Table of Contents
1
UI - 11436104
AU - Ayash LJ; Clarke M; Silver SM; Braun T; Uberti J; Ratanatharathorn V;
TI -
Reynolds C; Ferrara J; Broun ER; Adams PT
Double dose-intensive chemotherapy with autologous stem cell support for
relapsed and refractory testicular cancer: the University of Michigan
experience and literature review.
SO - Bone Marrow Transplant 2001 May;27(9):939-47
AD - Department of Medicine, University of Michigan Medical Center,
University of Michigan Medical School, Ann Arbor, MI 48109-0914, USA.
Testicular cancer patients refractory or in relapse after primary
chemotherapy have < or =25% 5-year progression-free survival with
salvage. To improve prognosis, patients entered a phase I/II tandem
dose-escalation trial of carboplatin (1500-2100 mg/m(2)) and etoposide
(1200-2250 mg/m(2)) with ABMT. Patients were eligible for a second cycle
if disease progression was absent and performance status allowed. From
of ABMT, 10 were chemosensitive, four were chemoresistant, and 10 were
absolutely refractory to platinum. Disease status (no. patients) at
transplant: primary refractory disease (six), first relapse (10), second
relapse (eight), third relapse (five). Fifteen (52%) received both
transplants. Treatment-related mortality was 10%. Best response after
ABMT included: two CR, one CR surgically NED, five PR, three PR
surgically NED, seven SD, and eight PD. Eight (28%) patients are
continuously progression-free a median 60 months (range, 31-93) from
first ABMT. Three seminoma patients remain progression-free. Of five
long-term NSGCT survivors, four were treated in first relapse with
platinum-sensitive disease. Eighteen relapses occurred a median of 4
months after ABMT I (two late relapses at 28 and 44 months). The median
PFS and OS for the whole group are 4 and 14 months, respectively.
Patients with relapsed/ refractory testicular cancer benefit most from
ABMT if they have platinum-sensitive disease in first relapse. Patients
who do poorly despite ABMT have a mediastinal primary site, true
cisplatin-refractory disease, disease progression prior to ABMT, and/or
markedly elevated betaHCG at ABMT. New treatment modalities are needed
for the latter group.
2
UI - 11419169
AU - Narlawar RS; Shah JR; Parikh V; Patankar T
TI -
Persistent mullerian duct syndrome with teratoma in an ectopic testis:
imaging features.
SO - Eur Radiol 2001;11(6):955-8
AD - Department of Radiology, Seth G.S. Medical College and K.E.M. Hospital,
Parel, Mumbai, India. drranjeet@hotmail.com
The persistent mullerian duct syndrome represents a rare form of male
pseudohermaphroditism, secondary to mullerian inhibiting factor (MIF)
deficiency. We describe imaging findings in a 30-year-old male (46 XY
karyotype) with bilateral cryptorchidism and mullerian duct anomalies
(presence of uterus and fallopian tubes). Grade-III teratoma with yolk
sac tumour was detected in one of the undescended testis, lying in the
pelvic cavity. The other testis was in the inguinal canal. The rest of
the wolffian duct structures (e.g. prostate, seminal vesicles) were
nearly normal. Very few reports of imaging findings of this entity have
been published thus far, probably because of the rarity of entity,
incidental detection of most of the cases at surgery and relatively
asymptomatic clinical presentation.
3
UI - 11455834
AU - Mola Arizo MJ; Navarro Anton JA; Gomez Castro A; Gonzalvo Perez V; Canto
TI -
Faubel E; Llopis Guixot B; Botella Almodovar R; Beltran Meseguer JF;
Polo Peris AC
[Total androgenic insensitivity syndrome. Presentation as giant inguinal
mass]
SO - Actas Urol Esp 2001 Apr;25(4):303-6
AD - Servicio de Urologia, Hospital Lluis Alcanyis, Xativa, Valencia.
The androgen insensitivity syndrome is the most frequent form of
masculine psedohermafroditism. The affected patients present female
phenotype without sexual ambiguity but with karyotype 46 XY. In this
syndrome the frequency of malignizacion of the testicles increases
progressively with the age, because of this, the importance of an
earlier diagnosis. We present a case of later diagnosis late of the
androgen insensitivity syndrome, that debut with a great inguinal mass.
4
UI - 11337274
AU - Poulopoulos AK; Antoniades K; Kiziridou A; Antoniades V
TI -
Testicular embryonal carcinoma metastatic to the labial mucosa of the
upper lip.
