title: Treatment of a stage I testicular yolk sac tumor with vascular invasion.
abstract: There is controversy concerning the treatment of stage I yolk sac tumor of the testis, particularly of those with histological factors that indicate a high risk of relapse. Usually orchiectomy alone is sufficient and adjuvant chemotherapy is unnecessary. Retroperitoneal lymphadenectomy is indicated for patients with persistently high alpha-fetoprotein. Once recurred, treatment at that time is thought to be curative. However, postoperative chemotherapy may be necessary for patients with a tumor expressing histological factors that predict possible relapse. In this paper we report on a case of a 2 year old boy whose tumor invaded the testicular veins. The patient suffered from recurrent disease but was successfully treated by chemotherapeutic regimens including cisplatin and retroperitoneal lymphadenectomy. The importance of the histological factors in making a decision on the treatment strategy for stage I testicular yolk sac tumor is discussed.
authors.affiliation: Department of Surgery, Gunma Children's Medical Center, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Ikeda
authors.forename: S
authors.initials: S
authors.lastname: Matsuyama
authors.forename: N
authors.initials: N
authors.lastname: Suzuki
authors.forename: A
authors.initials: A
authors.lastname: Takahashi
authors.forename: M
authors.initials: M
authors.lastname: Kuroiwa
authors.forename: K
authors.initials: K
authors.lastname: Nagashima
authors.forename: J
authors.initials: J
authors.lastname: Hirato
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002675:Child, Preschool; D003131:Combined Modality Therapy; D018240:Endodermal Sinus Tumor / Q000098:blood supply / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009919:Orchiectomy; D013736:Testicular Neoplasms / Q000098:blood supply / Q000473:pathology* / Q000628:therapy; D013737:Testis / Q000098:blood supply*; D014680:Veins / Q000473:pathology