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At least 667 records · Page 37Linked to original sources
PubMed1990

[Clinical studies on 29 cases of testicular tumors].

Clinical studies were performed on 29 cases of testicular tumors over the past 16 years. There were 14 cases of seminoma (S), 4 cases of E+Teratoma (T), 1 case of embryonal carcinoma (E), 1 case of E+STGC, 1 of S+E+T, 1 of S+E+ yolk sac tumor (Y) +choriocarcinoma (C) +STGC, 1 of mature teratoma, 6 of non-germ cell tumor. The stage of the germ cell tumors were stage I in 13 cases and stage II A in one case among 14 cases of seminoma, and stage I in 3 cases, stage II A in 3 cases, stage II B in one case, stage III in one case among 8 cases of non-seminoma. All of the patients underwent high orchiectomy. The seminomas were treated by radiotherapy and non-seminoma cases mainly by chemotherapy after retroperitoneal lymph nodes dissection (RPLND). Twenty one of 23 cases have survived, excluding one death (E+STGC, stage II A) and one unclear case. High orchiectomy and radiotherapy are the established procedures for the treatment of stage I seminoma. The significance of RPLND should decrease because of the high efficacy of current chemotherapy in cases of stage I and II A non-seminoma.

Adolescent↗
PubMed1990

[A case of erythropoietin-producing renal cancer].

A case of renal cell carcinoma with erythrocytosis is reported. A 58-year-old male had a right renal tumor with retroperitoneal lymph node and lung metastases. Preoperative laboratory data revealed a red blood cell count of 6.31 million/mm3, a hemoglobin concentration of 17.2 g/dl, a hematocrit of 52.1, and an erythropoietin (EPO) level of 47.3 mU/ml, which was determined by RIA method (normal range: 8-30). The patient underwent radical nephrectomy and retroperitoneal lymph node dissection without any blood transfusion because blood loss was only 300 g. The removed kidney weighed 400 g. Pathological examination showed a renal cell carcinoma not invading the fibrous capsule with lymph node metastasis. The EPO activities of extracts from the normal kidney and cancer tissues were less than 18 and 50.8 mU/g, respectively. At present, 3 months postoperatively, he receives daily UFT and HLBI every other day for the lung disease left, which does not change in size, and all laboratory data mentioned above have returned to normal ranges. These results enabled us to diagnose the present case as EPO-producing renal cell carcinoma.

Carcinoma, Renal Cell↗
PubMed1986

[Selection of treatment from a pathophysiological point of view. II: Studies on male urogenital tumors].

Testicular cancer is divided pathologically into two categories; seminoma and non-seminomatous germ cell tumor (NSGCT). Seminoma is a radio-sensitive tumor, so that radiation has been mainly used for stages I and II. Stage III seminoma is treated in the same way as NSGCT. Several years ago stages I and II NSGCT were treated primarily by retroperitoneal lymph node dissection. These days, chemotherapy, such as PVB, or VAB-6 therapy, is adopted as the first choice of treatment, followed by surgical intervention to elucidate the remaining bulky mass if present. Stage III NSGCT is also managed by chemotherapy. By these procedures 70-90% CR of patients with NSGCT is obtained. Prostatic cancer has been treated mainly according to its stages. As for stage A cancer palliative therapy has been shown to yield good results. However, in the case of poorly-differentiated tumors, local irradiation with anti-androgenic treatment should be employed. Stage B cancer should be treated by radical surgery. Local lymph node dissection is usually indicated. In addition local irradiation and anti-androgenic therapy should be considered. Most stage C or D patients do well for a while with antiandrogenic therapy. Within two or three years, however, drug resistance ensues, recessitating a change in the therapeutic modality. Treatments of choice include in chemotherapy, radiotherapy, and others. Treatment of penile cancer involves chemotherapy with bleomycin and irradiation, which result in considerable improvement.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

[Complete remission obtained in advanced testicular cancer treated by etoposide (NK-171)].

A 38-year-old man was admitted to Nara Medical University Hospital on Feb.7,1983, because of swelling of the scrotal contents on the right side and elevated serum AFP, beta-HCG and LDH suggestive of testicular tumor. Right orchiectomy was carried out and a pathological diagnosis of embryonal cell carcinoma of the right testis (pT3N0M1) was made. The patient, upon evidence of multiple pulmonary metastases, was treated with a combination chemotherapy of cis-Diamminedichloroplatinum, vincristine and peplomycin. After three courses of combination chemotherapy, pulmonary metastases were decreased, but their foci persisted. The patient was then treated with Etoposide 62 mg/m2 daily for 5 days every three weeks, and after this course, complete remission of pulmonary metastases was obtained. The patient recieved 3 courses of Etoposide and retroperitoneal lymph node dissection, and has since shown no evidence of disease for 2 years and 4 months after surgery.

