Background: Desmoid tumor is a rare benign soft tissue tumor which commonly affects the trunk and extremities. Case presentation: We report a patient who presented with a tumor that slowly grew at the left lower abdom...Background: Desmoid tumor is a rare benign soft tissue tumor which commonly affects the trunk and extremities. Case presentation: We report a patient who presented with a tumor that slowly grew at the left lower abdominal port site 1 year after post-chemotherapy laparoscopic retroperitoneal lymph node dissection (RPLND) for metastatic testicular tumor. The enlarging mass mimicking port site recurrence after laparoscopic retroperitoneal lymph node dissection for metastatic testicular tumor was diagnosed as a desmoid tumor. Conclusion: To our knowledge, this is the first report of a desmoid tumor that developed after laparoscopic RPLND for a testicular tumor.展开更多
Abstract: Gynecomastia is a benign enlargement of male breast tissue due to the proliferation of the ductal component. It can be physiological or pathological. Gynecomastia can be a sign for testicular tumors includin...Abstract: Gynecomastia is a benign enlargement of male breast tissue due to the proliferation of the ductal component. It can be physiological or pathological. Gynecomastia can be a sign for testicular tumors including sex-cord stromal tumors and germ cell tumors. Testicular physical examination in combination with testicular untrasonography and serum germ cell tumor markers when necessary in the presence of gynecomastia can help to reach a correct diagnosis.展开更多
BACKGROUND Testicular mixed germ cell tumors(TMGCTs)are rare malignant tumors that are more common in men aged 20–40 years.TMGCTs comprise two or more types of germ cell tumors that primarily affect the testis.Their ...BACKGROUND Testicular mixed germ cell tumors(TMGCTs)are rare malignant tumors that are more common in men aged 20–40 years.TMGCTs comprise two or more types of germ cell tumors that primarily affect the testis.Their onset is undetectable;thus,early diagnosis is challenging.However,early recognition and diagnosis substantially improve patient prognosis.CASE SUMMARY We evaluated a rare case of TMGCT in a male patient presenting with recurrent fever and left supraclavicular lymphadenectasis instead of testicular enlargement and pain,which may easily lead to misdiagnosis.We report the clinical signs and symptoms,histopathological characteristics,and immunohistochemical results of this case of malignant TMGCT.CONCLUSION Our case,which was typical with multiple components,along with a literature review,may serve as a basis for early diagnosis.展开更多
Introduction: Testicular cancer accounts for 5% of urological tumors, predominantly affecting young men. The aim of our study was to report the diagnostic and evolutionary aspects of testicular cancer cases treated in...Introduction: Testicular cancer accounts for 5% of urological tumors, predominantly affecting young men. The aim of our study was to report the diagnostic and evolutionary aspects of testicular cancer cases treated in our center. Patients and Methods: A retrospective study conducted over a 15-year period involving 12 patients treated for testicular cancer at the University Hospital of Brazzaville. Results: The median age was 31 years (range 11 to 49 years), with a median consultation delay of 10.6 months (range 3 to 27 months). Scrotal mass was the most common reason for consultation. Cancer was bilateral in two patients. Two patients were admitted with metastatic disease. Histopathological examination favored germ cell tumors in 7 cases, two cases of non-Hodgkin’s malignant lymphoma, and one case of epididymo-testicular adenocarcinoma. Adjuvant chemotherapy resulted in complete remission in patients with germ cell tumors. However, neoadjuvant chemotherapy was not effective in patients admitted with advanced-stage disease. Conclusion: Testicular cancer is a rare condition that is curable in the majority of cases, but its management is often complicated in our setting due to delayed diagnosis caused by taboos surrounding genital organ pathologies.展开更多
