Testicular seminoma with a progressing pulmonary nodule and mediastinal lymphadenopathy without retroperitoneal metastasis

Sano, Yuta; Fujiwara, Motohiro; Yuasa, Takeshi; Komai, Yoshinobu; Yamamoto, Tatsuya; Kohno, Atsushi; Nakao, Masayuki; Inamura, Kentaro; Yonese, Junji

doi:10.1002/iju5.12191

Cited by 2 publications

(2 citation statements)

References 17 publications

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“…Considering all the indications for the orchiectomy, suspicion of cancer remains the most important. Not only the lesion in the testis can resemble cancer, but pulmonary nodule and mediastinal lymphadenopathy can also resemble metastasis [ 20 ]. Therefore, sole removal of the tumor without orchiectomy remains an option in highly motivated patients whose cancer risk is small.…”

Section: Discussionmentioning

confidence: 99%

Sarcoidosis of the spermatic cord – case report and literature review

Ostrowska

Świniarski

Ostrowski

et al. 2022

Basic Clin. Androl.

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Background Sarcoidosis is a multi-system disease characterized by the formation of non-caseating granulomas in various organs. The lungs remain the most frequently affected organ, whereas lesions in the genitourinary system affect around 0.2% of patients. The primary site found in the spermatic cord is extremely rare. Case presentation We present a patient’s case where the spermatic cord involvement was the first manifestation of sarcoidosis. For several months, a number of tests had been performed, which showed, among others, non-caseating granulomas in pathomorphological material, bilateral hilar lymphadenopathy, and leukopenia with lymphopenia. Tumor markers were normal. Infection with urogenital pathogens (including Chlamydia Trachomatis, Neisseria gonorrhea, Mycoplasma hominis) was excluded. The patient did not report any general symptoms such as fever, excessive fatigue, weight loss. He denied swelling, shortness of breath. At the same time, a complete differential diagnosis was carried out, and the extent of the disease was assessed. Due to interdisciplinary management, the patient’s quality of life and fertility is preserved. In the discussion, we present the diagnosis, treatment, and prognosis of such patients. Conclusion Sarcoidosis is a multi-system disease, which should not be omitted in the differential diagnosis. Selective excision of the lesion with intraoperative examination plays a significant role while establishing a diagnosis. However, in the primary site in the genitourinary system, the diagnosis is challenging.

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Section: Discussionmentioning

confidence: 99%

Sarcoidosis of the spermatic cord – case report and literature review

Ostrowska

Świniarski

Ostrowski

et al. 2022

Basic Clin. Androl.

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“…Testicular germ cell cancer has a relatively good prognosis even if visceral and/or lymph node metastases are present, due to chemotherapy. If benign or malignant lesions are suspected, histopathological confirmation is required to make appropriate decisions (5).…”

Section: Introductionmentioning

confidence: 99%

Surgery for lung metastases in a testicular seminoma

Bufnea

Biro²,

Budin

2021

Pneumologia

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Invasive testicular cancer develops from carcinoma in situ (CIS)/testicular intraepithelial neoplasia (TIN), and these histological types are often identified in residual non-malignant testicular tissues. The objective was to highlight the need for an immediate multidisciplinary approach in a case of seminoma with lung metastases in a young patient, to approach optimal therapeutic behaviour. We present the case of a 33-year-old patient, a smoker, who presents with an influenced general condition, bilateral crackling rales, the right testicle slightly enlarged in volume. Emergency chest radiography raises suspicion of lung metastases. Computed tomography (CT) sustains the suspicion of secondary malignancies, which is why the pulmonary formation is approached endobronchial, having as a histopathological result seminoma metastasis. Blood tests, before urological intervention show an alpha-fetoprotein (AFP) = 11.05 mUI/mL, beta human chorionic gonadotropin (hCG) = 20.47 mUI/L, lactate dehydrogenase (LDH) = 754 U/L, subsequently performing right radical orchiectomy (2016), pT1N3M1a-stage IIIB. Repeating the blood tests after the fourth chemotherapy session [bleomycin, etoposide and cisplatin (BEP)] reveals a normalisation of AFP = 0.4 mUI/mL, beta hCG < 0.1 mUI/L, LDH = 276 U/L results, and at positron emission tomography-computed tomography (PET-CT) examination the pulmonary tumour formations were not metabolically active. Subsequently, lung metastases were removed by laser surgery (2020), with significant resorption and preservation of healthy lung parenchyma, and is classified according to the TNM8 staging in stage IV-pT3N0M1a. The particularity of this case was the multiple pulmonary secondary malignancies, which, although imagistically persisted, were not metabolically active, and is interpreted as remainings after oncological treatment. Considering the modifications, the advanced stage and the estimated prognosis, the case can be summarised as a therapeutic success.

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Testicular seminoma with a progressing pulmonary nodule and mediastinal lymphadenopathy without retroperitoneal metastasis

Cited by 2 publications

References 17 publications

Sarcoidosis of the spermatic cord – case report and literature review

Sarcoidosis of the spermatic cord – case report and literature review

Surgery for lung metastases in a testicular seminoma

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