Adult↗
PubMed1989

[Retrograde ejaculation from the urologic viewpoint and the current status of therapeutic possibilities].

The successful treatment of ejaculatory disturbances is an unresolved problem even today, especially in the patient group of young men after retroperitoneal lymph node dissection because of testicular cancer. A promising therapeutic measure is the treatment with alpha-sympathicomimetics as Pryleugan and Gutron. Pryleugan is recommended as a first- line treatment, whereas Gutron is indicated after failure of this initial therapy. After unsuccessful medical treatment a procedure of sperm production, conservation and insemination is presented. A close cooperation between urologists and gynecologists is necessary for higher therapeutic success rates in ejaculatory disturbances.

Ejaculation↗
PubMed1989

[A case of bilateral testicular tumor].

A case of bilateral germ cell tumor of the testis is reported. In 1988, a 36-year-old male presented with painless swelling of left scrotal contents. Right orchiectomy and retroperitoneal lymph node dissection for embryonal carcinoma had been performed 5 years earlier. Left orchiectomy was performed and its histological finding was seminoma and embryonal carcinoma. Evaluations including CT scan and Ga scintigraphy revealed no metastasis. Postoperatively, the patient was treated with PVB therapy. Previous reports of bilateral germ cell testicular tumor were reviewed, and the age distribution, interval, and histological classification of these cases are discussed.

Adult↗
PubMed1989

Rhabdomyosarcoma of the testis.

A case of pure rhabdomyosarcoma of the testis is reported. The origin of these tumors is discussed and it is believed that they are teratomas with rhabdomyoblastic overgrowth of the cells. Prophylactic retroperitoneal lymph node dissection is recommended at the time of the orchiectomy, in those cases where there is no evidence of lymph node metastases.

Adolescent↗
PubMed1989

[Autologous frozen sperm--an alternative in infertility in the patient with invasively treated testicular tumor?].

Through an optimal treatment of testicular cancer the life expectancy of patients is improved, but more early and late complications were observed after different therapeutic procedures and mainly fertility problems come to the fore. In 70% of the patients (n = 30) an abnormal spermiogram was found prior to treatment. At this time 54% of all patients with testicular cancer (n = 61) were 20 to 30 years old and 43% of these patients wish to have a child. After radical retroperitoneal lymph node dissection in 71% of cases (n = 45) a total or partial loss of ejaculation was found. The cytostatic chemotherapy and radiation treatment are the cause of reversible or irreversible reduction in spermatogenesis and possibly mutagenic alterations. There are several alternatives to treat the infertility problems of cured testicular cancer patients and autologous insemination is favoured by the half of these patients. In our experience with cryopreserved sperm (n = 22) only patients with appropriate sperm quality (greater than 10 Mill. sperms/ml, greater than 30% mobile sperms, greater than 30% thaw motility) are suited to this method. In consideration of these parameters only 25% of testicular cancer patients are suited for long-term sperm preservation. The technical problems of sperm preparation, storage and autologous insemination are described in detail.

Adult↗
PubMed1985

[Germ cell tumor of the testis--clinicopathologic analysis of 114 cases].

The histologic features and clinical records of 114 cases of germ cell tumors of the testis proved by pathology in our hospital from 1951 to 1980 are reviewed. These cases were divided into six types: seminoma 49.1%, embryonal carcinoma 8.8%, yolk sac tumor 17.5%, choriocarcinoma 0.9%, teratoma 14.9% and mixed carcinoma 8.8%. The over-all incidence of metastasis observed on exploration was 41.2%, and in embryonal and mixed carcinoma it was the highest, each amounting to 80%. Site of metastasis was: inguinal and retroperitoneal lymph nodes 63.8%, mesenteric lymph nodes 6.4%, liver 12.8%, lung 8.5% and supraclavicular lymph nodes 8.5%. In the 24 followed cases, 13 were seminomas and 11 non-seminomatous germ cell tumors. 5 of the former and 9 of the latter died of the tumor. It is advised that, in addition to radical orchiectomy, supplementary radiotherapy to the original site in the testis and the retroperitoneal draining lymphatics be given to seminoma and retroperitoneal lymph node dissection be given to non-seminomatous germ cell tumors except the pure choriocarcinoma to improve the result.

