Adjuvant chemotherapy is of value following retroperitoneal lymph node dissection for nonseminomatous testicular tumors.
Explore the source record for details and available documents.
SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Retroperitonela lymph node dissection (RPLND), cisplatin-based chemotherapy, and tumor surveillance has dramatically improved survival of patients with non-seminomatous germ cell tumors. Complications, including renal vascular injuries, have been encountered with post-chemotherapy RPLND. We report on a patient with delayed renovascular hypertension and nephritic sediment following RPLND. A thirty year old man presented with well-controlled hypertension following treatment of a left testicular non-seminomatous germ cell tumor 11 years earlier. Post-orchiectomy investigation revealed retroperitoneal lymphadenopathy which was treated with cispaltin-based chemotherapy. A residual mass was managed surgically and during perihilar dissection, the left renal vein was injured and repaired. Current investigation revealed hypertension and a nephritic urine sediment, both of which resolved with left simple nephrectomy. We believe that inadvertent renal artery injury was responsible for this late complication.
Explore the source record for details and available documents.
A case of metastatic mesothelioma of the tunica vaginalis testis in a 57-year-old man is reported. Clinicopathological findings and treatment options are reviewed.
Conservative treatment with low-fat diet, medium-chain triglyceride or total parenteral nutrition, depending on the general condition of the patient, is the mainstay in the treatment of chylous ascites. In patients with persistent chylous fistula direct surgical closure is a valid treatment option.
Two cases of chylous ascites secondary to lymph node dissection for testicular tumors are presented. The diagnosis is confirmed by analysis of the fluid obtained by paracentesis, revealing fat globules, a positive staining with Sudan III, a smear showing mainly lymphocytes, and a high fat content. Treatment consisted of a medium chain triglycerides (MCT) diet, furosemide, and salt restriction.
We report our experience with 11 cases of yolk sac tumors, which were treated between 1960 and 1982 at the Hôpital Sainte-Justine and the Montreal Children's Hospital. The role of lymphadenectomy in yolk sac tumors is analyzed critically and put into perspective with the use of serum alpha-fetoprotein. A flow sheet is presented for the management of yolk sac tumors. It seems that the indication for lymphadenectomy in yolk sac tumor should be restricted to patients with persistently elevated serum alpha-fetoprotein after inguinal orchiectomy and chemotherapy.
Laparoscopic RPLND for clinical stage I testicular tumors is superior to open surgery in terms of efficiency, morbidity, and costs and has equal diagnostic accuracy. A quality of life study has shown that patients prefer surgery to chemotherapy and laparoscopy to open surgery. Laparoscopic RPLND is also feasible after chemotherapy, and the results are as good as those achieved in clinical stage I disease. Patients with stage IIb lesions can be spared the third and fourth cycle of chemotherapy if diagnostic laparoscopic RPLND is performed to exclude active tumor or remove mature teratoma. Laparoscopic removal of residual tumors following conventional chemotherapy for stage IIb lesions can be performed with minimal morbidity. The long and steep learning curve remains the biggest obstacle in laparoscopic RPLND. Most centers specializing in the treatment of testicular cancer are not trained in laparoscopic surgery and vice versa; however, the growing importance of laparoscopy for oncologic indications should help to overcome this problem in the near future.