[Successful Management for Refractory Non-Seminomatous Testicular Cancer with Retroperitoneal Lymph Node, Liver, Lung and Brain Metastases : A Case Report]

Hinyokika Kiyo. 2021 Sep;67(9):433-437. doi: 10.14989/ActaUrolJap_67_9_433.
[Article in Japanese]

Abstract

An 18-year-old male was aware of painless left testicular enlargement. Contrast-enhanced computed tomography showed a retroperitoneal tumor, multiple liver tumors, and multiple lung tumors. A left testicular tumor was suspected, and left inguinal orchiectomy was performed. The pathological diagnosis was choriocarcinoma, yolk sac tumor, and embryonal carcinoma. Although bleomycin, etoposide and cisplatin therapy was performed as first-line chemotherapy and paclitaxel, iphosfamide and cisplatin therapy was performed as second-line chemotherapy, the tumor markers did not become negative. Retroperitoneal lymph node dissection and partial hepatectomy were performed as desperation surgery. However a new brain metastatic lesion appeared; then, radiation therapy (whole brain irradiation, stereotactic radiotherapy) and gemcitabine, oxaliplatin therapy were performed. The tumor marker became negative, and lung metastases were resected followed by right lower lung lobectomy. No recurrence has been observed for one year and six months after the lobectomy.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Brain Neoplasms* / diagnostic imaging
  • Brain Neoplasms* / surgery
  • Humans
  • Liver
  • Lung
  • Lymph Nodes
  • Male
  • Neoplasm Recurrence, Local
  • Testicular Neoplasms* / drug therapy
  • Testicular Neoplasms* / surgery