Late relapsing testicular cancer detected with 18F-FDG PET preceded by long-term alpha-fetoprotein elevation

Hiromichi Sakurai; Akinobu Katami; Hiroshi Yuki; Ryosuke Matsuoka; Koji Kawai; Takayuki Shiomi; Jun Miyazaki

doi:10.1016/j.eucr.2023.102511

Late relapsing testicular cancer detected with 18F-FDG PET preceded by long-term alpha-fetoprotein elevation

Urol Case Rep. 2023 Jul 22:50:102511. doi: 10.1016/j.eucr.2023.102511. eCollection 2023 Sep.

Authors

Hiromichi Sakurai¹, Akinobu Katami¹, Hiroshi Yuki¹, Ryosuke Matsuoka², Koji Kawai¹, Takayuki Shiomi², Jun Miyazaki¹

Affiliations

¹ Department of Urology, International University of Health and Welfare Narita Hospital, Narita, Japan.
² Department of Pathology, International University of Health and Welfare Narita Hospital, Narita, Japan.

Abstract

Late relapse (LR) of testicular cancer is often associated with chemoresistance, and thus the first choice of therapy is surgery if complete resection is possible. In some LR cases (including our patient, a 31-year-old Japanese man), elevation of alpha-fetoprotein (AFP) may precede the radiologic detection of LR. Approximately 500 days after the start of our patient's AFP elevation, 18F-fluordeoxyglucose positron emission tomography (FDG-PET) revealed strong FDG uptake in an equivocally enlarged external iliac lymph node. The lymphadenectomy as salvage surgery resulted in long-term complete remission without further treatment. Using FDG-PET made it possible to perform effective salvage surgery.

Keywords: 18F-fluordeoxyglucose positron emission tomography; Alpha-fetoprotein; Late relapse; Testicular cancer.

Publication types

Case Reports