Testicular cancer

睾丸癌
  • 文章类型: Case Reports
    我们报告了一例晚期睾丸癌,即使在诱导化疗期间感染COVID-19后,也通过早期适当恢复化疗治愈。
    患者是一名健康的36岁男性。诊断为IIIB期非精原细胞瘤(pT2N2M1a)。在第一个化疗周期的第14天,患者被诊断为轻度COVID-19。第二个化疗周期延迟1天开始(在COVID-19诊断后第10天)。患者在最小程度推迟化疗的情况下获得缓解。
    只有少数病例报告描述了COVID-19患者恢复抗癌化疗。在决定COVID-19感染后何时恢复化疗时,必须考虑癌症类型等因素,programming,和COVID-19的严重程度,应根据个体患者的需求量身定制。
    UNASSIGNED: We report a case of advanced testicular cancer cured by early and appropriate resumption of chemotherapy even after COVID-19 infection during induction chemotherapy.
    UNASSIGNED: The patient was a healthy 36-year-old male. The diagnosis was a stage IIIB nonseminoma (pT2N2M1a). On day 14 of the first chemotherapy cycle, the patient was diagnosed with mild COVID-19. The second chemotherapy cycle was initiated with a 1-day delay (on day 10 after the COVID-19 diagnosis). The patient achieved remission with minimal postponement of chemotherapy.
    UNASSIGNED: Only a few case reports have described the resumption of anticancer chemotherapy in patients with COVID-19. In deciding when to resume chemotherapy after COVID-19 infection, it is essential to consider factors such as cancer type, progression, and severity of COVID-19 and should be tailored to individual patient needs.
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  • 文章类型: Journal Article
    泌尿生殖系统癌症相关死亡率的社会人口统计学差异尚未得到充分研究,特别是在多种癌症类型中。本研究旨在调查性别,种族,以及美国最常见的泌尿生殖系统癌症死亡率的地理差异。
    前列腺死亡率数据,膀胱,肾,和睾丸癌从疾病控制和预防中心(CDC)WONDER数据库在1999年至2020年之间获得。按年份分析了年龄调整后的死亡率(AAMR),性别,种族,城乡地位,和地理区域使用P<0.05的显著性水平。
    总的来说,用于前列腺的AAMR,膀胱,肾癌显著下降,而睾丸癌相关死亡率保持稳定.膀胱和肾癌AAMR男性比女性高3-4倍。前列腺癌死亡率在黑人/非裔美国人中最高,2015年后开始增加。白种人膀胱癌死亡率显著下降,黑人个体,非洲裔美国人,和亚洲人/太平洋岛民,但在美洲印第安人/阿拉斯加原住民中保持稳定。与肾癌相关的死亡率在白人中最高,但在其他种族中显着下降。白人的睾丸癌死亡率显着增加,但黑人和非裔美国人保持稳定。大城市地区的泌尿生殖系统癌症死亡率下降,但在非大城市地区增加(膀胱癌和睾丸癌)或保持稳定(肾癌)。前列腺癌和肾癌死亡率在中西部最高,南方的膀胱癌,西方的睾丸癌.
    在美国泌尿生殖系统癌症的死亡率趋势中存在显著的社会人口统计学差异。这些发现强调了有针对性的干预措施和进一步研究的必要性,以解决这些差异并改善所有受泌尿生殖系统癌症影响的人群的结果。
    UNASSIGNED: Sociodemographic disparities in genitourinary cancer-related mortality have been insufficiently studied, particularly across multiple cancer types. This study aimed to investigate gender, racial, and geographic disparities in mortality rates for the most common genitourinary cancers in the United States.
    UNASSIGNED: Mortality data for prostate, bladder, kidney, and testicular cancers were obtained from the Centers for Disease Control and Prevention (CDC) WONDER database between 1999 and 2020. Age-adjusted mortality rates (AAMRs) were analyzed by year, gender, race, urban-rural status, and geographic region using a significance level of p < 0.05.