SO - Oral Oncol 2001 Jun;37(4):397-9
AD - Department of Oral Medicine and Pathology, Dental school, Aristotle
University of Thessaloniki, Thessaloniki, Greece.
An unusual case of testicular embryonal carcinoma metastatic to the
labial mucosa of the upper lip is reported. The clinical features and
the management of the metastatic oral lesion are presented. In patients
with known systemic malignancy, oral swellings may be an indication of a
metastatic deposit.
5
UI - 11517827
AU - Borri A; Nesi G; Bencini L; Pernice LM
TI -
Bizarre leiomyoma of the epididymis. A case report.
SO - Minerva Urol Nefrol 2000 Mar;52(1):29-31
AD - Department of General Surgery, University of Study, Florence.
A case of epididymal leiomyoma with bizarre nuclei is described. A
48-year-old man presented with a painless scrotal mass raising the
suspicion of a testicular neoplasm. A seven-year follow-up revealed no
evidence of local recurrence or distant metastasis. To personal
knowledge, this is the first reported case of bizarre leiomyoma of the
epididymis.
6
UI - 11517828
AU - Ferri E; Azzolini N; Sebastio N; Salsi P; Meli S; Cortellini P
TI -
[Unusual case of mesothelioma of the tunica vaginalis associated with
prostatic adenocarcinoma]
SO - Minerva Urol Nefrol 2000 Mar;52(1):33-5
AD - Divisione di Urologia, Azienda Ospedaliera, Parma.
emanuela_ferri@hotmail.com
Malignant mesothelioma of the tunica vaginalis testis, is a very rare
neoplasm with highly aggressive biological behaviour. It usually occurs
in patients aged between 55 and 75 years. A testicular mass is always
observed, often accompanied with hydrocele. The response to chemotherapy
and radiotherapy is poor. Initial aggressive surgery is necessary. The
median survival, without surgical treatment is 23 months. A rare case of
malignant mesothelioma of the tunica vaginalis testis, observed in a
patient affected by prostate neoplasm is reported. A radical retropubic
prostatectomy was performed. The patient was suffering from dysuria and
there was a suspect area at the digital examination. Rectal
ultrasonography and biopsy showed an adenocarcinoma at T1c clinical
stage. A radical prostatectomy was carried out and histology showed an
adenocarcinoma, Gleason score 7 pT3bN0M0. Surgery was followed by
radiation therapy. After three years, a pleural seroma, a cutaneous mass
and testicular nodule were observed and cytological examination showed
endothelial cells. Scrotal orchiectomy was performed, because he was
suffering from emphysema. Cytological examination confirmed malignant
mesothelioma of the tunica vaginalis testis. Only 73 cases of this
tumour have been reported in the last 30 years. The therapeutic options
for this aggressive neoplasm are discussed. Since chemotherapy and
radiation therapy had poor results, a rapid surgical treatment, by
radical orchiectomy, is important.
7
UI - 11528637
AU - Trobs RB; Hoepffner W; Friedrich T; Bennek J
TI -
Growth-arrest and inhomogenous echotexture of the affected testis after
tumor enucleation for unilateral Leydig cell tumor.
SO - J Pediatr Surg 2001 Sep;36(9):E20
AD - Departments of Pediatric Surgery, Pediatrics, and Pathology, University
of Leipzig, Germany.
The authors report on an 8-year-old boy with unilateral left-sided
Leydig cell tumor. After enucleation of the tumor, endocrine
disturbances resolved. Long-time follow-up for more than 7 years was
characterized by growth-arrest of the affected gonad and the unchanged
appearance of a circumscribed hypoechogenic residual lesion within the
testis. Copyright 2001 by W.B. Saunders Company.
8
UI - 11533096
AU - De Santis M; Bokemeyer C; Becherer A; Stoiber F; Oechsle K; Kletter K;
TI -
Dohmen BM; Dittrich C; Pont J
Predictive impact of 2-18fluoro-2-deoxy-D-glucose positron emission
tomography for residual postchemotherapy masses in patients with bulky
seminoma.
SO - J Clin Oncol 2001 Sep 1;19(17):3740-4
AD - Department of Medical Oncology and Luwdig Boltzmann Institute for
Applied Cancer Research, Kaiser Franz Josef Spital, Wien, Austria.