Background To systematically evaluate the incidence characteristics of testicular microlithiasis(TM)in children and its association with primary testicular tumors(PTT).Methods A systematic review and meta-analysis wer...Background To systematically evaluate the incidence characteristics of testicular microlithiasis(TM)in children and its association with primary testicular tumors(PTT).Methods A systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis(PRISMA)statement.A priori protocol was registered in the PROSPERO database(CRD42018111119),and a literature search of all relevant studies published until February 2019 was performed.Prospective,retrospective cohort,or cross-sectional studies containing ultrasonography(US)data on the incidence of TM or the association between TM and PTT were eligible for inclusion.Results Of the 102 identified articles,18 studies involving 58,195 children were included in the final analysis.The overall incidence of TM in children with additional risk factors for FTT was 2.1%.In children,the proportion of left TM in unilateral cases was 55.7%,the frequency of bilateral TM was 69.0%,and proportion of classic TM was 71.8%[95%confidence interval(Cl)62.4-81.1%,P=0.0,72=0.0%].About 93.5%of TM remained unchanged,and newly detected PTT rate was very low(4/296)during follow-up.The overall risk ratio of TM in children with a concurrent diagnosis of PTT was 15.46(95%Cl 6.93-34.47,P<0.00001).Conclusions The incidence of TM in children is highly variable.Nonetheless,TM is usually bilateral,of the classic type,and remains stable or unchanged at follow-up.Pediatric patients with TM and contributing factors for PTT have an increased risk for PTT;however,there is no evidence to support mandatory US surveillance of children with TM.展开更多
The molecular basis for enhanced chemosensitivity of testicular germ cell tumors （GCT） has been an area of great interest, as it could potentially give us therapeutic leads in other resistant malignancies. Thus far,...The molecular basis for enhanced chemosensitivity of testicular germ cell tumors （GCT） has been an area of great interest, as it could potentially give us therapeutic leads in other resistant malignancies. Thus far, however, the increased sensitivity of C＆T has been variously attributed to multiple factors -- an inability to detoxify cisplatin, a lack of export pumps, an inability to repair the DNA damage, an intact apoptotic cascade and lack of p53 mutation; but a unifying underlying etiology leading to the aforementioned processes and having a translational implication has so far been elusive. Herein, we offer evidence to support a potential significant role for the previously demonstrated low hypoxia inducible factor-la （HIF-la） expression in mediating the general exquisite chemosensitivity of testicular GCT, through the aforementioned processes. This molecular mechanism based hypothesis could have a significant translational implication in platinum refractory GCT as well as other platinum resistant malignancies.展开更多
For children with stage II testicular malignant germ cell tumors(MGCT), the survival is good with surgery and adjuvant chemotherapy. However, there is limited data on surgical results for cases in which there was no i...For children with stage II testicular malignant germ cell tumors(MGCT), the survival is good with surgery and adjuvant chemotherapy. However, there is limited data on surgical results for cases in which there was no imaging or pathologic evidence of residual tumor, but in which serum tumor markers either increased or failed to normalize after an appropriate period of half-life time post-surgery. To determine the use of chemotherapy for children with stage II germ cell tumors, we analyzed the outcomes(relapse rate and overall survival) of patients who were treated at the Sun Yat-sen University Cancer Center between January 1990 and May 2013. Twenty-four pediatric patients with a median age of 20 months(range, 4 months to 17 years) were enrolled in this study. In 20 cases(83.3%), the tumors had yolk sac histology. For definitive treatment, 21 patients underwent surgery alone, and 3 patients received surgery and adjuvant chemotherapy. No relapse was observed in the 3 patients who received adjuvant chemotherapy, whereas relapse occurred in 16 of the 21 patients(76.2%) treated with surgery alone. There were a total of 2 deaths. Treatment was stopped for 1 patient, who died 3 months later due to the tumor. The other patient achieved complete response after salvage treatment, but developed lung and pelvic metastases 7 months later and died of the tumor after stopping treatment. For children treated with surgery alone and surgery combined with adjuvant chemotherapy, the 3-year event-free survival rates were 23.8% and 100%, respectively(P = 0.042), and the 3-year overall survival rates were 90.5% and 100%, respectively(P = 0.588). These results suggest that adjuvant chemotherapy can help to reduce the recurrence rate and increase the survival rate for patients with stage II germ cell tumors.展开更多
