testicular neoplasms

睾丸肿瘤
  • 文章类型: Journal Article
    2014年12月,一名74岁的男子以尿潴留为主要主诉来到泌尿外科诊所。血清初始前列腺特异性抗原(PSA)为50ng/ml,诊断为Gleason评分4+4的前列腺腺癌伴区域淋巴结肿大(cT3aN1M0)。联合雄激素阻断治疗后PSA水平下降。2018年11月,他被诊断为去势抵抗前列腺癌(CRPC),因为通过计算机断层扫描(CT)检测到局部进展,而PSA水平没有增加。由于局部症状恶化,导致恩杂鲁胺治疗后反复出现血尿,对前列腺进行姑息性放射治疗(45Gy)。五个月后,随访CT显示双肺及左睾丸多发转移。血清神经元特异性烯醇化酶(NSE)水平为24.4ng/ml,血清PSA水平未升高。他接受了前列腺再活检,但没有观察到恶性结果。因此,进行双侧睾丸切除术以诊断左睾丸肿瘤。病理检查提示神经内分泌前列腺癌(NEPC)转移。睾丸切除术后使用顺铂和伊立替康进行化疗。肺部病变完全反应,血清NSE水平降低在正常范围内。化疗完成后4年内未证实复发。
    A 74-year-old man visited the urology clinic with the chief complaint of urinary retention in December 2014. Serum level of initial prostate specific antigen (PSA) was 50 ng/ml and he was diagnosed with Gleason Score 4+4 prostate adenocarcinoma with regional lymphadenopathy (cT3aN1M0). PSA level had declined after the treatment with combined androgen blockade. In November 2018, he was diagnosed with castration resistant prostate cancer (CRPC) as local progression was detected by computed tomography (CT) while PSA level did not increase. Since local symptoms worsened, resulting in repeated hematuria after the treatment with enzalutamide, palliative radiation therapy to the prostate (45 Gy) was performed. Five months later, follow-up CT showed multiple metastasis in bilateral lung and left testicle. Serum level of neuron-specific enolase (NSE) was 24.4 ng/ml without an elevated in serum PSA level. He received rebiopsy of the prostate, but no malignant findings were observed. Consequently, bilateral orchiectomy was performed for diagnosis of left testicular tumor. Pathological examination revealed metastasis of neuroendocrine prostate cancer (NEPC). Chemotherapy using cisplatin and irinotecan was administered after orchiectomy. Complete response of lung lesions was achieved and serum level of NSE decreased within normal range. No recurrence has been confirmed for 4 years after the completion of chemotherapy.
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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: Journal Article
    我们介绍了三例双侧异时睾丸肿瘤。病例1中的患者在19岁时曾因睾丸未降而进行左睾丸切除术。病理结果显示生殖细胞原位瘤形成。二十四年后(年龄=43岁),诊断为右睾丸肿瘤伴淋巴结和肺转移(IIIc期)。进行了右睾丸切除术,病理显示为非精原细胞生殖细胞肿瘤。他接受了化疗,其次是淋巴结清扫术和肺转移瘤切除术。病例2的患者在41岁时有睾丸肿瘤的左睾丸切除术史。左睾丸的病理发现显示精原细胞瘤(IA期)。19年后(年龄=60岁),他被诊断为右睾丸肿瘤,并接受了右睾丸切除术。在这里,病理发现为精原细胞瘤(IA期)。病例3中的患者在25岁时有睾丸肿瘤的右睾丸切除术史。病理显示精原细胞瘤(IS期),他接受了主动脉旁区域的辅助放疗,随后没有复发。14年后(年龄=39岁),他被诊断为左睾丸肿瘤,并接受了左睾丸切除术。病理发现显示精原细胞瘤(IB期)。患者接受了卡铂辅助单药治疗以防止复发。由于双侧异位睾丸肿瘤的发生间隔时间较长(平均19年;3例),长期观察是必要的,以检测对侧睾丸肿瘤的可能发生。如果与睾丸萎缩和/或睾丸未降史有关,则在睾丸切除单侧睾丸肿瘤时可考虑对侧睾丸活检。
    We present three cases of bilateral metachronous testicular tumors. The patient in case 1 had a history of left orchiectomy for undescended testis at the age of 19. The pathological findings revealed germ cell neoplasia in situ. Twenty-four years later (age=43), he was diagnosed with right testicular tumor with lymph node and lung metastasis (stage IIIc). Right orchiectomy was performed, and the pathological finding showed nonseminomatous germ cell tumor. He underwent chemotherapy, followed by lymph node dissection and lung metastasectomy. The patient in case 2 had a history of left orchiectomy for testicular tumor at the age of 41. The pathological finding of the left testis revealed seminoma (stage IA). Nineteen years later (age=60), he was diagnosed with right testicular tumor and underwent right orchiectomy. Herein, the pathological finding showed seminoma (stage IA). The patient in case 3 had a history of right orchiectomy for testicular tumor at the age of 25. The pathological findings revealed seminoma (stage IS), and he underwent adjuvant radiation of the para-aortic field without subsequent recurrence. Fourteen years later (age=39), he was diagnosed with left testicular tumor and underwent left orchiectomy. The pathological finding revealed seminoma (stage IB). The patient underwent adjuvant carboplatin monotherapy to prevent recurrence. Due to the long interval between the occurrence of bilateral metachronous testicular tumors (mean=19 years ; three cases), long-term observation is necessary to detect the possible occurrence of contralateral testicular tumors. Contralateral testicular biopsy might be considered at the time of orchiectomy for unilateral testicular tumor if associated with testicular atrophy and/or a history of undescended testis.