PURPOSE: To establish the predictive potential of
2-18fluoro-2-deoxy-D-glucose positron emission tomography (FDG PET) for
detecting viable tumor tissue in residual postchemotherapy masses of
seminoma patients. PATIENTS AND METHODS: In this prospective multicenter
trial, results of FDG PET studies in seminoma patients with
postchemotherapy masses > or = 1 cm were correlated with either the
histology of the resected lesion or the clinical outcome on follow-up
without resection. Negative PET scans of residual lesions that were
devoid of viable tumor tissue on resection or disappeared, shrunk, or
remained stable in size for at least 2 years were rated as true-negative
(TN). Positive scans without histologic or clinical evidence of tumor
tissue were classified as false-positive. In patients with
histologically positive or progressive lesions, positive PET scans were
defined as true-positive (TP) and negative scans, false-negative (FN).
RESULTS: Thirty-seven PET scans of 33 patients were assessable at a
median follow-up time of 23 months (range, 2 to 46 months). Histologic
data were available from nine patients who had undergone resection.
Twenty-eight patients were followed-up clinically and radiologically.
Twenty-eight scans were TN, eight were TP, and one was FN. All 14
residual lesions more than 3 cm and 22 (96%) of the 23 < or = 3 cm were
correctly predicted by FDG PET. The specificity (100%; 95% confidence
interval [CI], 87.7% to 100%), sensitivity (89%; 95% CI, 51.7% to
99.7%), positive predictive value (100%), and the negative predictive
value (97%) of FDG PET were superior to data obtained by assessing
residual tumor size (< or = or > 3 cm). CONCLUSION: FDG PET is a
clinically useful predictor of viable tumor in postchemotherapy
residuals of pure seminoma, especially those greater than 3 cm.
9
UI - 11549508
AU - Hara S; Miyake H; Nakamura I; Arakawa S; Kamidono S; Hara I
TI -
Increased Fas ligand expression in the tumor tissue and serum of
patients with testicular germ cell tumors with seminomatous elements.
SO - Urology 2001 Sep;58(3):471-6
AD - Department of Urology, Kobe University School of Medicine, Kobe, Japan.
OBJECTIVES: To measure the expression levels of Fas and Fas ligand
(FasL) in testicular germ cell tumor (TGCT) and to determine whether the
serum level of soluble FasL (sFasL) could be used as a marker for
patients with TGCT. METHODS: The expression of Fas and FasL in 51
specimens obtained from patients with TGCT was examined by reverse
transcriptase-polymerase chain reaction, and the results were confirmed
by Western blot analysis. The serum levels of sFasL in 24 patients with
TGCT were measured using an enzyme-linked immunosorbent assay system.
RESULTS: Of 33 TGCT specimens that included seminomatous elements, Fas
and FasL was expressed in 24 (73%) and 24 (73%), respectively. On the
other hand, 10 (56%) and 2 (11%) specimens expressed Fas and FasL,
respectively, in 18 TGCT specimens without seminomatous elements.
Moreover, the serum levels of sFasL were significantly higher in
patients with TGCT with a seminomatous element than in those without it.
CONCLUSIONS: These results indicate that FasL is strongly expressed in
tumor tissue and is present at high levels in the serum of patients with
TGCT with a seminomatous element compared with those without it and that
the serum levels of sFasL could be used as a novel diagnostic marker for
TGCT with seminomatous elements.
10
UI - 11564217
AU - Kurabayashi A; Furihata M; Matsumoto M; Sonobe H; Ohtsuki Y; Aki M;
TI -
Kuwahara M
Primary intrapelvic seminoma in Klinefelter's syndrome.
SO - Pathol Int 2001 Aug;51(8):624-8
AD - Department of Pathology II, Kochi Medical School, Nankoku, Kochi
783-8505, Japan.
