title: Late relapse of stage I testicular seminoma metastatic to just a para-ureteropelvic region.
abstract: A follow-up ultrasonography study 43 months after an operation for left stage I testicular seminoma in a 39-year-old man revealed left hydronephrosis. Serum beta-human chorionic gonadotropin (beta-hCG) levels were slightly increased. Computed tomography scans of the abdomen showed a bulky tumor around the ureteropelvic region without para-aortic lymph node enlargement, but did not show a clear distinction between a recurrence of the testicular tumor and an invasive ureteral tumor. After the patient underwent two cycles of chemotherapy with cisplatin and etoposide, the tumor mass decreased by approximately 60% and beta-hCG levels returned to normal. We then performed a resection of the residual tumor involving the upper ureter and left kidney and a retroperitoneal lymph node dissection under a clinical diagnosis of recurrence of the testicular tumor. Histologically, no viable cancer cells remained. The patient has been well with no evidence of recurrence for more than two years.
authors.affiliation: Department of Urology and Reproductive Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan. tatokoro@yahoo.co.jp
authors.forename: Manabu
authors.initials: M
authors.lastname: Tadokoro
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Masuda
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Fujii
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Yukio
authors.initials: Y
authors.lastname: Kageyama
authors.forename: Kazunori
authors.initials: K
authors.lastname: Kihara
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D002945:Cisplatin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D006869:Hydronephrosis / Q000209:etiology; D007682:Kidney Pelvis / Q000473:pathology*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000628:therapy; D018239:Seminoma / Q000473:pathology* / Q000628:therapy; D013736:Testicular Neoplasms / Q000473:pathology* / Q000628:therapy; D014516:Ureteral Neoplasms / Q000556:secondary* / Q000628:therapy
chemical_list: D018997:Chorionic Gonadotropin, beta Subunit, Human; D005047:Etoposide; D002945:Cisplatin