Retroperitoneal Seminoma Research Articles

Tumor extragonadal de células germinales con fenómeno “burned-out” en testículo

AbstractThe “burned-out” phenomenon in germ-cell neoplasias is defined by the presence of an extragonadal germ-cell tumour with no tumour at the testis level where a series of distinctive histological lesions can be detected indicative of the earlier presence of an already disappeared testicle tumoration. Extragonadal germ-cell tumours with “burned-out” phenomenon show better evolution than their primary counterparts and are treated similarly to primary tumours of the testis. Currently, in the presence of retroperitoneal tumoration, a scrotal ultrasound study with high frequency transducers can lead to a suspected picture of tumoral involution. This paper contributes one retroperitoneal seminoma with “burned-out” phenomenon in the homolateral testis in a 35-year old patient. Available clinical and radiological criteria were enough to reach a suspected diagnosis. Homolateral orchiectomy and biopsy of retroperitoneal tumoration were performed, rounding treatment up with polychemotherapy. Evolution was good with immediate complete response.

Two cases of retroperitoneal seminoma secondary to “burned out” testicular tumour

Testicular tumours with locai regression and progressive retroperitoneal progressive metastases are rarely described in medicai literature with the term of “burned out” tumours. We present two cases of retroperitoneal metastases causing a symptomatology of retroperitoneal compression. Examination of the testis revealed no palpable abnormaiity. In both cases a fine needle biopsy of a retroperitoneal nodal mass was done. Microscopic examination revealed a typical seminoma. Scrotal sónography revealed the presence of a small asymptomatic testicular lesion on the same side as the retroperitoneal mass. In both cases a homolateral orchiectomy was done. At the histological study a fibrous scar was found without malignant neoplastic cells, so it was diagnosed a “burned out’ testicular tumour. The possibility of testicular origin must be considered in the presence of extragonadal germ cell tumours, even if the testes are without palpable abnormaiity.

Extragonadal germ cell tumors. A 14-year Toronto experience.

Extragonadal germ cell tumors (EGCT) represent only 2-5% of adult germ cell malignancies. Because they are rare and biologically distinct from testis cancer, their natural history and optimal management continue to be defined. The clinical characteristics, treatment, and outcome of 40 patients are presented here. Patients were identified through the medical records of four University of Toronto teaching hospitals. All patients were treated in specialized oncology units between 1978 and 1993. Thirty-seven males and three females age 16-54 years (median, 24 years) with primary mediastinal (n = 24), retroperitoneal (n = 7), CNS (n = 7), and widespread (n = 2) EGCT were identified. Eight of nine patients (88%) with mediastinal seminoma are alive with no evidence of disease (NED) at 4-132 months (median, 45 months). After combined modality therapy, only 8 of 15 patients (53%) with mediastinal nonseminomas achieved complete remission (CR); 1 experienced relapse and died, resulting in 7 of 15 patients (47%) with NED at 45-86 months (median, 70 months). All three patients with retroperitoneal seminomas achieved CR and all have NED at 77, 103, and 120 months, respectively. Two of four patients with retroperitoneal nonseminomas have died, and the other two are alive at 36 and 54 months. Seven patients with CNS germinomas (seminoma) achieved CR after craniospinal radiation therapy, but one subsequently died after local relapse. The overall survival rate was 87% (median, 74 months). One patient with widespread choriocarcinoma died and the other achieved CR. Regardless of site of presentation, extragonadal seminomas have a greater than 80% 5-year disease-free survival rate. Mediastinal nonseminomas are biologically distinct, with a poorer prognosis. Treated with cisplatin-based chemotherapy followed by aggressive resection, approximately 50% of patients survive. CNS seminomas have a good prognosis. Nonseminomas of the CNS are extremely rare and were not represented in the current series. These findings concur with other reported series.

An unusual case of retroperitoneal seminoma and fatal peliosis of the liver

We report an unusual case of fatal peliosis of the liver, spleen and lymph nodes in a 37-year-old man who had previously been treated for retroperitoneal seminoma with surgery and radiotherapy. The current hypotheses for the pathogenesis of peliosis are reviewed and discussed.