Seminoma arising in patients with Klinefelter's syndrome is extremely
rare; to our knowledge, only three cases have been reported in the
English language literature. We report a case of intrapelvic seminoma in
a 39-year-old man with Klinefelter's syndrome. Gross examination
revealed that the tumor was a solid and irregular mass measuring 90 mm
in diameter. The cut surfaces of this ill-defined tumor were
yellow-white with necrotic foci. Histologically, the tumor cells were
separated into lobules by branching, fibrous septa containing
lymphocytes. In some parts of the tumor, a cord-like arrangement of
tumor cells was present. Immunohistochemically, the tumor cells were
strongly and diffusely positive for antiplacental alkaline phosphatase
antibody along their cytoplasmic membranes, but negative for both
chorionic gonadotrophin and alpha-fetoprotein. Based on these findings,
we diagnosed this tumor as a seminoma. The testes when examined were
found to be atrophic bilaterally, but with no tumor lesions. Chromosomal
analysis yielded a 47XXY karyotype, compatible with Klinefelter's
syndrome. These findings indicate a case of primary intrapelvic seminoma
in Klinefelter's syndrome. The patient underwent intensive radiation
therapy postoperatively, and he demonstrated no evidence of recurrence
or metastasis during the 13-month period following surgery.
11
UI - 11574759
AU - Schrader M; Heicappell R; Muller M; Straub B; Miller K
TI -
Impact of chemotherapy on male fertility.
SO - Onkologie 2001 Aug;24(4):326-30
AD - Department of Urology, University Hospital Benjamin Franklin, Free
University of Berlin, Germany. schrader@medizin.fu-berlin.de
Testicular tumors and malignant lymphomas are, with increasing
incidence, the most frequent malignant diseases in men between the age
of 15 and 34. With the introduction of cisplatin-based polychemotherapy,
cure rates rose to over 90% in patients with germ cell tumors and were
comparably favorable at around 80% in those with malignant lymphomas. In
view of these high cure rates, increasing clinical importance is
attached to chemotherapy induced fertility disorders. One problem
involved in assessing the influence of chemotherapy on fertility is the
fact that the malignant disease itself strongly alters spermatogenesis.
This complicates an evaluation of the effect of cytostatic therapy on
fertility disorders. There are significant cytostatic- and dose-specific
differences. Longterm infertility due to cytostatic therapy may be
expected in more than 50% of the patients at a cumulative dose of
cisplatin > 0.6 g/m(2), cyclophosphamide > 6 g/m(2), and procarbazine
>/= 4 g/m(2). However, it takes up to 3 years or more for
spermatogenesis to recover after the termination of chemotherapy. An
individual assessment of the post-therapeutic fertility status is
extremely limited, since variance of the pretherapeutic fertility status
causes interindividual differences, and the numerical data mentioned
above only permit a vague estimation. Before patients undergo cytostatic
therapy, cryopreservation of germ cells should thus be suggested or, in
some cases, testicular extraction of spermatozoa. Copyright 2001 S.
Karger GmbH, Freiburg
12
UI - 11574772
AU - Cohn DA; Stuart-Harris R
TI -
Isolated central nervous system relapse of non-seminomatous germ cell
tumour of the testis. A case report and review of the literature.
SO - Oncology 2001;61(3):184-8
AD - Medical Oncology Unit, The Canberra Hospital, Canberra, Australia.
Isolated central nervous system (CNS) relapse of non-seminomatous germ
cell tumour (NSGCT) of the testis has been reported in only 12 patients
previously. We report a patient with an isolated CNS relapse of NSGCT,
following a prior systemic relapse. From a review of previous cases,
isolated CNS relapse appears to be more common in patients with
embryonal cell histology (alone or mixed with other elements) and
occurred after a median of 8.5 months following initial presentation.
Long-term survival appears possible using multi-modal treatment with
whole-brain radiotherapy, surgery and/or chemotherapy. However, the
optimal treatment of isolated CNS relapse remains undefined. Copyright
2001 S. Karger AG, Basel
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UI - 11597804
AU - Zagars GK; Pollack A
TI -
Radiotherapy for stage II testicular seminoma.
SO - Int J Radiat Oncol Biol Phys 2001 Nov 1;51(3):643-9
AD - Department of Radiation Oncology, University of Texas M. D. Anderson
Cancer Center, Houston, TX 77030, USA.
PURPOSE: To compare the outcome of patients with Stage II seminoma
treated with prophylactic mediastinal irradiation, without any
supradiaphragmatic irradiation, and with prophylactic left
supraclavicular irradiation (PLSCI). METHODS AND MATERIALS: Between 1960
and 1999, 73 men with Stage II seminoma received postorchiectomy
radiotherapy. Before 1984, 36 received prophylactic mediastinal
irradiation (Series I); between 1984 and 1992, 17 received no
supradiaphragmatic irradiation (Series II); and after 1992, 20 received
PLSCI (Series III). The outcomes in these series were compared. RESULTS:
The abdominal tumor sizes were as follows: Series I,
UI - 11597562
AU - Lutke Holzik MF; Sonneveld DJ; Hoekstra HJ; te Meerman GJ; Sleijfer DT;
TI -
Schaapveld M
Do the eastern and northern parts of The Netherlands differ in
testicular cancer?
