1/80. Surgical management of chylous fistula after retroperitoneal lymph node dissection. Conservative treatment with low-fat diet, medium-chain triglyceride or total parenteral nutrition, depending on the general condition of the patient, is the mainstay in the treatment of chylous ascites. In patients with persistent chylous fistula direct surgical closure is a valid treatment option. ( info) |
2/80. The role of chemotherapy in intracranial germinoma: a case report. BACKGROUND: The case of a 29-year-old man with histologically proven simultaneous germinoma (seminoma) of the pineal gland and a stage I embryonal carcinoma of the testis is reported. An intradural metastatic lesion from the pineal germinoma was diagnosed at the level of the first thoracic vertebra. Treatment, after inguinal orchiectomy, was chemotherapy only, rather than conventional radiotherapy for the pineal germinoma. methods: Therapy consisted of bleomycin (B), etoposide (E) and cisplatin (P). MRI was used to assess the effectiveness of BEP chemotherapy. RESULTS: A complete remission of the pineal gland germinoma and the epidural metastasis was documented after two cycles of BEP chemotherapy and after 15 months of follow-up the patient remains free of relapse. DISCUSSION: The pathogenesis of simultaneously occurring germinoma of the pineal gland and embryonal cell carcinoma of the testis is discussed. The choice of therapy in these circumstances is a matter of debate and the good result of chemotherapy alone in this patient suggest that primary chemotherapy may be the therapy of choice in patients with pineal germinomas. ( info) |
3/80. Early cystic relapse of embryonal carcinoma of testis in obturator fossa. OBJECTIVE: We report a case of embryonal carcinoma stage IIB arising from the right testis that subsequently underwent chemotherapy and retroperitoneal lymph node dissection and presented with an early cystic recurrence in the obturator fossa. methods: This case is reanalyzed retrospectively and literature is reevaluated for the early recurrences of testicular tumors at atypical locations. We discuss the rarity of obturator fossa as a location for early recurrences of testis tumors. RESULTS: Only one case of recurrence in obturator fossa has been reported. CONCLUSIONS: This case provides an example of the possibility of recurrence in an unpredictable short interval subsequent to proper therapies and underscores the importance of close follow-up. ( info) |
4/80. Hepatoid variant of yolk sac tumor of the testis. A case of testicular yolk sac tumor (endodermal sinus tumor) consisting predominantly of hepatoid cells is documented. A mass measuring approximately 4 x 3 cm was noted in the left testis of a 64-year-old man. Preoperative examination revealed an elevated serum level of alpha-fetoprotein (5479 ng/mL). Histologically, the lesion was composed predominantly of sheet-like or trabecular proliferation of hepatocyte-like cells with eosinophilic or clear cytoplasm. The tumor cells were immunoreactive for alpha-fetoprotein, antimitochondrial antibody, cytokeratin (AE1/AE3), alpha-1-antichymotrypsin, alpha-1-antitrypsin, albumin, carcinoembryonic antigen and epithelial membrane antigen. It was necessary to distinguish this variant lesion from metastatic hepatocellular carcinoma, embryonal carcinoma and hepatoid carcinoma. ( info) |
5/80. Peritoneal carcinomatosis in germ-cell tumor: relations with retroperitoneal lymph node dissection. Peritoneal carcinomatosis from germ-cell tumor has rarely been described, and thus remains largely unknown. We report here five cases involving this entity. All five patients had embryonal carcinoma in their primary germ-cell tumor. Four of them had undergone retroperitoneal lymph node dissection (RPLND), and viable malignant cells were found. RPLND was performed for relapses (n = 3) and as primary therapy for stage II disease (n = 1). The peritoneum was the only site of relapse in three patients, and was associated with pleural effusion in one. The time to relapse after RPLND ranged from 6 to 14 months. One patient sustained injury to lymph nodes during RPLND, and another patient had a peritoneal xanthelasma. The only three patients already described in the literature underwent RPLND or surgical biopsy. All these observations suggest a striking relation between RPLND and occurrence of subsequent peritoneal carcinomatosis. ( info) |
6/80. Intestinal testis tumor metastasis as a cause of intussusception: a case report. We report on an extraordinary testicular tumour causing intussusception with its intestinal metastases. ( info) |
7/80. Early myocardial infarction during chemotherapy for testicular cancer. A 36-year-old man with testicular cancer had an acute myocardial infarction during the first course of chemotherapy with bleomycin, etoposide and cisplatin. Since the patient had no significant risk factors for coronary heart disease, the infarction was likely to be attributable to the chemotherapy regimen. The physiopathological mechanisms of this causal relationship are discussed here. ( info) |
8/80. Testicular tumor metastatic to the nose. A case report. In this paper we present an uncommon tumor found in the nasal cavity, the result of a metastasis from primary tumor of testis (embryonal carcinoma) in a young patient of 24 years of age. For this uncommon tumor we discuss the case with the Greek and foreign bibliography. ( info) |
9/80. Testicular embryonal carcinoma metastatic to the labial mucosa of the upper lip. An unusual case of testicular embryonal carcinoma metastatic to the labial mucosa of the upper lip is reported. The clinical features and the management of the metastatic oral lesion are presented. In patients with known systemic malignancy, oral swellings may be an indication of a metastatic deposit. ( info) |
10/80. Multidisciplinary treatment of advanced testicular tumor with bulky liver metastasis. A 21-year-old man with far-advanced nonseminomatous germ cell tumor of the left testis is presented. He had multiple bulky metastases in the liver and retroperitoneum with an extraordinarily elevated serum alpha-fetoprotein (23,500 ng/ml). He received multidisciplinary treatment consisting of systemic chemotherapy, cytoreductive left hepatic lobectomy, percutaneous ablation therapy, transarterial chemoembolization, and external beam irradiation for median segments of the liver. The efficient combination treatment normalized the tumor markers within 6 months and has maintained complete serological remission for 4.7 years. ( info) |