Late relapse of stage I testicular seminoma metastatic to just a para-ureteropelvic region.
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.
Tadokoro
Manabu
M
Department of Urology and Reproductive Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan. tatokoro@yahoo.co.jp
Masuda
Hitoshi
H
Fujii
Yasuhisa
Y
Kobayashi
Tsuyoshi
T
Kageyama
Yukio
Y
Kihara
Kazunori
K
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
D018997:Chorionic Gonadotropin, beta Subunit, Human; D005047:Etoposide; D002945:Cisplatin