    UNASSIGNED: Overall, AAMRs for prostate, bladder, and kidney cancer declined significantly, while testicular cancer-related mortality remained stable. Bladder and kidney cancer AAMRs were 3-4 times higher in males than females. Prostate cancer mortality was highest in black individuals/African Americans and began increasing after 2015. Bladder cancer mortality decreased significantly in White individuals, Black individuals, African Americans, and Asians/Pacific Islanders but remained stable in American Indian/Alaska Natives. Kidney cancer-related mortality was highest in White individuals but declined significantly in other races. Testicular cancer mortality increased significantly in White individuals but remained stable in Black individuals and African Americans. Genitourinary cancer mortality decreased in metropolitan areas but either increased (bladder and testicular cancer) or remained stable (kidney cancer) in non-metropolitan areas. Prostate and kidney cancer mortality was highest in the Midwest, bladder cancer in the South, and testicular cancer in the West.
    UNASSIGNED: Significant sociodemographic disparities exist in the mortality trends of genitourinary cancers in the United States. These findings highlight the need for targeted interventions and further research to address these disparities and improve outcomes for all populations affected by genitourinary cancers.
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  • 文章类型: Case Reports
    博来霉素是一种具有出色抗肿瘤作用的糖肽抗生素。博来霉素的主要不良反应是肺纤维化。然而,白内障作为严重不良反应的发展尚未有报道。
    这里,我们描述了1例22岁男性睾丸癌患者通过博莱霉素治疗诱发白内障的病例.在手术干预和BEP方案的五个连续化疗周期后,包括博来霉素,依托泊苷和顺铂,患者报告视力逐渐无痛丧失,随着视觉能力的大幅下降,尤其是右眼。在全面的眼科检查之后,诊断为白内障。最终,患者接受了白内障超声乳化术和人工晶状体置换.
    博来霉素可引起白内障,这导致了视力的显著丧失。因此,临床医生应观察早期症状,适当调整治疗方法,防止症状加重。
    UNASSIGNED: Bleomycin is a glycopeptide antibiotic with outstanding anti-tumor effects. A major adverse effect of bleomycin is lung fibrosis. However, the development of cataracts as a severe adverse effect has not been reported.
    UNASSIGNED: Herein, we describe the first case of cataract induced by bleomycin therapy in a 22-year-old male with testicular cancer. After surgical intervention and following five successive chemotherapy cycles of the BEP regimen, including bleomycin, etoposide and cisplatin, the patient reported a gradual painless loss of vision, with substantial decline in visual ability, especially in the right eye. Following comprehensive eye examinations, a cataract was diagnosed. Eventually, the patient underwent phacoemulsification and received replacement of the intraocular lenses.
    UNASSIGNED: Bleomycin can cause cataracts, which induces a significant loss of vision. Therefore, clinicians should observe early symptoms and properly adjust treatment to prevent aggravation of symptoms.
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  • 文章类型: Case Reports
    睾丸生殖细胞肿瘤(GCT)是一种可治愈的癌症,即使它是广泛转移的;然而,结果可能因肿瘤组织学而异.某些表型的化学抗性,如畸胎瘤和卵黄囊瘤,导致一些GCT患者的临床结局不佳。尽管对S-YSTemic疗法有这种抗性,这些肿瘤亚型中的许多仍然适合手术切除和可能的治愈。在这项研究中,我们报告了一系列7例患者,重点是非精原细胞生殖细胞肿瘤(NSGCT)的两种化学耐药亚型,肉瘤样卵黄囊瘤(S-YST),和上皮样滋养细胞肿瘤(ETT),早期切除而不是额外的挽救性化疗或大剂量强化疗可能提供更好的临床结果并提高治愈率。
    Germ cell tumor of the testis (GCT) is a curable cancer even when it is widely metastatic; however, outcomes can differ based on tumor histology. Chemo-resistance in certain phenotypes, such as teratoma and yolk sac tumor, contributes to poor clinical outcomes in some patients with GCT. Despite this resistance to S-YSTemic therapy, many of these tumor subtypes remain amenable to surgical resection and possible cure. In this study, we report on a series of seven patients highlighting two chemo-resistant subtypes of nonseminomatous germ cell tumor (NSGCT), sarcomatoid yolk sac tumor (S-YST), and epithelioid trophoblastic tumor (ETT) for which early resection rather than additional salvage chemotherapy or high-dose intense chemotherapy might provide a superior clinical outcome and enhance cure rate.
