Asahi Rosai Hospital
  • Yamada Yoshiaki
    The Department of Urology, Japan Community Health care Organization Kani Tono Hospital
  • Aoki Shigeyuki
    The Department of Urology, Japan Community Health care Organization Kani Tono Hospital
  • Hara Koji
    The Department of Urology, Japan Community Health care Organization Kani Tono Hospital
  • Muramatsu Hiroyuki
    The Department of Urology, Aichi Medical University School of Medicine
  • Nishikawa Genya
    The Department of Urology, Aichi Medical University School of Medicine
  • Ono Kenzo
    The Department of Pathology, Japan Organization of Occupational Health and Safety Asahi Rosai Hospital
  • Takayanagi Yuta
    The Division of Nursing, Shiroyama Rehabilitation Hospital
  • Nakamura Kogenta
    The Department of Urology, Aichi Medical University School of Medicine

Bibliographic Information

Other Title
  • 後腹膜原発性腺外胚細胞腫治療20年後に異時性精巣腫瘍の発生を認めた1例
  • アトバラマク ゲンパツセイセン ガイハイサイボウ シュ チリョウ 20ネンゴ ニ イジセイセイソウ シュヨウ ノ ハッセイ オ ミトメタ 1レイ

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Abstract

A 49-year-old male visited our department of gastroenterology with chief complaints of blackish feces and ill complexion in February 1997. Computed tomography (CT) revealed a right retroperitoneal tumor, which was removed the same month. Histopathological examination showed teratoma and yolk sac tumor. He was diagnosed with primary retroperitoneal extragonadal germ cell tumor, and received three cycles of chemotherapy (bleomycin/etoposide/cisplatin ; BEP) starting in March 1997. Periodic imaging and determination of tumor markers (α fetoprotein, human chorionic gonadotropin, and lactate dehydrogenase) showed no recurrence or metastasis for five years after treatment. After his visit in April 2002 he stopped visiting our outpatient ward. In November 2017, the patient visited our department with chief complaints of indolent right scrotum enlargement and a right inguinal mass. Past history showed that he had undergone hydrocele of the right testicle in August 1999. Contrast enhanced CT showed a 35-mm contrast effect with uneven contents in the right testis, and enlarged nodes that were suspicious of metastases in the right inguinal and right external iliac lymph nodes. All tumor markers were within the normal ranges. He underwent right high orchiectomy and resection of the right inguinal lymph nodes in the same month. Histopathological findings revealed seminoma (pT1, pN2, M0, S0, and clinical Stage IIA). He received postoperative chemotherapy starting in January 2018 ; one cycle of BEP therapy and three cycles of etoposide and cisplatin (EP) therapy. Post-chemotherapeutic CT confirmed clinical complete response at the right external iliac lymph nodes, and this response was confirmed 12 months later. Neither recurrence nor metastasis has occurred so far.

Journal

  • 泌尿器科紀要

    泌尿器科紀要 66 (6), 171-176, 2020-06-30

    泌尿器科紀要刊行会

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