Large focal tumor-like demyelinating lesions of the brain: intermediate entity between multiple sclerosis and acute disseminated encephalomyelitis? A study of 31 patients.

Thirty-one patients with large, focal cerebral demyelinating lesions are reported. Twenty-four patients had solitary lesions and 7 had multiple foci, the latter apparently of identical age. The lesions presented clinically and radiologically as brain tumors (gliomas or metastases) or as multiple cysts. Six patients were older than 57 years (2 in their 70s) at the onset of their symptoms. The demyelinating nature of the lesions was established through biopsy in each patient and all improved significantly after corticosteroid therapy. Three patients developed additional lesions during the follow-up periods ranging from 9 months to 12 years consistent with the course of multiple sclerosis. Twenty-eight patients did not develop additional lesions. These included 6 patients with multiple lesions at the onset. In 1 of the patients, the first symptoms developed 10 days after receiving vaccination against influenza. Two patients had concomitant malignancy (chronic monomyelogenous leukemia and retroperitoneal seminoma respectively) and 1 patient developed immunoblastic sarcoma in the opposite hemisphere after biopsy diagnosis and steroid treatment of her demyelinating lesion. Tumor-like masses of demyelination may occupy an intermediate position between multiple sclerosis and postinfectious/postvaccination encephalitis. The clinical course (history of vaccination in one instance, acute onset, good response to corticosteroids, no clinical or radiological evidence of new lesions in the great majority of patients) favored postinfectious/postvaccination encephalitis. Lesion size however greatly exceeded that of the small foci of perivenous demyelination seen in typical postinfectious/postvaccination encephalitis and tended to present as space-occupying masses.

Retroperitoneal seminoma and intratubular germ cell neoplasia

A 30-year-old man with a 6-month history of flank pain was found to have a large retroperitoneal seminoma. A subsequent ultrasound examination revealed an inhomogeneous echo pattern in the normal-sized right testicle, which on orchiectomy showed extensive intratubular germ cell neoplasia. Level sectioning of the entire testicle revealed no extratubular extension of the tumor cells. The retroperitoneal and testicular lesions could represent double primaries. However, the possibility exists that an apparently intratubular germ cell neoplasm may not actually be an in situ lesion and that the retroperitoneal tumor in our case represents a metastasis from the intratubular germ cell neoplasia of the testicle.

Occult primary seminoma: Eighteen-year delay in presentation

Primary retroperitoneal seminoma is well documented. A case is reported in which a patient presented with a seminoma of testis eighteen years after removal of a retroperitoneal seminoma. Histologic appearance of the testis was identified to the original pathology, and it is proposed that this represents recurrence of an occult testicular seminoma.

Chemotherapy of metastatic seminoma.

Response to chemotherapy and survival was retrospectively analyzed in 28 patients with bulky retroperitoneal and disseminated seminoma treated between 1977 and 1983. The median age was 41 years (range: 23-52). All patients had histological evidence of pure testicular seminoma, however, 14 patients revealed moderate increases of human beta-chorionic gonadotropin levels. Prior radiotherapy had been given to 9/28 (32%) patients. Treatment consisted of at least four courses of simultaneous or sequentially alternating therapy with cisplatin, vinblastine, bleomycin plus/minus adriamycin (PVB +/- A), administration of ifosfamide or combination therapy with ifosfamide/cisplatin (IFS/DDP) or ifosfamide/etoposide (IFS/ETP). Twenty-five of 28 patients (89%) achieved a complete (CR), and 3/28 patients a partial remission. Relapse occurred in 1/8 CR patients after adjuvant postchemotherapeutic irradiation, and in 1/11 patients without any further radiotherapy. So far, 23/28 patients (82%) are free of disease after a median follow-up of 28+ (14+----82+) months. Marked myelosuppression was observed in previously irradiated patients, mainly after PVB +/- A therapy. In two patients, transient nephrotoxicity developed after PVB and IFS/DDP, respectively. After PVB +/- A chemotherapy, three patients revealed polyneuropathy, paralytic subileus and bleomycin-induced pneumonitis, respectively. In conclusion, the present series suggests a high probability of continuous CR in even bulky retroperitoneal and widespread metastatic seminoma. So far, no definite conclusions can be made on the therapeutic superiority of one of the different chemotherapeutic regimens used. However, this preliminary experience suggests that the combination of ifosfamide and etoposide or cisplatin may prove less toxic than sequentially alternating or simultaneous PVB +/- A chemotherapy.