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  • 文章类型: Case Reports
    背景:脊索瘤,一种罕见的由脊索组织引起的恶性肿瘤,通常发生在脊柱轴。只有少数已发表的原发性肺脊索瘤的报道。在这里,我们介绍了一例原发性肺脊索瘤,并讨论了诊断罕见脊索瘤的重要考虑因素。
    方法:我们报告一例39岁男性原发性肺脊索瘤,有睾丸混合生殖细胞卵黄囊肿瘤和畸胎瘤病史。计算机断层扫描显示左下叶缓慢生长的实性病变。我们对可疑生殖细胞肿瘤肺转移进行了楔形切除术。组织学上,大的圆形或卵圆形细胞与嗜酸性细胞的细胞质被大的细胞包围,颗粒,轻度嗜酸性细胞浆。肿瘤细胞为生唾液。免疫组织化学检查对短尾畸形呈阳性,S-100蛋白,上皮膜抗原,波形蛋白,和细胞角蛋白AE1/AE3,提示肺脊索瘤。睾丸混合生殖细胞肿瘤的重新检查未发现脊索元素。尽管某些区域的短尾染色呈阳性,苏木精和伊红(HE)染色未显示脊索瘤的典型形态特征。肺肿瘤的互补荧光原位杂交(FISH)证实不存在同染色体12p和12p扩增。因此,确定了原发性肺脊索瘤的最终诊断.
    结论:在有睾丸混合生殖细胞肿瘤病史的患者中,肺和睾丸肿瘤的HE和Brachyury染色的组织形态学比较,使用FISH分析肺肿瘤中的12p和12p扩增对于诊断罕见肺脊索瘤至关重要。
    BACKGROUND: Chordoma, a rare malignant tumor arising from notochordal tissue, usually occurs along the spinal axis. Only a few published reports of primary lung chordomas exist. Herein, we present a case of primary lung chordoma and discuss important considerations for diagnosing rare chordomas.
    METHODS: We report a case of primary lung chordoma in a 39-year-old male with a history of testicular mixed germ-cell tumor of yolk sac and teratoma. Computed tomography revealed slow-growing solid lesions in the left lower lobe. We performed wedge resection for suspected germ-cell tumor lung metastasis. Histologically, large round or oval cells with eosinophilic cytoplasm were surrounded by large cells with granular, lightly eosinophilic cytoplasm. Tumor cells were physaliphorous. Immunohistochemistry was positive for brachyury, S-100 protein, epithelial membrane antigen, vimentin, and cytokeratin AE1/AE3, suggesting pulmonary chordoma. Re-examination of the testicular mixed germ-cell tumor revealed no notochordal elements. Although some areas were positive for brachyury staining, hematoxylin and eosin (HE) staining did not show morphological features typical of chordoma. Complementary fluorescence in situ hybridization (FISH) of the lung tumor confirmed the absence of isochromosome 12p and 12p amplification. Thus, a final diagnosis of primary lung chordoma was established.
    CONCLUSIONS: In patients with a history of testicular mixed germ cell tumors, comparison of histomorphology using HE and Brachyury staining of lung and testicular tumors, and analyzing isochromosome 12p and 12p amplification in lung tumors using FISH is pivotal for the diagnosis of rare lung chordomas.
