Improved Management of Abdominal Undescended Testicular Tumors with Bulky Confluent Retroperitoneal Nodal Metastases

Kulkarni, Jagdeesh N.; Desai, Samir M.; Phadke, Girish K.; Tongaonkar, Hemant

doi:10.1097/00005392-199610000-00024

Cited by 1 publication

(4 citation statements)

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“…Kulkarni et al [3] reported 10 patients with nonseminomatous tumours; six of these were disease‐free after initial chemotherapy and the others underwent a one‐stage surgical removal of the primary and residual metastases [3]. Adjuvant chemotherapy was given to those with active tumour [3]. The present case is exceptional as a large‐volume mixed germ cell tumour appeared to have arisen within an intra‐abdominal testis late after apparent orchidectomy for an abdominal testis.…”

Section: Commentmentioning

confidence: 98%

“…Undescended testes are 35±48 times more likely to undergo malignant change than a normal testis, and < 10% of testicular tumours occur within an undescended testis [2]. In adults with uncorrected intra-abdominal testes nonseminomatous germ cell tumours are less common than pure seminomas [3]. Kulkarni et al [3] reported …”

Section: Commentmentioning

confidence: 99%

“…Undescended testes are 35–48 times more likely to undergo malignant change than a normal testis, and ≈ 10% of testicular tumours occur within an undescended testis [2]. In adults with uncorrected intra‐abdominal testes nonseminomatous germ cell tumours are less common than pure seminomas [3]. Kulkarni et al [3] reported 10 patients with nonseminomatous tumours; six of these were disease‐free after initial chemotherapy and the others underwent a one‐stage surgical removal of the primary and residual metastases [3].…”

Section: Commentmentioning

confidence: 99%

“…In adults with uncorrected intra‐abdominal testes nonseminomatous germ cell tumours are less common than pure seminomas [3]. Kulkarni et al [3] reported 10 patients with nonseminomatous tumours; six of these were disease‐free after initial chemotherapy and the others underwent a one‐stage surgical removal of the primary and residual metastases [3]. Adjuvant chemotherapy was given to those with active tumour [3].…”

Section: Commentmentioning

confidence: 99%

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Mixed germ cell tumour arising from abdominal testicular tissue after apparent orchidectomy

et al. 2001

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A 19-year-old man presented with a pain in the right iliac fossa, and a mass. He had a history of bilateral cryptorchidism and underwent laparotomy, left orchidopexy and right orchidectomy when 7 years old. On examination there was a large right iliac fossa mass, a small testis at the left super®cial ring and a prosthesis in the right side of the scrotum. CT con®rmed a large intra-abdominal mass of 18r17r8 cm (Fig. 1). There was no apparent disease elsewhere. A needle biopsy showed teratoma; his serum AFP and bhCG levels were 9757 kU/L and 1976 U/L, respectively. He received three cycles of chemotherapy (cisplatinum, vincristine, methotrexate, bleomycin/actinomycin-D, cyclophosphamide, etoposide), with a marked reduction in the size of the right abdominal mass. After chemotherapy his AFP and bhCG levels reduced to 33 kU/L and 53 U/L, respectively. At laparotomy a large mass (20r11.5r7.5 cm) was dissected from the ascending colon. The right gonadal vessels were attached to the mass (Fig. 2). A nerve-sparing retroperitoneal lymph node dissection was also undertaken. Histology showed a malignant teratoma intermediate (teratoma differentiated and malignant teratoma undifferentiated) with yolk sac tumour and a small focus of seminoma. There was no tumour in the resected lymph nodes. After surgery his AFP and bhCG levels decreased to 22 kU/L and 2 U/L, respectively. He restarted chemotherapy 6 weeks after surgery because of rising bhCG levels and the development of liver metastases. Both AFP and bhCG rose after the completing salvage chemotherapy. The patient died with disseminated chemotherapy-resistant disease 8 months later. CommentThe incidence of cryptorchidism is 3.4% in neonates of >2.5 kg and 0.8% in the adult population [1]; < 20% of undescended testes are clinically impalpable and 20±25% of these are intra-abdominal. Undescended testes are 35±48 times more likely to undergo malignant change than a normal testis, and < 10% of testicular tumours occur within an undescended testis [2]. In adults with uncorrected intra-abdominal testes nonseminomatous germ cell tumours are less common than pure seminomas [3]. Kulkarni et al. [3] reported

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Section: Commentmentioning

confidence: 98%

Section: Commentmentioning

confidence: 99%