SO - Urology 2001 Oct;58(4):636-7
UI - 11675968
AU - Benchekroun A; Jira H; Ghadouane M; Kasmaoui EH; Marzouk M; Faik M
TI -
[Paratesticular malignant mesothelioma. Report of a new case]
SO - Ann Urol (Paris) 2001 Sep;35(5):293-5
AD - Clinique urologique A, hopital Avicenne, CHU de Rabat, Rabat, Maroc.
Malignant mesothelioma of the tunica vaginalis is a rare and aggressive
tumor. It appears that surgery have a high value in the treatment. We
report a case of malignant mesothelioma of the tunica vaginalis in 65
years old patient and a review of the literature is presented.
UI - 11675969
AU - Kasmaoui E; Jira H; Alami M; Ghadouane M; Ameur A; Abbar M
TI -
[Paratesticular rhabdomyosarcoma. Three case reports]
SO - Ann Urol (Paris) 2001 Sep;35(5):296-300
AD - Service d'urologie, hopital militaire d'instruction Mohamed V, Rabat,
Maroc.
Paratesticular rhabdomyosarcoma is a rare and highly aggressive tumor.
The authors discuss the diagnosis and therapeutic problems raised by
this lesion and report three cases with a review of the literature.
UI - 11607856
AU - Klatt S; Jellinghaus W; Beckh K
TI -
[Initial symptoms of hyperthyroidism in a young man with lumbar pain]
SO - Dtsch Med Wochenschr 2001 Oct 19;126(42):1168-70
AD - Abteilung Innere Medizin II, Stadtkrankenhaus Worms.
UI - 11675318
AU - Sriprasad S; Kooiman GG; Muir GH; Sidhu PS
TI -
Acute segmental testicular infarction: differentiation from tumour using
high frequency colour Doppler ultrasound.
SO - Br J Radiol 2001 Oct;74(886):965-7
AD - Department of Urology, Kings College Hospital, Denmark Hill, London SE5
9RS, UK.
Segmental testicular infarction is rare, of variable aetiology but
usually idiopathic. B-mode ultrasound may demonstrate a focal mass
indistinguishable from a testicular tumour, with confirmation only
achieved following surgery. We report a case of segmental testicular
infarction presenting as a heterogeneous mass on B-mode ultrasound,
confidently diagnosed as an area of infarction on high frequency colour
Doppler ultrasound and proven on histology. The pre-operative
differentiation of tumour from segmental infarction allows
testis-sparing surgery.
UI - 11688573
AU - Fisher C; Goldblum JR; Epstein JI; Montgomery E
TI -
Leiomyosarcoma of the paratesticular region: a clinicopathologic study.
SO - Am J Surg Pathol 2001 Sep;25(9):1143-9
AD - Department of Pathology, the Royal Marsden NHS Trust, London, UK.
cfisher@icr.ac.uk
The behavior of leiomyosarcoma (LMS) is site related, but there are
limited data on such tumors presenting in the paratesticular region.
Cases diagnosed as LMS of the paratesticular region from the files of
three institutions were reviewed. Immunohistochemistry was performed in
cases with available blocks, and follow-up information was obtained.
From 31 cases originally diagnosed as LMS, 24 were retained after
review. These were from men aged 34-86 years (mean 62 years; median 64
years) and involved the testicular tunica (10), spermatic cord (10),
scrotal subcutis and dartos muscles (1 each), and the epididymis (1).
Tumors ranged in size from 2-9 cm (mean 5 cm; median 4 cm). On
immunohistochemical staining they expressed muscle-specific actin (13 of
14), smooth muscle actin (10 of 10), desmin (16 of 17), and CD34 (3 of
9); all of the latter three were strongly desmin-positive. Focal
reactivity for cytokeratin (3 of 8) and S-100 protein (1 of 8) was seen.
