Development of testicular alpha-fetoprotein-secreting germ cell tumor 3 years after treatment of intracranial lesion identified as non-secreting germ cell tumor on the basis of clinical data--case report.
A 22-year-old Asian male developed testicular alpha-fetoprotein (AFP)-secreting germ cell tumor 3 years after treatment of a disseminated intracranial lesion identified as non-secreting germ cell tumor on the basis of clinical data. Magnetic resonance imaging showed a massive lesion with necrosis appearing as hypointense on T1- and hyperintense on T2-weighted imaging, with heterogeneous enhancement. The blood AFP level was as high as 129 ng/ml (previously, as low as 5 ng/ml) and abdominal computed tomography showed para-aortic lymph node swelling. Left orchidectomy was performed and histological examination indicated the presence of AFP-secreting germ cell tumor despite severe necrosis of the tissue. Improved chemoradiotherapy for intracranial germ cell tumor will lead to long-term survival of most patients with germ cell tumor. Patients may subsequently develop germ cell tumors at other sites in the body. Therefore, follow up should monitor for tumor recurrence not only in the brain but also in other locations.
Takahashi
Satoshi
S
Department of Neurosurgery, Keio University School of Medicine, Tokyo, Japan. satoshi710@mac.com
Yoshida
Kazunari
K
Mikami
Shuji
S
Oya
Mototsugu
M
Kawase
Takeshi
T
D016190:Carboplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D018572:Disease-Free Survival; D005047:Etoposide / Q000008:administration & dosage; D005500:Follow-Up Studies; D006423:Hemianopsia / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009363:Neoplasm Proteins / Q000032:analysis* / Q000378:metabolism; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy / Q000532:radiotherapy / Q000556:secondary*; D016609:Neoplasms, Second Primary / Q000378:metabolism / Q000601:surgery; D009919:Orchiectomy; D015173:Supratentorial Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy; D013736:Testicular Neoplasms / Q000097:blood / Q000378:metabolism / Q000556:secondary* / Q000601:surgery; D055815:Young Adult; D000509:alpha-Fetoproteins / Q000032:analysis* / Q000378:metabolism
D009363:Neoplasm Proteins; D000509:alpha-Fetoproteins; D005047:Etoposide; D016190:Carboplatin