Adolescent↗
PubMed1988

Complicated problems in testicular cancer.

Although testicular cancer is a relatively rare disease, it nevertheless is extremely important, as it has become a model for a curable neoplasm. Cisplatin combination chemotherapy has revolutionized the cure rate in this once highly lethal disease: Today over 90% of all patients are cured of their disease, including an 80% cure rate in disseminated testicular cancer. However, these dramatic advances have created a new set of questions relating to the proper management of clinical stage I disease, challenging the role of retroperitoneal lymph node dissection (RPLND) in such patients. Despite the potential value of a surveillance policy, we continue to advocate routine RPLND for clinical stage I nonseminomatous germ cell tumors. Salvage chemotherapy has been refined and improved with the availability of new active agents such as ifosfamide. Dosage intensity is very important in oncology, and this concept is also being tested in refractory testicular cancer with very high-dose carboplatin plus etoposide with autologous bone marrow transplantation. We are currently in the enviable position in testicular cancer where we can now concentrate on small subsets of patients with advanced disseminated disease and evaluate innovative aggressive regimens. We expect future fine-tuning to provide continued improved therapeutic index in testicular cancer patients.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

[A case of intrascrotal rhabdomyosarcoma].

We report a case of intrascrotal rhabdomyosarcoma. A 15-year-old boy visited our clinic with the chief complaint of swelling of the right hemiscrotum. He had a history of fever and right hemiscrotal pain. With the initial diagnosis of acute epididymitis, the patient underwent medical therapy with antibiotics. One month later, because the mass had not responded to medical therapy, a right inguinal orchiectomy was done. Histologic examination revealed rhabdomyosarcoma. The patient received retroperitoneal lymph node dissection and combined chemotherapy with cyclophosphamide, bleomycin, actinomycin-D, adriamycin and vinblastine. He was well 5 years and 10 months postoperatively with no evidence of tumor recurrence or metastasis.

Combined Modality Therapy↗
PubMed1987

[Successful chemotherapy with adriamycin and methotrexate in a case of advanced transitional cell carcinoma of the ureter--a clinical application of subrenal capsule assay].

A case of advanced transitional cell carcinoma of the left ureter was treated with a combination of adriamycin and methotrexate. These drugs were selected using the subrenal capsule assay for which tumor tissues were obtained from a biopsy specimen of the left supraclavicular lymph node. Complete regression of left supraclavicular lymph node metastasis and 90% regression of para-aortic lymph node metastasis were obtained after four courses of the combination therapy. Subsequently, left total nephro-uretrectomy and retroperitoneal lymph node dissection were carried out. Pathological examination revealed the remains of tumor cells in the primary lesion and in the para-aortic lymph node. The tumor tissues obtained from the para-aortic lymph node were not susceptible to adriamycin and methotrexate. However, the tendency of the regression rates in the drug-treated groups was the same as that apparent before chemotherapy. Three courses of the same regimen as that given before surgery were then prescribed. The patient is currently alive with no evidence of disease. We therefore suggest the usefulness of the subrenal capsule assay for predictive chemosensitivity testing.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1985

[An operative case of spermatic cord rhabdomyosarcoma--with a review of similar cases in Japan].

A 17-year-old Japanese boy was admitted with the complaint of painless, progressive enlargement of the left scrotal contents during the preceding two months. The tumor was firm and nontender without transillumination. Orchitectomy with high ligatation of the spermatic cord was performed. The tumor, weighing 13.1 g, was gray, solid, located at the distal part of the spermatic cord, and separated from the testis and epididymis. The pathological diagnosis showed left spermatic cord rhabdomyosarcoma of the combined embryonal and alveolar type. All of the retroperitoneal lymph nodes dissected were negative for metastasis. The patient was treated with actinomycin D and vincristin postoperatively, and is well three years after the operation. Ninety-two cases of intrascrotal rhabdomyosarcoma reported in Japan are reviewed.

Adolescent↗
PubMed1979

Analysis of the feasibility of storing human semen for future artificial insemination.