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  • 文章类型: Journal Article
    我们的目的是报告化疗后机器人辅助腹膜后单侧淋巴结清扫术(PC-rRPLND)治疗非精原细胞生殖细胞肿瘤(NSGCT)后的性和生殖结果。我们收集了2018年1月至2021年11月在II期NSGCT中接受单侧PC-rRPLND的患者的性和生殖结局的记录。术前和术后(12个月时)射精功能以及勃起功能,根据国际勃起功能指数-5(IIEF-5)和勃起硬度评分(EHS),被评估。本分析仅包括术前IIEF-5≥22和EHS≥3的患者。总的来说,22例接受单侧PC-rRPLND的患者符合纳入标准。其中,7例(31.8%)患者在PC-rRPLND后出现任何类型的男性疾病.具体来说,3例(13.6%)患者出现逆行射精,1例(4.5%)患者出现精子症.此外,3例(13.6%)患者出现勃起功能障碍(IIEF-5<22和/或EHS<3)。最后,两名(9.1%)在PC-rRPLND后成功自然怀孕。逆行射精被证实是PC-rRPLND最常见的并发症之一。此外,一个不可忽视的数量的患者经历勃起功能障碍。
    We aimed to report sexual and reproductive outcomes following post-chemotherapy robot-assisted retroperitoneal unilateral lymph node dissection (PC-rRPLND) for non-seminomatous germ cell tumors (NSGCTs) at a high-volume cancer center. We collected records regarding sexual and reproductive outcomes of patients undergoing unilateral PC-rRPLND for stage II NSGCTs from January 2018 to November 2021. Preoperative and postoperative (at 12 months) ejaculatory function as well as erectile function, based on the International Index of Erectile Function-5 (IIEF-5) and Erection Hardness Score (EHS), were assessed. Only patients with a pre-operative IIEF-5 of ≥22 and EHS of ≥3 were included in this analysis. Overall, 22 patients undergoing unilateral PC-rRPLND met the inclusion criteria. Of these, seven (31.8%) patients presented an andrological disorder of any type after PC-rRPLND. Specifically, retrograde ejaculation was present in three (13.6%) patients and hypospermia was present in one (4.5%) patient. Moreover, three (13.6%) patients yielded erectile dysfunction (IIEF-5 < 22 and/or EHS < 3). Lastly, two (9.1%) succeeded in naturally conceiving a child after PC-rRPLND. Retrograde ejaculation is confirmed to be one of the most common complications of PC-rRPLND. Moreover, a non-negligible number of patients experience erectile dysfunction.
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  • 文章类型: Case Reports
    孤立的睾丸结核是罕见的,由于其无症状性质,通常在组织病理学检查期间偶然诊断。我们介绍了一例35岁的男性,其左睾丸肿块模仿恶性肿瘤。尽管肿瘤标志物正常,肺结核影像学检查阴性,左腹股沟睾丸切除术显示睾丸结核。该疾病的稀有性和非典型表现加剧了诊断挑战。泌尿生殖系统结核的诊断复杂性强调了临床怀疑的必要性,特别是在结核病流行地区。虽然睾丸切除术可能是必要的,该病例强调了睾丸肿块中考虑结核病的重要性。早期识别有助于适当的管理,并强调了诊断警惕的重要性。
    Isolated testicular tuberculosis is rare, often diagnosed incidentally during histopathological examination due to its asymptomatic nature. We present a case of a 35-year-old male with a left testicular mass mimicking malignancy. Despite normal tumor markers and negative imaging for pulmonary tuberculosis, left inguinal orchiectomy revealed testicular tuberculosis. Diagnostic challenges are compounded by the disease\'s rarity and atypical presentation. Genitourinary tuberculosis\'s diagnostic complexity underscores the need for heightened clinical suspicion, particularly in tuberculosis-endemic regions. While orchiectomy may be necessary, this case underscores the importance of considering tuberculosis in testicular masses. Early recognition facilitates appropriate management and underscores the importance of diagnostic vigilance.
