[A case of teratoma of the testis with retroperitoneal lymph nodes involved with malignant teratoma after chemotherapy].
This report describes a case of teratoma with retroperitoneal lymph nodes involved with malignant teratoma (enteric adenocarcinoma) after extensive chemotherapy for the original testicular cancer. A 18-year-old man with a mixed cell tumor (embryonal carcinoma+teratoma+yolk sac tumor) received three courses of VAB-6 chemotherapy for bulky mass following inguinal orchiectomy. He was referred to Tochigi Cancer Center for treatment of a residual mass. He was treated with resection of the mass combined with left nephrectomy due to severe adhesion and pathological diagnosis of the resected lymph node was mature teratoma with a massive necrotic tissue. Two courses of BEP chemotherapy were given to the patient following the surgery. Six months after completion of chemotherapy, a retroperitoneal mass of 1.5 cm in diameter, was detected by CT scan. Standard retroperitoneal lymph node dissection was performed and the pathological diagnosis of the lymph node was teratoma with malignant transformation containing enteric adenocarcinoma. Teratomatous portion of the primary lesion was precisely re-examined and adenocarcinoma, similar histology to the retroperitoneal mass, was identified. He received two courses of EAP chemotherapy (Cis-platin+etoposide+doxorubicin) as an adjuvant chemotherapy following the surgery and he is alive with no evidence of recurrence for 21 months. Presence of non germ cell malignancy after chemotherapy in testicular cancer has been regarded as a rare phenomenon. Flow cytometric DNA analyses of both embryonal carcinoma and teratoma in the primary lesion, mature teratoma and teratoma with malignant transformation of the retroperitoneal lymph node disclosed that these tumors were all aneuploid tumors.(ABSTRACT TRUNCATED AT 250 WORDS)
Muraki
J
J
Department of Urology, Tochigi Cancer Center.
Nakazono
M
M
D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology; D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage; D002471:Cell Transformation, Neoplastic / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D013724:Teratoma / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D013736:Testicular Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery
D001761:Bleomycin; D005047:Etoposide; D002945:Cisplatin