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    文章类型: Journal Article
    Testicular tumors are rarely reported in rabbits. In this case study, a 4-year-old Holland lop rabbit, previously diagnosed with unilateral cryptorchidism, was presented because of enlargement of the descended testis. The rabbit was clinically normal. Following unilateral orchiectomy and scrotal ablation, histopathological analysis revealed 2 distinct types of testicular tumor in the descended testis: a granular cell tumor and a seminoma. To the best of the author\'s knowledge, this is the first documented report of simultaneous testicular tumors in the testis of a rabbit with unilateral cryptorchidism.
    Tumeur à cellules granulaires et séminome simultanés dans le testicule descendu d’un lapin cryptorchideLes tumeurs testiculaires sont rarement rapportées chez le lapin. Dans cette étude de cas, un lapin Holland Lop de 4 ans, précédemment diagnostiqué avec une cryptorchidie unilatérale, a été présenté en raison d’une hypertrophie du testicule descendu. Le lapin était cliniquement normal. Après orchidectomie unilatérale et ablation scrotale, l’analyse histopathologique a révélé 2 types distincts de tumeur testiculaire dans le testicule descendu : une tumeur à cellules granuleuses et un séminome. À la connaissance de l’auteur, il s’agit du premier rapport documenté de tumeurs testiculaires simultanées dans le testicule d’un lapin atteint de cryptorchidie unilatérale.(Traduit par Dr Serge Messier).
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  • 文章类型: Editorial
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  • 文章类型: Letter
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  • 文章类型: Case Reports
    背景:恶性实体瘤的睾丸转移极为罕见。通常在睾丸标本的尸检或病理检查中偶然发现。因此,我们认为有必要报告患者的结肠癌睾丸转移病例。
    方法:我们报告了一名61岁的汉族男性患者,他在我们的诊所就诊,右睾丸进行性无痛性肿胀2年。正电子发射断层扫描-计算机断层扫描显示右睾丸中18F-氟代脱氧葡萄糖代谢增加,可能是由于远处转移。他以前的病史表明,他在4年前接受了腹腔镜辅助右半结肠切除术治疗升结肠癌。考虑到升结肠癌转移到右睾丸,我们通过腹股沟入路进行了右睾丸根治性切除术.术后组织学检查为肠转移性腺癌。
    结论:结肠癌转移到睾丸并不常见。该肿瘤的临床和影像学表现是非特异性的,所以诊断依赖于术后病理。如果发现睾丸转移,应遵循晚期结肠癌的治疗原则。
    BACKGROUND: Testicular metastasis from malignant solid tumors is extremely rare. It is usually found by chance during autopsy or pathological examination of testicular specimens. Therefore, we consider it necessary to report our patient\'s case of testicular metastasis from colon cancer.
    METHODS: We report a 61-year-old Han Chinese male patient who presented to our clinic with progressive painless swelling of the right testicle for 2 years. Positron emission tomography-computed tomography scans showed increased 18F-fluorodeoxyglucose metabolism in the right testicle, possibly owing to distant metastasis. His previous medical history suggested that he had undergone laparoscopic-assisted right hemicolectomy for ascending colon cancer 4 years ago. Considering the ascending colon cancer metastasis to the right testicle, we performed a right radical testicular resection through an inguinal approach. Postoperative histological examination showed intestinal metastatic adenocarcinoma.
    CONCLUSIONS: Colon cancer metastasis to the testes is uncommon. The clinical and imaging manifestations of this tumor are nonspecific, so the diagnosis relies on postoperative pathology. If testicular metastasis is found, treatment principles for advanced colon cancer should be followed.
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
    睾丸癌不成比例地影响育龄男性,使生育能力成为睾丸癌生存的重要方面。与普通人群相比,患有睾丸癌的男性精液参数异常更多,不育的发生率更高。睾丸癌的所有治疗选择都会对生育能力产生负面影响,恢复率因治疗而异。由于这些原因,临床医生应该提供精子冷冻保存,理想的是在睾丸切除术前,以最大限度地提高生物亲子关系的可能性,如果需要的话。一些创新对这一领域产生了积极影响,包括直接面向消费者的冷冻保存和台式研究,证明了治疗后重新引入睾丸细胞的可行性。
    Testicular cancer disproportionally affects men of reproductive age making fertility an important aspect of testicular cancer survivorship. Men with testicular cancer have more semen parameter abnormalities and a higher incidence of infertility compared to the general population. All treatment options for testicular cancer negatively affect fertility with recovery rates varying by treatment. For these reasons, clinicians should offer sperm cryopreservation, ideally before orchiectomy to maximize the possibility of biologic paternity, if desired. Several innovations have positively impacted this space including direct-to-consumer cryopreservation and bench research demonstrating the feasibility of reintroducing testicular cells post-therapy.
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