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  • 文章类型: Journal Article
    背景:非精原细胞生殖细胞肿瘤(NSGCT)是年轻男性中罕见但最普遍的恶性肿瘤。骨转移(BMs)在这种肿瘤中非常罕见,和关于最初疾病表现的可用数据,生存结果,并且BMs的预后意义有限。方法:我们对2001年至2021年在我们的三级护理中心接受治疗的40例NSGCT患者进行了回顾性分析。根据诊断时或仅在复发时存在BM,将队列分为同步组(n=29)和异时组(n=11)。分别。我们评估了总生存期(OS),无进展生存期(PFS),疾病介绍,和治疗。结果:在中位随访93个月后,同步组5年PFS和OS分别为37.6%和53.9%,异期组分别为18.2%和36.4%,分别。在最初的诊断中,大多数患者被分为IGCCCG预后不良组(n=34,85%).BMs大多无症状(n=23,57.5%),涉及脊柱(n=37,92.5%),并且只有在疾病反应后才能变得可见(n=4,10%)。一线治疗后切除的骨病变的病理检查显示坏死(n=5,71.4%),畸胎瘤,或精原细胞瘤(均n=1,14.3%)。一开始复发,同步组8例患者未出现骨复发,而8例患者在最初受累的骨部位复发。结论:在NSGCT患者中,BMS通常以渐近方式出现,最初可能未被注意到。然而,与IGCCCG预后不良组相比,这些患者的预后可能较差.需要包括对照组在内的进一步研究来评估BM的独立预后意义。
    Background: Non-seminomatous germ cell tumors (NSGCTs) represent a rare yet the most prevalent malignancy among young men. Bone metastases (BMs) are exceedingly uncommon in this neoplasm, and available data regarding the initial disease presentation, survival outcomes, and prognostic significance of BMs are limited. Methods: We conducted a retrospective analysis of 40 NSGCT patients with BMs treated between 2001 and 2021 in our tertiary care center. The cohort was stratified into synchronous (n = 29) and metachronous (n = 11) groups based on the presence of BM at diagnosis or only at relapse, respectively. We assessed overall survival (OS), progression-free survival (PFS), disease presentation, and treatments. Results: After a median follow-up of 93 months, the 5-year PFS and OS rates were 37.6% and 53.9% in the synchronous group and 18.2% and 36.4% in the metachronous group, respectively. At the initial diagnosis, most patients were classified into the IGCCCG poor prognostic group (n = 34, 85%). BMs were mostly asymptomatic (n = 23, 57.5%), involved the spine (n = 37, 92.5%), and could become visible only after disease response (n = 4, 10%). A pathological examination of resected bone lesions after first-line treatment revealed necrosis (n = 5, 71.4%), teratoma, or seminoma (both n = 1, 14.3%). At first relapse, eight patients in the synchronous group did not experience bone recurrence, while eight patients experienced recurrence at the initial affected bone site. Conclusions: In NSGCT patients, BMs often present asymptomatically and may initially be unnoticed. However, these patients may have a poorer prognosis compared to those in the IGCCCG poor prognostic group. Further studies including control groups are needed to assess the independent prognostic significance of BMs.
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  • 文章类型: Case Reports
    一名二十七岁男子于九月初出现右睾丸不适,2021年,五天后去了医院。体格检查未发现阴囊有任何异常。然而,超声波显示右睾丸中央有肿瘤,磁共振成像(MRI)显示肿瘤直径2.7cm,边界清晰,表面光滑。甲胎蛋白的水平,人绒毛膜促性腺激素,人绒毛膜促性腺激素β亚基,乳酸脱氢酶在正常范围内。计算机断层扫描(CT)扫描未显示异常。我们不能排除恶性肿瘤的可能性,在2021年9月中旬进行了右睾丸根治性切除术,诊断为右睾丸肿瘤.宏观病灶大小1.5×1.3cm,病理上没有发现活的肿瘤细胞。在精索的生精小管中观察到非典型细胞,免疫组织化学染色CD117(c-kit)阳性,D2-40和MIB-1,但与甲胎蛋白呈阴性,人绒毛膜促性腺激素,和人绒毛膜促性腺激素β亚基。病理诊断为生殖细胞原位瘤,并且在这些细胞和出血坏死之间没有观察到连续性。术后随访1年4个月,未观察到复发或转移。
    A 27-year-old man experienced discomfort in his right testis in early September, 2021, and visited the hospital five days later. Physical examination did not detect any abnormalities in the scrotum. However, an ultrasound revealed a tumor in the central part of the right testis, and a Magnetic Resonance Imaging (MRI) showed a tumor 2.7cm in diameter with clear boundaries and a marginally smooth surface. The level of alpha-fetoprotein, human chorionic gonadotropin, human chorionic gonadotropin-β subunit, and lactate dehydrogenase were within normal limits. A Computed Tomography (CT) scan showed no abnormalities. We can\'t rule out the possibility of malignancy, right radical orchiectomy was performed with a diagnosis of right testicular tumor in mid-September 2021. The macroscopic lesion was 1.5×1.3 cm in size, and no viable tumorous cells were found pathologically. Atypical cells were observed in the seminiferous tubules from the spermatic cord, which were positively stained with immune-histochemical staining CD117 (c-kit), D2-40, and MIB-1 but negatively with alpha-fetoprotein, human chorionic gonadotropin, and human chorionic gonadotropin-β subunit. The pathological diagnosis was germ cell neoplasia in situ, and no continuity was observed between these cells and bleeding necrosis. The patient has been followed up for 1 year and 4 months after surgery, with no recurrence or metastasis observed.