Testicular cancer is rare. The authors report the case of a young Senegalese 21, who has consulted for an occlusive syndrome evolving for 48 hours that prompted his hospitalization. Note that the patient has consulted...Testicular cancer is rare. The authors report the case of a young Senegalese 21, who has consulted for an occlusive syndrome evolving for 48 hours that prompted his hospitalization. Note that the patient has consulted several times to persistent inguinal scrotal pain, a big right purse with chronic analgesic requirements and anti-inflammatory. Occlusive before this table, abdominal pelvic CT was performed and highlighted the presence of lung metastases, a large pelvic lymph node casting bridging the inter vesico-rectal space and responsible for extrinsic compression of the small intestine, lymph node inter casting aorto-cellar and latero aortic liver and multiple secondary locations. Faced with this bundle of arguments, clinical and laboratory, metastatic testicular tumor was raised and measured tumor markers. A right orchiectomy by inguinal was made with histology: A non-seminomatous germ cell tumor stage III. After orchiectomy germinal markers were still high and there was the problem of persistent occlusive syndrome despite resuscitation. A chemotherapy regimen was initiated with 4 cycles of chemotherapy according to the protocol BEP (bleomycin, etoposide, cisplatin). A significant regression of occlusive syndrome with a decline in clinical symptoms was noted. The revaluation at 3 months, 6 months and 1 year were highlighted: A normal clinical examination associated with a persistent correction rate of germline markers and lack of active lesion at thoraco-abdominopelvic CT.展开更多
Testicular metastasis is rare with the prostate being the most common site of primary cancer.We report a case of a 72-year-old man with castration-resistant prostate cancer(CRPC)and known metastases to bone and lymph ...Testicular metastasis is rare with the prostate being the most common site of primary cancer.We report a case of a 72-year-old man with castration-resistant prostate cancer(CRPC)and known metastases to bone and lymph nodes,who developed bilateral painful swollen testes 3 years after the initial diagnosis of prostate cancer.He had first presented with lower urinary tract symptoms(LUTS)with suspicious findings on digital rectal examination of the prostate,and an elevated serum prostate specific antigen(PSA)level of 129 ng/mL.Transrectal prostate biopsy revealed Gleason 4þ5 adenocarcinoma.Radiological staging showed locally advanced prostate cancer with extensive metastases to bone and pelvic and retroperitoneal lymph nodes.He was given hormonal therapy for over 2 years until progression to CRPC.Six months later he developed painful bilateral testicular swellings,and serum markers for testicular germ cell cancer were normal.Bilateral orchiectomy was performed,showing metastatic prostate cancer(Gleason 4þ5)on histology.One month postoperatively his PSA level dropped to 0.1 ng/mL from a presurgery level of 6.24 ng/mL.展开更多
Objective:This study was performed to evaluate the clinical and perioperative outcomes of laparoscopic retroperitoneal lymph node dissection(L-RPLND)and open retroperitoneal lymph node dissection(O-RPLND)performed by ...Objective:This study was performed to evaluate the clinical and perioperative outcomes of laparoscopic retroperitoneal lymph node dissection(L-RPLND)and open retroperitoneal lymph node dissection(O-RPLND)performed by one surgeon at a single center.Methods:We evaluated 30 patients with stage IIA germ cell tumors who underwent retroperitoneal lymph node dissection(15 underwent L-RPLND and 15 underwent O-RPLND)at our institution between April 1,2010 and March 31,2018.The clinical parameters were compared between patients who underwent L-RPLND using the retroperitoneal approach and those who underwent O-RPLND using the transperitoneal approach.There were no significant differences in the background characteristics of the two groups except for the median follow-up duration(46 months for L-RPLND and 71 months for O-RPLND,p=0.02).Results:L-RPLND was associated with a shorter mean operative time(mean 222 min for L-RPLND vs.453 min for O-RPLND,p<0.001).There was significantly less blood loss during surgery in the L-RPLND group compared to the O-RPLND group(mean 165 mL for L-RPLND vs.403 mL for O-RPLND,p<0.001).Parameters related to postoperative recovery were significantly better for the L-RPLND group than for the O-RPLND group.There were no differences in the histopathological characteristics between the two groups.No patients in either group exhibited disease recurrence.Conclusion:Patients who underwent L-RPLND had more rapid recovery,and shorter hospital stay compared to those who underwent O-RPLND;complications were comparable between the two groups.L-RPLND is an efficient procedure with the benefits of minimally invasive surgery.展开更多