Patients about to undergo vasectomy, retroperitoneal lymph node dissection, pelvic radiotherapy or chemotherapy frequently wish to store semen for future artificial insemination. The probability that this will result in a pregnancy is approximately 33% and the logistics are complicated. These problems are discussed and a cost analysis is presented. A list of semen banks presently storing homologous human semen and registered with the American Association of Tissue Banks also is presented.

Costs and Cost Analysis↗
PubMed1977

Germ cell tumors of the testes.

Most malignant testicular neoplasms are of germ cell origin. They are divided into five basic types: seminomas, embryonal carcinomas, teratocarcinomas, adult teratomas and choriocarcinomas. Clinically they may present as an enlarging testicular mass, or with symptoms resulting from metastases or hormonal secretions. The treatment of choice for patients with seminomas is orchiectomy, followed by radiation therapy. This combination results in an 80 to 100 percent five-year survival rate in patients with nonmetastatic or locally metastatic disease. The treatment of nonseminomatous germ cell tumors is more controversial. An aggressive approach, however, with retroperitoneal lymph node dissection and adjuvant chemotherapy has resulted in an overall 78 percent survival rate. Several placental and fetal proteins are secreted by these tumors. Two of these, human chorionic gonadotropin and alpha-fetoprotein, have been shown to be useful for the diagnosis of these neoplasms, for following the disease activity during therapy and for detection of recurrences.

Choriocarcinoma↗
PubMed1984

[Clinical outcome of adult testicular tumor. I. Study on patients of nonseminoma with negative human chorionic gonadotropin].

The outcome of clinical therapy of adult nonseminomatous testis tumor presenting with negative human chorionic gonadotropin (hCG) at our hospital is reported. Of 45 nonseminoma, 28 cases showed negative hCG and they had no chorionic element. Embryonal carcinoma was found in 14 cases (50%), teratoma in 5 cases (17.9%), and teratomatous mixed tumor in 9 cases (32.1%). The 5 year actuarial survivals were 94% for stage I disease, 40% for stage II and 16.6% for stage III. Prophylactic irradiation was given to the patient with stage I disease and no relapse occurred in the irradiated area, but later, neoplasms had spread by vascular dissemination in 3 cases (17.6%). In the treatment of stage II disease, radiotherapy has proved unsatisfactory and retroperitoneal lymph nodes dissection was a choice of modality. Of 11 patients with lung metastasis including vascular dissemination from stage II and III disease, 3 cases (27.3%) were cured by localized radiotherapy and chemotherapy of the pre-VAB regimen era.

Adult↗
PubMed1982

[Treatment of non-seminomatous testicular tumors in combination with vinblastine/bleomycin and adriamycin/cisplatin].

Following orchiectomy and retroperitoneal lymph node dissection (RND) 11 patients with non-seminomatous testicular cancer were treated alternately with combination chemotherapy consisting of vinblastine/bleomycin and adriamycin/cis-dichlorodiammineplatinum (II) (DDP). A total of 39 course of vinblastine/bleomycin and 36 course of adriamycin/DDP were administered. The two patients with disseminated testicular cancer came into complete and partial remission respectively. 1 patient with stage N3 and minor residual disease after RND, 7 patients with stages N1-2 and complete RND and 1 patient with stage N0, but chorio-carcinomatous portions in the testicular tumour show not sign of recidivation at present. The period of observation after orchiectomy ranges from 4 to 21 months, the median being 13 months. The side effects of chemotherapy are discussed in detail and both combinations are judged to be aggressive. The avoidance of DDP-nephrotoxicity by forced diuresis and the distinct and rapidly beginning intensification of the effect of phenprocoumon due to both regimens are stressed.

Antineoplastic Agents↗
PubMed1984

The place of surgery in the treatment of seminomatous testicular tumors.

Accepted indications for surgical intervention in the seminoma patient include, elevated beta HCG of greater than 30 international units, elevated alpha fetoprotein, the presence of mixed germinal tumor and in selected cases of recurrent seminoma and secondary primary seminoma. Questionable indications for surgical intervention include the diagnosis of anaplastic seminoma, any elevation of beta HCG and the presence of bulk disease. Clinical evidence does suggest that the combination of chemotherapy and debulking surgery for high stage seminoma allows for a superior survival of patients in this disease catagory. Its application to patients with low stage disease is largely theoretical, with only rare clinical reports supporting this hypothesis. A study of patients with low stage seminoma, randomizing such patients between retroperitoneal lymph node dissection and definitive radiation therapy appears to be indicated.

Chorionic Gonadotropin↗