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  • 文章类型: Case Reports
    尽管生殖细胞肿瘤可以在儿童时期出现,他们在30岁左右最常见。这些肿瘤对化疗反应强烈,甚至复发病例的治愈率也相对较高。关于50岁以后诊断的患者的文献有限,在这种情况下没有进行具体的试验。这些病人,被认为是“老年人”,与年轻患者相同的含顺铂组合治疗,尽管毒性较高。该报告介绍了在75岁患者中发现的巨大睾丸混合生殖细胞肿瘤的观察结果。
    Although germ cell tumours can appear in childhood, they are most common around the age of 30. These tumours are highly responsive to chemotherapy, and even cases of relapse have relatively high cure rates. There is limited literature on patients diagnosed after the age of 50, and no specific trials have been carried out in this context. These patients, considered \'elderly\', are treated with the same cisplatin-containing combinations as younger patients, despite the higher toxicity. This report presents an observation of a giant testicular mixed germ cell tumour discovered in a 75-year-old patient.
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  • 文章类型: Journal Article
    睾丸癌(TCA)是一种罕见但有影响的恶性肿瘤,主要影响年轻男性。了解TCA的死亡率对于改善预防和治疗策略以降低患者死亡风险至关重要。我们按地点(5个国家)获得了TCA死亡率数据,年龄(20-79岁),和年份(1990-2019)来自2019年全球疾病负担研究。使用年龄-周期-队列模型来估计净漂移,局部漂移,年龄影响,时期和队列效应。2019年,TCA的全球死亡率上升至10842(95%UI9961,11902),与1990年相比增长了50.08%。2019年TCA的全年龄段死亡率从中国的0.17/100,000(95%UI0.13,0.20)上升到俄罗斯联邦的0.48/100,000(95%UI0.38,0.59),而2019年年龄标准化死亡率最高的是南非0.47/100,000(95%UI0.42,0.53),最低的是中国0.16/100,000(95%UI0.13,0.19)。中国人口老龄化使死亡模式向老年人转变,在俄罗斯联邦,年轻人主要受到死亡分布的影响。为了解决金砖国家不同的TCA死亡率进步,我们提出了一种情境适应性和资源意识的方法来优先考虑TCA预防。根据情境多样性定制策略,包括政策框架,人力资源,和财政能力,将增强针对性干预措施和降低TCA死亡率的有效性。
    Testicular cancer (TCa) is a rare but impactful malignancy that primarily affects young men. Understanding the mortality rate of TCa is crucial for improving prevention and treatment strategies to reduce the risk of death among patients. We obtained TCa mortality data by place (5 countries), age (20-79 years), and year (1990-2019) from the Global Burden of Disease Study 2019. Age-period-cohort model was used to estimate the net drift, local drift, age effects, period and cohort effects. In 2019, the global mortality of TCa increased to 10842 (95% UI 9961, 11902), with an increase of 50.08% compared to 1990.The all-age mortality rate for TCa in 2019 increased from 0.17/100,000 (95% UI 0.13, 0.20) in China to 0.48/100,000 (95% UI 0.38, 0.59) in Russian Federation, whereas the age-standardized mortality rate in 2019 was highest in the South Africa 0.47/100,000 (95% UI 0.42, 0.53) and lowest in the China 0.16/100,000 (95% UI 0.13, 0.19). China\'s aging population shifts mortality patterns towards the elderly, while in Russian Federation, young individuals are primarily affected by the distribution of deaths. To address divergent TCa mortality advancements in BRICS countries, we propose a contextually adaptive and resource-conscious approach to prioritize TCa prevention. Tailoring strategies to contextual diversity, including policy frameworks, human resources, and financial capacities, will enhance targeted interventions and effectiveness in reducing TCa mortality.
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