Primary Retroperitoneal Seminoma Presenting as Renal Colic

We describe a case of primary retroperitoneal seminoma, presenting as intractable renal colic. Awareness of this entity might lead us to a correct preoperative diagnosis.

Ultrasound Identification of Impalpable Testicle Tumor

We describe an ultrasound technique that accurately detected an occult testicular primary in a young man with a large retroperitoneal seminoma. A simple water bath system and commonly available ultrasound equipment are used to provide high resolution scans and excellent patient acceptance.

Radiation therapy in bulky seminoma

Between 1969 and 1980. 17 patients with bulky retroperitoneal seminoma and 1 patient with bulky mediastinal seminoma were treated with radiation therapy. One patient had resection of gross retroperitoneal disease, and 1 patient had resection of gross mediastinal disease. Fifteen patients received adjuvant irradiation to the mediastinum and paraclavicular lymph nodes, and 1 patient received adjuvant chemotherapy. At last follow-up, 17 of 18 patients (94%) remain free of disease. No patient has sustained treatment-related morbidity or mortality.

Primary retroperitoneal seminoma.

In a retrospective review (1950-1975) of the Mayo Clinic experience with seminomas (483 cases), twelve patients (2.5%) were found to have a retroperitoneal seminoma without evidence of testicular involvement. The mean age was 47 years (range, 31-67). Eleven patients were treated by radiation alone, with doses ranging from less than 2,000-5,800 rads. Seven patients are alive with a median follow-up of six years. The median survival of the five that died is ten months. Good prognostic factors are typical histopathology and an encapsulated tumor. Poor prognostic factors are atypical histopathology, a nonencapsulated tumor, a symptomatic abdominal mass and a nonfunctioning kidney at the time of diagnosis. Although the review includes few patients, it seems reasonable to suggest irradiation of the tumor bed and para-aortic lymph nodes to a minimum dose of 2,000 rads. Prophylactic treatment of the mediastinum and supraclavicular lymph nodes should be considered if one or more of the poor prognostic factors are present.

Primary retroperitoneal seminoma

In a retrospective review (1950-1975) of the Mayo Clinic experience with seminomas (483 cases), twelve patients (2.5%) were found to have a retroperitoneal seminoma without evidence of testicular involvement. The mean age was 47 years (range, 31-67). Eleven patients were treated by radiation alone, with doses ranging from less than 2,000-5,800 rads. Seven patients are alive with a median follow-up of six years. The median survival of the five that died is ten months. Good prognostic factors are typical histopathology and an encapsulated tumor. Poor prognostic factors are atypical histopathology, a nonencapsulated tumor, a symptomatic abdominal mass and a nonfunctioning kidney at the time of diagnosis. Although the review includes few patients, it seems reasonable to suggest irradiation of the tumor bed and para-aortic lymph nodes to a minimum dose of 2,000 rads. Prophylactic treatment of the mediastinum and supraclavicular lymph nodes should be considered if one or more of the poor prognostic factors are present.

Retroperitoneal Seminoma

A case of retroperitoneal seminoma is discussed, emphasizing the importance of diagnosing the primary lesion. Although the testes were normal to palpation and exploration a focus of seminoma was recognized in the left testicle. We prefer radical treatment of this potentially curable disease.