Primary germ cell tumors of lung are extremely rare. The prognosis is usually poor, with various symptoms seriously affecting quality of life. In this paper we describe the unique case of a patient affected by an embr...Primary germ cell tumors of lung are extremely rare. The prognosis is usually poor, with various symptoms seriously affecting quality of life. In this paper we describe the unique case of a patient affected by an embryonal carcinoma of lung and a testicular seminoma after ten years. We also report literature about pulmonary extragonadal germ cell tumors.展开更多
文摘Background: Desmoid tumor is a rare benign soft tissue tumor which commonly affects the trunk and extremities. Case presentation: We report a patient who presented with a tumor that slowly grew at the left lower abdominal port site 1 year after post-chemotherapy laparoscopic retroperitoneal lymph node dissection (RPLND) for metastatic testicular tumor. The enlarging mass mimicking port site recurrence after laparoscopic retroperitoneal lymph node dissection for metastatic testicular tumor was diagnosed as a desmoid tumor. Conclusion: To our knowledge, this is the first report of a desmoid tumor that developed after laparoscopic RPLND for a testicular tumor.
文摘Abstract: Gynecomastia is a benign enlargement of male breast tissue due to the proliferation of the ductal component. It can be physiological or pathological. Gynecomastia can be a sign for testicular tumors including sex-cord stromal tumors and germ cell tumors. Testicular physical examination in combination with testicular untrasonography and serum germ cell tumor markers when necessary in the presence of gynecomastia can help to reach a correct diagnosis.
文摘BACKGROUND Testicular mixed germ cell tumors(TMGCTs)are rare malignant tumors that are more common in men aged 20–40 years.TMGCTs comprise two or more types of germ cell tumors that primarily affect the testis.Their onset is undetectable;thus,early diagnosis is challenging.However,early recognition and diagnosis substantially improve patient prognosis.CASE SUMMARY We evaluated a rare case of TMGCT in a male patient presenting with recurrent fever and left supraclavicular lymphadenectasis instead of testicular enlargement and pain,which may easily lead to misdiagnosis.We report the clinical signs and symptoms,histopathological characteristics,and immunohistochemical results of this case of malignant TMGCT.CONCLUSION Our case,which was typical with multiple components,along with a literature review,may serve as a basis for early diagnosis.
文摘Introduction: Testicular cancer accounts for 5% of urological tumors, predominantly affecting young men. The aim of our study was to report the diagnostic and evolutionary aspects of testicular cancer cases treated in our center. Patients and Methods: A retrospective study conducted over a 15-year period involving 12 patients treated for testicular cancer at the University Hospital of Brazzaville. Results: The median age was 31 years (range 11 to 49 years), with a median consultation delay of 10.6 months (range 3 to 27 months). Scrotal mass was the most common reason for consultation. Cancer was bilateral in two patients. Two patients were admitted with metastatic disease. Histopathological examination favored germ cell tumors in 7 cases, two cases of non-Hodgkin’s malignant lymphoma, and one case of epididymo-testicular adenocarcinoma. Adjuvant chemotherapy resulted in complete remission in patients with germ cell tumors. However, neoadjuvant chemotherapy was not effective in patients admitted with advanced-stage disease. Conclusion: Testicular cancer is a rare condition that is curable in the majority of cases, but its management is often complicated in our setting due to delayed diagnosis caused by taboos surrounding genital organ pathologies.
基金This study was supported by the National Natural Science Foundation of China(Protocol no.81873828).
