scholarly journals Posterior retroperitoneoscopic resection of recurrent nonseminomatous tumor mass: a case report of the surgical procedure

2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
Çiğdem Öztürk ◽  
Harald J Hoekstra ◽  
Patrick H J Hemmer ◽  
Jourik A Gietema ◽  
Schelto Kruijff

Abstract Treatment of stage II–IV nonseminomatous testicular germ cell tumors (NSTGCTs) consists of cisplatin-based combination chemotherapy and, when present, resection of residual retroperitoneal tumor mass (RRTM) by conventional laparotomy or laparoscopy. In case of a retroperitoneal recurrence, a second conventional or laparoscopic procedure may be challenging. A case of late relapse after prior conventional resection of a RRTM and tailor-made surgical management with a posterior retroperitoneoscopic resection (PRR) is reported. A posterior retroperitoneoscopic RRTM resection was performed in a 26-year-old male with a history of stage IIC NSTGCT, presenting with a late left-sided retroperitoneal relapse, 6 years after initial treatment. Postoperative course was uneventful and at 1-year follow-up the patient had no evidence of disease. Reoperative surgery by a minimal invasive retroperitoneoscopic approach should be considered as an alternative for patients with a recurrent retroperitoneal tumor mass of a NSTGCT.

2011 ◽  
Vol 26 (2) ◽  
pp. 458-467 ◽  
Author(s):  
Çiğdem Öztürk ◽  
Robert J. van Ginkel ◽  
Ruby M. Krol ◽  
Jourik A. Gietema ◽  
Hendrik S. Hofker ◽  
...  

2007 ◽  
Vol 93 (5) ◽  
pp. 428-431
Author(s):  
Beatrice Detti ◽  
Lorenzo Livi ◽  
Silvia Scoccianti ◽  
Icro Meattini ◽  
Mauro Gacci ◽  
...  

Aims and Background Analysis of patients with late relapse of testicular germ cell tumors (GCTs) with reports on clinicopathological features and outcomes. Methods We identified all patients diagnosed with testicular GCTs at our Institute between 1988 and 2004 who developed relapse ≥24 months after completion of primary therapy. A retrospective case-note review was performed to extract clinical, pathological, treatment and outcome data. Results Six patients (1.25%) developed late relapse. All patients presented with stage I disease and were classified as “good risk” according to the International Germ Cell Consensus Classification. Mean time to late relapse was 48 months. Markers at late relapse were normal in all patients. Relapse was confined to retroperitoneal sites in five patients and located in the mediastinum in one patient. Five patients were managed by chemotherapy alone while one underwent combined treatment with surgery followed by chemotherapy. All patients obtained a complete response and all remained free from recurrence with a mean follow-up of 115 months. Conclusions The incidence of late relapse in this small series is low. Chemonaive patients with late relapse were successfully salvaged with chemotherapy alone or surgical excision followed by cisplatin-based chemotherapy. The optimal duration of follow-up in patients with testicular GCTs is not known and practice varies widely. At our Institute we advise lifelong follow-up of all patients with malignant GCTs of the testis.


1997 ◽  
Vol 4 (4) ◽  
pp. 321-327 ◽  
Author(s):  
Mariël E. Gels ◽  
Jan Marrink ◽  
Petra Visser ◽  
Dirk Th. Sleijfer ◽  
Jos H. J. Droste ◽  
...  

2019 ◽  
Vol 12 (2) ◽  
pp. 500-505
Author(s):  
Toshirou Fukushima ◽  
Takuro Noguchi ◽  
Takashi Kobayashi ◽  
Nodoka Sekiguchi ◽  
Takesumi Ozawa ◽  
...  