Primary Extratesticular Seminoma in Non-Twin Brothers

Herein is reported the cases of non-twin brothers, 1 with primary mediastinal seminoma and the other with primary retroperitoneal seminoma. Both tumor types were histologically documented.

Diamminodichloroplatinum in the chemotherapy of testicular tumors.

No AccessJournal of Urology1 Jul 1974Diamminodichloroplatinum in the Chemotherapy of Testicular Tumors Donald J. Higby, H.J. Wallace, David Albert, and James F. Holland Donald J. HigbyDonald J. Higby More articles by this author , H.J. WallaceH.J. Wallace More articles by this author , David AlbertDavid Albert Current address:Sisters of Charity Hospital, Buffalo, New York 14214. More articles by this author , and James F. HollandJames F. Holland Current address:Sisters of Charity Hospital, Buffalo, New York 14214. More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)59652-4AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail © 1974 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited BySrougi M, Simon S and de Góes G (2018) Vinblastine, Actinomycin D, Bleomycin, Cyclophosphamide and Cis-Platinum for Advanced Germ Cell Testis Tumors: Brazilian ExperienceJournal of Urology, VOL. 134, NO. 1, (65-69), Online publication date: 1-Jul-1985.Richie J (2018) Editorial CommentJournal of Urology, VOL. 134, NO. 1, (69-69), Online publication date: 1-Jul-1985.Bracken R, Johnson D, Frazier O, Logothetis C, Trindade A and Samuels M (2018) The Role of Surgery Following Chemotherapy in Stage III Germ Cell NeoplasmsJournal of Urology, VOL. 129, NO. 1, (39-43), Online publication date: 1-Jan-1983.Mendenhall W, Williams S, Einhorn L and Donohue J (2018) Disseminated Seminoma: Re-Evaluation of Treatment ProtocolsJournal of Urology, VOL. 126, NO. 4, (493-496), Online publication date: 1-Oct-1981.Smith R, Dekernion J and Skinner D (2018) Management of Advanced Testicular SeminomaJournal of Urology, VOL. 121, NO. 4, (429-431), Online publication date: 1-Apr-1979.Whitmore W (2018) Editorial CommentJournal of Urology, VOL. 121, NO. 4, (431-431), Online publication date: 1-Apr-1979.Carey R, Weitzman S, Wilkins E, Chu A and Prout G (2018) Long-Term Unmaintained Remissions after Aggressive Multidisciplinary Treatment of Advanced Non-Seminomatous Testicular Germ Cell TumorsJournal of Urology, VOL. 118, NO. 4, (597-600), Online publication date: 1-Oct-1977.Einhorn L and Donohue J (2018) Improved Chemotherapy in Disseminated Testicular CancerJournal of Urology, VOL. 117, NO. 1, (65-69), Online publication date: 1-Jan-1977.Dekernion J and Lupu A (2018) The Response of Metastatic Retroperitoneal Seminoma to ChemotherapyJournal of Urology, VOL. 117, NO. 6, (736-738), Online publication date: 1-Jun-1977.E.E.F (2018) CommentJournal of Urology, VOL. 117, NO. 6, (738-738), Online publication date: 1-Jun-1977.Skinner D (2018) Non-Seminomatous Testis Tumors: a Plan of Management Based on 96 Patients to Improve Survival in All Stages by Combined Therapeutic ModalitiesJournal of Urology, VOL. 115, NO. 1, (65-69), Online publication date: 1-Jan-1976. Volume 112Issue 1July 1974Page: 100-104 Advertisement Copyright & Permissions© 1974 by The American Urological Association Education and Research, Inc.MetricsAuthor Information Donald J. Higby More articles by this author H.J. Wallace More articles by this author David Albert Current address:Sisters of Charity Hospital, Buffalo, New York 14214. More articles by this author James F. Holland Current address:Sisters of Charity Hospital, Buffalo, New York 14214. More articles by this author Expand All Advertisement PDF DownloadLoading ...

Testicular tumors: 40 years' experience.

