title: [Tumor thrombus arising from the superior vena cava and extending into the right atrium in a patient with advanced testicular germ cell tumor].
abstract: A 24-year-old man was referred to our hospital with a painless mass on the left side of his neck. Ultrasonography detected right testicular tumor and computerized tomography scanning revealed a left supraclavicular lymph node mass and bulky retroperitoneal lymph node mass. He initially underwent right high orchiectomy, combination chemotherapy and retroperitoneal lymph node dissection for advanced testicular non-seminomatous germ cell tumor. Six years later, late relapse was detected in the lung. After complete remission of the lung metastasis with chemotherapy, the serum alpha-fetoprotein began to increase because of superior vena caval thrombus extending into the right atrium. Emergency surgical excision was performed successfully using extracorporeal circulation to prevent pulmonary embolism and the resected specimen pathologically revealed adenocarcinoma interpreted as teratoma malignant transformation. Adjuvant chemotherapy consisting of paclitaxel, ifosfamide and nedaplatin were administered for subsequent slight elevation of serum F-human chorionic gonadotropin beta, resulting in successful normalization again. Later, he suddenly died of cerebral infarction without any evidence of recurrence 138 months after his initial presentation. We report herein an extremely uncommon case of advanced testicular germ cell tumor with development of superior vena caval thrombus extending into the right atrium.
authors: Department of Urology, Nara Medical University.
authors: Makito
authors: M
authors: Miyake
authors: Kiyohide
authors: K
authors: Fujimoto
authors: Chie
authors: C
authors: Matsushita
authors: Yoshitomo
authors: Y
authors: Chihara
authors: Masahiro
authors: M
authors: Tanaka
authors: Akihide
authors: A
authors: Hirayama
authors: Yoshihiko
authors: Y
authors: Hirao
authors: Hirotsugu
authors: H
authors: Uemura
mesh_terms: D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D006325:Heart Atria / Q000473:pathology*; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000473:pathology*; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D013736:Testicular Neoplasms / Q000473:pathology*; D013927:Thrombosis / Q000473:pathology* / Q000601:surgery; D014683:Vena Cava, Superior / Q000473:pathology*; D055815:Young Adult
chemical_list: D018997:Chorionic Gonadotropin, beta Subunit, Human