Patients with stage I testicular germ cell tumors have a long life expectancy, but the tumors have a potential to relapse after treatment. Although relapse is observed within a few years in most cases, late relapse over 10 years after initial treatment has also been reported in patients with stage I testicular germ cell tumors. We encountered a case of testicular seminoma that developed mediastinal lymph node metastasis 13 years after radical surgery for the primary tumor. The relapsed disease progressed rapidly and the patient died within 1 month due to respiratory failure without any chance for therapy. On postmortem examination, the thoracic lesions were pathologically confirmed to be metastases from the testicular seminoma with yolk sac tumor. Here, we report the clinical course and a review of the relevant literature. Based on our experience, we emphasize long-term follow-up and/or careful examination in patients with stage I testicular germ cell tumors.


Cancers ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 759
Author(s):  
Nina Mørup ◽  
Ewa Rajpert-De Meyts ◽  
Anders Juul ◽  
Gedske Daugaard ◽  
Kristian Almstrup

New microRNA-based serum biomarkers (miRNA-367-3p, -371a-3p, -372-3p, and -373-3p) have shown great potential for the detection of testicular germ cell tumors (TGCTs), but few studies have investigated the clinical utility and performance of these tests in treatment monitoring. In this study, circulating miRNA levels were measured, together with serum tumor markers alpha-fetoprotein (AFP), β-subunit of human chorionic gonadotropin (β-HCG) and lactate dehydrogenase (LDH) in 406 consecutive blood samples obtained during the treatment and follow-up of 52 TGCT patients at the Copenhagen University Hospital. After testing three different methods of RNA isolation from peripheral blood and PCR quantification in a subset of samples (n = 15), the best performing setup of targeted isolation of miRNAs inside and outside exosomes was selected to analyze all samples. At primary diagnosis, the miRNAs significantly outperformed the serum tumor markers, with a sensitivity and specificity of 78% and 100% (based on 40 patients), respectively. The picture was not as clear when patient trajectories were investigated, with both positive and negative signals for miRNAs and serum tumor markers. To establish whether measuring miRNAs adds value beyond the primary diagnosis, large prospective clinical trials comparing miRNAs and classical tumor markers during the treatment and follow-up of TGCT patients are needed.


1995 ◽  
Vol 13 (5) ◽  
pp. 1170-1176 ◽  
Author(s):  
J Baniel ◽  
R S Foster ◽  
R Gonin ◽  
J E Messemer ◽  
J P Donohue ◽  
...  

PURPOSE This study analyzed a large group of patients with testicular germ cell cancer in complete remission, who relapsed more than 2 years after completion of treatment. PATIENTS AND METHODS A review of all patients treated at Indiana University Medical Center from 1979 through 1992 for late relapse was conducted. Eighty-one patients were treated for late relapse of testicular cancer. Forty-seven patients relapsed more than 5 years after successful management of their initial disease. RESULTS At initial diagnosis, 35 patients had clinical stage I, 18 stage II, and 28 stage III disease. Twenty-three of 35 stage I, all 18 stage II, and all 28 stage III patients were treated by chemotherapy before their late relapse. The median follow-up duration of patients post-management of late relapse was 4.8 years. Twenty-one patients (25.9%) are continuously disease-free. Nineteen of these 21 patients had surgical resection of carcinoma or teratoma as a component of their therapy. Of sixty-five patients treated for late relapse by chemotherapy, 17 (26.2%) had a complete response, but only two have been continuously disease-free with chemotherapy alone. These two never received prior chemotherapy. CONCLUSION Late relapse of testis cancer is more common than previously thought. Surgery is the preferred mode of therapy. Chemotherapy has only modest success in this entity, in contrast to the excellent results in de novo germ cell tumors. Patients treated for testicular germ cell cancer need annual follow-up evaluations throughout their life due to the possibility of late relapse.


2015 ◽  
Vol 42 (3) ◽  
pp. 359-368 ◽  
Author(s):  
Matthew J. O’Shaughnessy ◽  
Darren R. Feldman ◽  
Brett S. Carver ◽  
Joel Sheinfeld

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10039-10039 ◽  
Author(s):  
J. Coffey ◽  
R. A. Huddart ◽  
A. R. Norman ◽  
D. Dudakia ◽  
M. R. Stratton ◽  
...  

