title: Aortic and vena caval reconstruction with retroperitoneal lymph node dissection for metastatic germ cell tumor.
abstract: A 49-year-old man who had a huge testicular tumor with retroperitoneal lymph node metastasis and bilateral multiple pulmonary metastases was referred to our hospital. Firstly orchiectomy was done obtaining the pathological diagnosis of mixed type germ cell tumor. After cisplatin-based chemotherapy, he underwent resection of the retroperitoneal lymph node involving the abdominal aorta and the inferior vena cava. Both great vessels were resected with the tumor and reconstructed with prosthetic grafts. Two months after the laparotomy, 12 metastatic nodules in the left lung were resected. Seven months later, he furthermore underwent resection of 4 metastatic nodules in the right lung. Microscopically, all resected metastatic tumors were diagnosed to be mature teratoma without viable malignant cells. The patient remains well 30 months after the first operation. Follow-up CT scan demonstrates patency of aortic and vena caval bypass grafts without local recurrence or distant metastasis.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. ytsuji@med.kobe-u.ac.jp
authors.forename: Y
authors.initials: Y
authors.lastname: Tsuji
authors.forename: H
authors.initials: H
authors.lastname: Matsuda
authors.forename: I
authors.initials: I
authors.lastname: Hara
authors.forename: M
authors.initials: M
authors.lastname: Yoshimura
authors.forename: Y
authors.initials: Y
authors.lastname: Okita
mesh_terms: D001011:Aorta / Q000601:surgery*; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009373:Neoplasms, Germ Cell and Embryonal / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy*; D010537:Peritoneum / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000379:methods; D013736:Testicular Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D016896:Treatment Outcome; D014684:Venae Cavae / Q000601:surgery*