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1/66. Late recurrence with malignant degeneration of testicular teratoma. Case report.

    Radical orchiectomy was performed on a 25-year-old man for benign mature teratoma. A synchronous without change 3 cm retroperitoneal mass was followed for five years. The mass enlarged and became symptomatic twelve years after orchiectomy. Excision of the mass revealed a non-seminomatous germ cell tumor. Possible explanation is malignant degeneration of the teratomatous elements. Testicular teratomas should be treated as potentially malignant non-seminomatous tumor.
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ranking = 1
keywords = seminoma
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2/66. 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.
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ranking = 0.5
keywords = seminoma
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3/66. The seminoma decoy: measurement of serum human chorionic gonadotropin in patients with seminoma.

    serum human chorionic gonadotropin levels were determined in 20 patients with histologically proved seminoma. The test was positive in 2 of the 20 patients and was predictive of non-seminomatous metastasis in each case. serum human chorionic gonadotropin is a useful tumor marker in detecting and following non-seminomatous metastases in men with pure seminoma of the testis.
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ranking = 6
keywords = seminoma
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4/66. Synchronous appearance of germ cell tumor and papillary carcinoma of the thyroid.

    Synchronous appearance of 2 different malignancies in one patient is a rare phenomenon. We describe our experience of 2 patients with synchronous malignancies of the testis and thyroid gland, and of a third patient who developed a thyroid neoplasm unrelated to recent treatment for a germ cell tumor. The medical records of 3 male patients treated for both a germ cell tumor and a thyroid cancer between 1989 and 1994 were reviewed. Two patients with nonseminomatous germ cell tumor received postoperative chemotherapy after orchiectomy and developed a papillary carcinoma of the thyroid during treatment. A third patient, who received radiation therapy for a clinical stage 1 seminoma, recurred with biopsy proven seminoma in the neck in association with a thyroid nodule 2 years later. All 3 patients had their thyroid cancer treated by surgical resection, and one received adjuvant radioactive iodine. Two of the patients are currently alive and disease-free. One patient died of pulmonary complications that stemmed from bleomycin toxicity. Synchronous appearance of germ cell tumor and papillary carcinoma of the thyroid has not been previously described. Genetic predisposition may play a role in the development of such simultaneous neoplasms.
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ranking = 1.5
keywords = seminoma
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5/66. A case of bilateral seminoma in the setting of persistent mullerian duct syndrome.

    We are reporting on the case of a 46XY male patient that presented a bilateral testicular seminoma in the setting of bilateral cryptorchidia and left inguinal hernia. The patient received five courses of cisplatin/ciclophosphamide followed by 3,000 cGy of radiation. The patient then, underwent resection of the residual mass and of an unrecognizable pelvic structure. The histopathological analysis revealed necrosis of the residual seminoma and an atrophic uterus. Currently, the patient is alive and asymptomatic at 88 months of follow-up. This is the third case reported of a patient with persistent mullerian duct syndrome and bilateral seminoma.
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ranking = 3.5
keywords = seminoma
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6/66. Synchronous occurrence of bladder carcinosarcoma and testicular seminoma.

    We report a case of urinary bladder carcinosarcoma with simultaneous testicular seminoma. A 60-year-old male presented with painless gross hematuria and a left testicular mass. The bladder tumor was deeply infiltrating muscular tissue and had histologic features of both carcinoma and sarcoma. Testicular tumor was diagnosed as classical seminoma. Radical cystectomy, pelvic and left-modified retroperitoneal lymphadenectomy were performed. The lymph nodes did not show metastasis. At the 26 months follow-up, the patient is free of disease.
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ranking = 3
keywords = seminoma
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7/66. 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.
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keywords = seminoma
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8/66. Testicular germ cell tumor with rhabdomyosarcoma successfully treated by disease-adapted chemotherapy including high-dose chemotherapy: case report and review of the literature.

    Treatment and prognosis have not been well characterized in germ cell tumors (GCT) with a malignant nongerm cell component. patients with a mediastinal tumor, neural or rhabdomyosarcomatous differentiation and distant metastases have the poorest prognosis. We report a rare case of mixed GCT composed of seminoma, teratoma and rhabdomyosarcoma with the rhabdomyosarcomatous component metastasized into the liver and bone marrow (BM) causing hypercalcemia. The patient was treated with differentiation-tailored chemotherapy (CHT) including a disease-adapted high-dose (HD) CHT regimen with purified autologous PBSCT (APBSCT) and pamidronate. To date, remission has lasted for 4 years. Tumor-adapted CHT including HD-CHT with APBSCT can induce long term remissions in high-risk patients with transformed GCT. A review of the literature is given.
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keywords = seminoma
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9/66. Primary prostatic endodermal sinus tumor (yolk sac tumor) combined with a small focal seminoma.

    We report on a primary endodermal sinus tumor (EST) (yolk sac tumor) combined with a focal seminoma of the prostate occurring in a 24-year-old man. The prostate was widely infiltrated with neoplasms that penetrated the capsule and invaded into the bladder wall and urethra. Most areas of the tumor were composed of papillary and glandular epithelium in the fibrous or myxoid stroma. Schiller-Duval bodies and periodic acid-Schiff-positive hyaline bodies were focally present. In addition to yolk sac tumor, solid nests of seminoma were found in some areas. immunohistochemistry using specific antibodies for alpha-fetoprotein and cytokeratin showed positive reaction on the EST portion, and placental alkaline phosphatase revealed positive staining in the seminoma portion and a part of EST. Tumor cells exhibited negative staining for prostate-specific antigen, prostatic acid phosphatase, carcinoembryonic antigen, vimentin, chromogranin a, and human chorionic gonadotropin. Despite radical surgery and ordinary cisplatin-based chemotherapy, the patient died 8 months after operation. At autopsy, only EST elements had metastasized to the lungs, liver, and brain, and no tumors were found in either testis. To our knowledge, this is the first reported case of a primary EST combined with a focal seminoma in the prostate.
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ranking = 4
keywords = seminoma
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10/66. Bilateral seminomas in a 45X/46XY mosaic with Turner's phenotype: an unusual case of mixed gonadal dysgenesis.

    A wide spectrum of phenotypic manifestations are seen in cases with 45X/46XY mosaicism. We present a case with 45X/46XY having female phenotype with Turner's stigmata. Prophylactic laparoscopic gonadectomy was performed and the patient was found to have mixed gonadal dysgenesis with bilateral gonadoblastomas. Microinvasive seminomas were also detected in both gonadoblastomas. The presence of Y cell line in karyotype prompted early and prophylactic gonadectomy, a procedure which is life-saving for these individuals.
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ranking = 2.5
keywords = seminoma
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