文摘Background To systematically evaluate the incidence characteristics of testicular microlithiasis(TM)in children and its association with primary testicular tumors(PTT).Methods A systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis(PRISMA)statement.A priori protocol was registered in the PROSPERO database(CRD42018111119),and a literature search of all relevant studies published until February 2019 was performed.Prospective,retrospective cohort,or cross-sectional studies containing ultrasonography(US)data on the incidence of TM or the association between TM and PTT were eligible for inclusion.Results Of the 102 identified articles,18 studies involving 58,195 children were included in the final analysis.The overall incidence of TM in children with additional risk factors for FTT was 2.1%.In children,the proportion of left TM in unilateral cases was 55.7%,the frequency of bilateral TM was 69.0%,and proportion of classic TM was 71.8%[95%confidence interval(Cl)62.4-81.1%,P=0.0,72=0.0%].About 93.5%of TM remained unchanged,and newly detected PTT rate was very low(4/296)during follow-up.The overall risk ratio of TM in children with a concurrent diagnosis of PTT was 15.46(95%Cl 6.93-34.47,P<0.00001).Conclusions The incidence of TM in children is highly variable.Nonetheless,TM is usually bilateral,of the classic type,and remains stable or unchanged at follow-up.Pediatric patients with TM and contributing factors for PTT have an increased risk for PTT;however,there is no evidence to support mandatory US surveillance of children with TM.
文摘The molecular basis for enhanced chemosensitivity of testicular germ cell tumors （GCT） has been an area of great interest, as it could potentially give us therapeutic leads in other resistant malignancies. Thus far, however, the increased sensitivity of C＆T has been variously attributed to multiple factors -- an inability to detoxify cisplatin, a lack of export pumps, an inability to repair the DNA damage, an intact apoptotic cascade and lack of p53 mutation; but a unifying underlying etiology leading to the aforementioned processes and having a translational implication has so far been elusive. Herein, we offer evidence to support a potential significant role for the previously demonstrated low hypoxia inducible factor-la （HIF-la） expression in mediating the general exquisite chemosensitivity of testicular GCT, through the aforementioned processes. This molecular mechanism based hypothesis could have a significant translational implication in platinum refractory GCT as well as other platinum resistant malignancies.
文摘For children with stage II testicular malignant germ cell tumors(MGCT), the survival is good with surgery and adjuvant chemotherapy. However, there is limited data on surgical results for cases in which there was no imaging or pathologic evidence of residual tumor, but in which serum tumor markers either increased or failed to normalize after an appropriate period of half-life time post-surgery. To determine the use of chemotherapy for children with stage II germ cell tumors, we analyzed the outcomes(relapse rate and overall survival) of patients who were treated at the Sun Yat-sen University Cancer Center between January 1990 and May 2013. Twenty-four pediatric patients with a median age of 20 months(range, 4 months to 17 years) were enrolled in this study. In 20 cases(83.3%), the tumors had yolk sac histology. For definitive treatment, 21 patients underwent surgery alone, and 3 patients received surgery and adjuvant chemotherapy. No relapse was observed in the 3 patients who received adjuvant chemotherapy, whereas relapse occurred in 16 of the 21 patients(76.2%) treated with surgery alone. There were a total of 2 deaths. Treatment was stopped for 1 patient, who died 3 months later due to the tumor. The other patient achieved complete response after salvage treatment, but developed lung and pelvic metastases 7 months later and died of the tumor after stopping treatment. For children treated with surgery alone and surgery combined with adjuvant chemotherapy, the 3-year event-free survival rates were 23.8% and 100%, respectively(P = 0.042), and the 3-year overall survival rates were 90.5% and 100%, respectively(P = 0.588). These results suggest that adjuvant chemotherapy can help to reduce the recurrence rate and increase the survival rate for patients with stage II germ cell tumors.
