Coincidence of seminoma and sarcoidosis: a myth or fact?
A patient with a stage II seminoma of the testis was treated with a routine orchidectomy and irradiation. One and a half years later enlarged mediastinal lymph nodes were noted. Additional staging showed no other abnormalities and a mediastinoscopy was performed. The initial histologic examination confirmed the clinically suspected diagnosis of sarcoidosis. However, additional immunohistochemical analysis unexpectedly demonstrated that there was also a microscopic relapse of the testis tumor. The literature concerning the co-incidence of non-caseating granulomas and testis tumors is reviewed. It is not clear, whether the granulomas indicate the presence of genuine idiopathic sarcoidosis or whether they reflect a sarcoid-like reaction against tumor antigens. The immunopathogenesis of sarcoid formation and its possible biologic significance in obtaining a spontaneous tumor remission is discussed.
Tjan-Heijnen
V C
VC
Department of Medical Oncology, University Hospital Nijmegen, the Netherlands.
Vlasveld
L T
LT
Pernet
F P
FP
Pauwels
P
P
De Mulder
P H
PH
D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D018572:Disease-Free Survival; D006801:Humans; D007150:Immunohistochemistry; D008207:Lymphatic Metastasis; D008297:Male; D008477:Mediastinal Diseases / Q000473:pathology*; D008481:Mediastinoscopy; D009919:Orchiectomy; D012507:Sarcoidosis / Q000150:complications / Q000473:pathology* / Q000628:therapy; D018239:Seminoma / Q000150:complications / Q000556:secondary* / Q000628:therapy; D013736:Testicular Neoplasms / Q000150:complications / Q000473:pathology* / Q000628:therapy; D014057:Tomography, X-Ray Computed
D000970:Antineoplastic Agents