10039 Background: Testicular germ cell tumors (TGCTs) account for 1% of all male cancers with increasing incidence rates documented. A family history of TGCT occurs in 2% of patients, conferring relative risks of 8–10 for brothers and 4–6 for fathers or sons of patients. These risks are high in comparison to other solid cancers and suggest that the risk of developing TGCT may be, at least in part, inherited rather than acquired. Methods: Pedigrees with >1 male family member with TGCT were identified from a tumor database and systematically collected from 1992. Patients donated samples and medical details with full informed consent and under ethical review board approval. Pedigree and medical data were obtained by interview, mail and telephone contact. Results: This series examines 78 pedigrees, containing 160 cases and 170 TGCTs. In the period 1994–2003 6% of all cases had a family history of TGCT. It includes 35 sib-pairs, 12 father-son pairs, 11 uncle-nephew pairs, 10 cousin pairs and 4 pedigrees with ≥ 3 cases of TGCT. The dataset contains 66 seminomas, 56 non-seminomas, 17 mixed histology, 1 CIS and 30 tumors of unconfirmed histology. The median age at diagnosis was 33 (range 17 to 87). The median difference in age at diagnosis between the cases in each pedigree was 6 years (0–58). Histology was concordant between family members in 22 of the 53 (41.5%) 2-case pedigrees. 11 pedigrees contained a case with bilateral TGCTs (6.9% of all cases, compared to 1.1% in the sporadic patient population, p<0.001) with 50% histological concordance. The median age at diagnosis of bilateral tumors was 32 (21–42) for the first tumor and 35 (26–49) for second tumors. 24 TGCT cases (15%, compared to an expected rate of 10%, p=0.045) reported a history of UDT. 9/162 (5.5%) of TGCT cases also developed non-TGCT cancers, including penile, bladder, colorectal, hepatic and pancreatic tumors. Conclusions: When systematic collection is undertaken the incidence of familial TGCT may be higher than previously reported. Familial cases have a higher incidence of UDT and bilateral disease. The majority of this set has been used in an international genome-wide linkage analysis to identify TGCT susceptibility genes. No significant financial relationships to disclose.


2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 14576-14576
Author(s):  
C. Theodore ◽  
S. Droupy ◽  
A. Laplanche ◽  
P. Wibault ◽  
K. Fizazi ◽  
...  

14576 Background: Surveillance is an alternative to retroperitoneal lymph node dissection or adjuvant chemotherapy for stage I M or NS TGCT. It has been shown to be associated with a low mortality rate of about 1%, similar to that of the other therapeutic options. However, there are few reports of long-term results. The aim of this retrospective study was to investigate late relapses in this setting. Methods: Screening of the computerized database from 1984 to 2005 for patients (pts) treated for a relapse of a M or NS TGCT at 10 years or more after an orchidectomy. Results: From 1994 to 2006, the files of 5 pts were retrieved. Two pts were referred from other institutions whereas 3 pts had initially been included in the surveillance program of the Institution out of a total of 88 from 1984 to 1996. (3.4% CI 95% 0.7–9.6). Initial histology was available in 4pts: it was pure mature and immature teratoma in one pt and mixed GCT with seminoma in 3 pts. There was no vascular invasion in any of the tumors. Relapse occurred between 10 and 13 years after orchidectomy (median 11 years). The diagnosis of relapse was made based on a systematic 10-year follow-up CT scan in one pt. The 4 other pts who relapsed presented with symptoms: abdominal and back pain due to retroperitoneal involvement in 2 pts, walking disability due to a spinal cord compression in one pt and acute respiratory distress syndrome due to massive metastatic lung involvement in one pt respectively. All 4 pts had bulky retroperitoneal masses. According to the IGCCCG classification, the prognosis was poor in 2 pts and intermediate in 2pts. One pt died of disease despite cisplatin-based chemotherapy. Conclusion: These data demonstrate that there is a small but clinically significant risk of late relapse of stage I M or NS GCT after orchidectomy alone and support the need for long-term surveillance and patient information. No significant financial relationships to disclose.


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