No AccessJournal of Urology1 Nov 1973Testicular Tumors: 40 Years’ Experience D.A. Culp, D.L. Boatman, and V.B. Wilson D.A. CulpD.A. Culp More articles by this author , D.L. BoatmanD.L. Boatman More articles by this author , and V.B. WilsonV.B. Wilson More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)60277-5AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail © 1973 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited BySmith R, Dekernion J and Skinner D (2018) Management of Advanced Testicular SeminomaJournal of Urology, VOL. 121, NO. 4, (429-431), Online publication date: 1-Apr-1979.Whitmore W (2018) Editorial CommentJournal of Urology, VOL. 121, NO. 4, (431-431), Online publication date: 1-Apr-1979.Geller R, Kuremsky D, Copeland J and Stept R (2018) Sarcoidosis and Testicular Neoplasm: An Unusual AssociationJournal of Urology, VOL. 118, NO. 3, (487-488), Online publication date: 1-Sep-1977.Dekernion J and Lupu A (2018) The Response of Metastatic Retroperitoneal Seminoma to ChemotherapyJournal of Urology, VOL. 117, NO. 6, (736-738), Online publication date: 1-Jun-1977.Waldbaum R, Katz R, Susin M and Perlmutter M (2018) Late Recurrence of Testicular Tumor (choriocarcinoma)Journal of Urology, VOL. 116, NO. 2, (261-262), Online publication date: 1-Aug-1976.Skinner D (2018) Non-Seminomatous Testis Tumors: a Plan of Management Based on 96 Patients to Improve Survival in All Stages by Combined Therapeutic ModalitiesJournal of Urology, VOL. 115, NO. 1, (65-69), Online publication date: 1-Jan-1976. Volume 110Issue 5November 1973Page: 548-553 Advertisement Copyright & Permissions© 1973 by The American Urological Association Education and Research, Inc.MetricsAuthor Information D.A. Culp More articles by this author D.L. Boatman More articles by this author V.B. Wilson More articles by this author Expand All Advertisement Loading ...

Primary Retroperitoneal Seminoma without Gonadal Involvement: A Report of 3 Cases

Primary Retroperitoneal Seminoma without Gonadal Involvement: A Report of 3 Cases

Chemotherapy of germinal tumors.

Twenty-one evaluable patients with germinal tumors of the genital system were treated with a combination of vincristine, methotrexate, and melphalan. Tumor regression was obtained in three patients with seminoma of the testis, one with teratocarcinoma of the testis, two with choriocarcinoma of the testis, four with embryonal carcinoma of the testis, one with retroperitoneal seminoma, one with choriocarcinoma of unknown primary site, one with dysgerminoma of the ovary, and one with teratocarcinoma of the ovary. Because of a high incidence of toxicity and brevity of the responses in the patients with more malignant tumors, the program was changed to vincristine, methotrexate, and cyclophosphamide. Of 13 evaluable patients thus treated, one with seminoma of the testis, five with embryonal carcinoma of the testis, one with dysgerminoma of the ovary, and one with choriocarcinoma of the ovary had objective benefit. There was no improvement in toxicity or in duration of response. Four patients from the two programs currently continue in remissions longer than one year in duration.

RETROGRESSION IN TESTICULAR SEMINOMA WITH VIABLE METASTASES.

Stages in the retrogression of testicular seminoma are described. Eosinophilic necrosis fringed by palisaded histiocytes may be followed by fibrous replacement. Oxidation of unsaturated phospholipids in necrotic tumour may lead to deposition of lipofuscin around the lesion. Search for partially or completely scarred lesions is essential before contemplating a diagnosis of primary retroperitoneal seminoma. Retrogressed seminoma can often be distinguished from retrogressed teratoid tumours. Apparently paradoxical teratoid metastases in association with a testicular seminoma are explained on the basis of misinterpreted retrogressed teratoid tumours in association with the seminoma. Inguinal node metastases from testicular seminoma may be the result of abnormal lymphatic drainage following previous scrotal operations, testicular torsion etc.