文摘Testicular cancer is rare. The authors report the case of a young Senegalese 21, who has consulted for an occlusive syndrome evolving for 48 hours that prompted his hospitalization. Note that the patient has consulted several times to persistent inguinal scrotal pain, a big right purse with chronic analgesic requirements and anti-inflammatory. Occlusive before this table, abdominal pelvic CT was performed and highlighted the presence of lung metastases, a large pelvic lymph node casting bridging the inter vesico-rectal space and responsible for extrinsic compression of the small intestine, lymph node inter casting aorto-cellar and latero aortic liver and multiple secondary locations. Faced with this bundle of arguments, clinical and laboratory, metastatic testicular tumor was raised and measured tumor markers. A right orchiectomy by inguinal was made with histology: A non-seminomatous germ cell tumor stage III. After orchiectomy germinal markers were still high and there was the problem of persistent occlusive syndrome despite resuscitation. A chemotherapy regimen was initiated with 4 cycles of chemotherapy according to the protocol BEP (bleomycin, etoposide, cisplatin). A significant regression of occlusive syndrome with a decline in clinical symptoms was noted. The revaluation at 3 months, 6 months and 1 year were highlighted: A normal clinical examination associated with a persistent correction rate of germline markers and lack of active lesion at thoraco-abdominopelvic CT.
文摘Testicular metastasis is rare with the prostate being the most common site of primary cancer.We report a case of a 72-year-old man with castration-resistant prostate cancer(CRPC)and known metastases to bone and lymph nodes,who developed bilateral painful swollen testes 3 years after the initial diagnosis of prostate cancer.He had first presented with lower urinary tract symptoms(LUTS)with suspicious findings on digital rectal examination of the prostate,and an elevated serum prostate specific antigen(PSA)level of 129 ng/mL.Transrectal prostate biopsy revealed Gleason 4þ5 adenocarcinoma.Radiological staging showed locally advanced prostate cancer with extensive metastases to bone and pelvic and retroperitoneal lymph nodes.He was given hormonal therapy for over 2 years until progression to CRPC.Six months later he developed painful bilateral testicular swellings,and serum markers for testicular germ cell cancer were normal.Bilateral orchiectomy was performed,showing metastatic prostate cancer(Gleason 4þ5)on histology.One month postoperatively his PSA level dropped to 0.1 ng/mL from a presurgery level of 6.24 ng/mL.
文摘Objective:This study was performed to evaluate the clinical and perioperative outcomes of laparoscopic retroperitoneal lymph node dissection(L-RPLND)and open retroperitoneal lymph node dissection(O-RPLND)performed by one surgeon at a single center.Methods:We evaluated 30 patients with stage IIA germ cell tumors who underwent retroperitoneal lymph node dissection(15 underwent L-RPLND and 15 underwent O-RPLND)at our institution between April 1,2010 and March 31,2018.The clinical parameters were compared between patients who underwent L-RPLND using the retroperitoneal approach and those who underwent O-RPLND using the transperitoneal approach.There were no significant differences in the background characteristics of the two groups except for the median follow-up duration(46 months for L-RPLND and 71 months for O-RPLND,p=0.02).Results:L-RPLND was associated with a shorter mean operative time(mean 222 min for L-RPLND vs.453 min for O-RPLND,p<0.001).There was significantly less blood loss during surgery in the L-RPLND group compared to the O-RPLND group(mean 165 mL for L-RPLND vs.403 mL for O-RPLND,p<0.001).Parameters related to postoperative recovery were significantly better for the L-RPLND group than for the O-RPLND group.There were no differences in the histopathological characteristics between the two groups.No patients in either group exhibited disease recurrence.Conclusion:Patients who underwent L-RPLND had more rapid recovery,and shorter hospital stay compared to those who underwent O-RPLND;complications were comparable between the two groups.L-RPLND is an efficient procedure with the benefits of minimally invasive surgery.
文摘Primary germ cell tumors of lung are extremely rare. The prognosis is usually poor, with various symptoms seriously affecting quality of life. In this paper we describe the unique case of a patient affected by an embryonal carcinoma of lung and a testicular seminoma after ten years. We also report literature about pulmonary extragonadal germ cell tumors.
