Testicular seminoma with mediastinal lymphadenopathy -- a diagnostic pitfall.
Relapse following adjuvant paraaortic radiation therapy in patients with Stage I seminoma is rare, occurring in approximately 4% of men. The majority of relapses are sited in the pelvis but relapse in the mediastinum is also recognised. As such, radiological imaging using chest radiographs remains commonplace in follow-up. However, there are reports of the association of testicular cancers with sarcoidosis and sarcoid-like processes in the mediastinum, emphasising the importance of making histological diagnosis prior to commencement of any treatment. We report on two men treated for testicular seminoma who on follow-up developed mediastinal lymphadenopathy, which was initially assumed to be metastatic seminoma. Both patients underwent mediastinascopy and biopsy prior to commencement of anti-cancer therapy. In both cases, the biopsies showed sarcoidosis, and unnecessary anti-cancer treatment was avoided.
Jegannathen
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A
Departments of Clinical Oncology, Christie Hospital NHS Foundation Trust, Manchester, UK.
Taylor
M B
MB
Jones
M
M
Logue
J P
JP
D000328:Adult; D001706:Biopsy; D003937:Diagnosis, Differential; D006801:Humans; D008206:Lymphatic Diseases / Q000175:diagnosis / Q000209:etiology / Q000473:pathology*; D008297:Male; D008477:Mediastinal Diseases / Q000209:etiology / Q000473:pathology*; D008481:Mediastinoscopy; D008482:Mediastinum / Q000473:pathology*; D012507:Sarcoidosis / Q000209:etiology / Q000473:pathology*; D018239:Seminoma / Q000532:radiotherapy / Q000556:secondary; D013736:Testicular Neoplasms / Q000473:pathology / Q000532:radiotherapy; D014057:Tomography, X-Ray Computed