[Initial chemotherapy followed by orchiectomy and retroperitoneal lymphadenectomy--a case of seminoma with a testicular tumor and enlarged regional lymph nodes].
A 43-year-old male visited our hospital with complaints of right scrotal swelling and lower abdominal mass. Computed tomographic (CT) scan showed the right testicular tumor and regional enlarged lymph nodes. However, there were no metastasis in lung, brain, liver, and bone. First, we performed chemotherapy of modified PVB regimen (cisplatinum, vinblastine, peplomycin) prior to the right orchiectomy, because a tumor lump was palpable from the right testis to the lower abdominal mass. After three courses of modified PVB chemotherapy, beta-HCG, HCG and LDH values became within normal limits and all tumors were necrotic on the CT scan. Then, we performed the right orchiectomy and retroperitoneal lymphadenectomy simultaneously. After operation, two courses of VIP chemotherapy (etoposide, ifosfamide, cisplatinum) were performed since viable cells in one of the obturator lymph nodes were pathologically noticed. The patient has been free of recurrence of the tumor for 15 months after the treatment. In the particular case, in which the primary testicular tumor was not extirpated en bloc, the initial chemotherapy followed by orchiectomy was found to be feasible.
Onishi
T
T
Department of Urology, Mie University School of Medicine.
Nakano
S
S
Yanagawa
M
M
Sugimura
Y
Y
Tochigi
H
H
Kawamura
J
J
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001761:Bleomycin / Q000627:therapeutic use; D002945:Cisplatin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005047:Etoposide; D006801:Humans; D007069:Ifosfamide; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D009919:Orchiectomy; D017663:Peplomycin / Q000008:administration & dosage; D012187:Retroperitoneal Space; D018239:Seminoma / Q000473:pathology / Q000628:therapy*; D013736:Testicular Neoplasms / Q000473:pathology / Q000628:therapy*; D014747:Vinblastine / Q000627:therapeutic use
D001761:Bleomycin; D017663:Peplomycin; D014747:Vinblastine; D005047:Etoposide; D002945:Cisplatin; D007069:Ifosfamide