Follow-up information was available in 14 patients. Four (29%) had
recurrences, in one case four times. Metastases to lymph nodes, lungs,
or liver were seen in four patients (29%), of whom two had prior
recurrences. Ten were alive with no evidence of disease (ANED), and four
were dead of disease (DOD). Comparing outcome with tumor grade, all
seven patients with grade 1 tumors (of whom two had recurrences) and all
three with grade 2 tumors were ANED, whereas all four patients with
grade 3 tumors were DOD. In summary, paratesticular LMSs are rare
neoplasms. The majority in this site are low-grade, although high-grade
lesions behave aggressively.
UI - 11688457
AU - Venara M; Rey R; Bergada I; Mendilaharzu H; Campo S; Chemes H
TI -
Sertoli cell proliferations of the infantile testis: an intratubular
form of Sertoli cell tumor?
SO - Am J Surg Pathol 2001 Oct;25(10):1237-44
AD - Endocrinology Division, Children's Hospital Ricardo Gutierrez, CONICET,
Buenos Aires, Argentina. hchemes@cedie.guti.gov.ar
We report on six boys with intratubular Sertoli cell proliferations
(ISCPs), studied by routine histologic methods, electron microscopy, and
immunohistochemistry of anti-mullerian hormone (AMH), inhibin
alpha-subunit, 3beta-hydroxysteroid dehydrogenase (3beta-HSD),
proliferative cellular nuclear antigen, and p53, and carefully followed
for extended periods with periodic clinical examinations, testicular
ultrasonographies, and determinations of serum levels of AMH and inhibin
B. Peutz-Jeghers syndrome was found in four of six patients, and
gynecomastia occurred in five of six patients. One boy had isosexual
pseudoprecocity. ISCPs were observed as multiple foci of seminiferous
tubules with large and proliferated Sertoli cells replacing germ cells
and limited by the basement membrane. Mitotic figures, atypia, and/or
interstitial invasion were not observed. Bilateral ISCPs were the only
pathologic finding in three patients (patient nos. 1-3) and were
associated with a microscopic tumor that resembled a large-cell
calcifying Sertoli cell tumor (LCCSCT) in a fourth patient (patient no.
4). In the two remaining patients (patient nos. 5 and 6) ISCPs and
LCCSCT were found in both testes. Ultrastructural examination showed
large Sertoli cells, with round nuclei, sparse organelles, and some
glycogen. Inhibin alpha-subunit immunolocalization was positive in the
five patients in whom it was determined (patient nos. 2-6), AMH was
positive in those ISCPs associated with tumors (patient nos. 4-6) and
negative in isolated ISCPs (patient nos. 2 and 3); 3beta-HSD and PCNA
were variable, and p53 was negative in all ISCPs. Patient nos. 1-4 have
been followed for 2-19 years. One of them is currently entering puberty,
the other two have already completed puberty and have testes of normal
size, and the remaining one is an adult with clinically normal testes
and sperm production. None of these patients had evidence of tumor
development during follow-up as shown by serial ultrasonographies and
serum levels of AMH and inhibin B. Patient nos. 5 and 6 who had
bilateral ISCPs and LCCSCT were orchidectomized and evolved for 2-10
years after surgery without tumor recurrence. The prognostic
significance of ISCPs, particularly when they are the only pathologic
finding in a testicular biopsy, is a matter of controversy. Based on the
long normal evolution, we recommend a conservative approach to therapy.
The bilateral and multicentric character of ISCPs and their association
with Sertoli tumors and Peutz-Jeghers syndrome suggest that they
represent either proliferative lesions with tumorigenic potential or the
intraepithelial stage in the evolution of some testicular Sertoli cell
tumors.
UI - 11688466
AU - Butnor KJ; Sporn TA; Hammar SP; Roggli VL
TI -
Well-differentiated papillary mesothelioma.
SO - Am J Surg Pathol 2001 Oct;25(10):1304-9
AD - Department of Pathology, Duke University Medical Center, Durham, North
Carolina 27710, USA. butno001@mc.duke.edu
Well-differentiated papillary mesothelioma is an unusual variant of
epithelial mesothelioma considered to be of low malignant potential. The
majority of previously reported cases developed in the peritoneum of
young women without a history of asbestos exposure. The authors report
14 cases of well-differentiated papillary mesothelioma, seven of which
originated in the pleura, six in the peritoneum, and one in the tunica
vaginalis. Eleven of the patients were male and three were female, with
an average age at presentation of 58 years (range 32-82 years). Six of
the patients had a quantifiable history of asbestos exposure. Of the
nine cases with complete follow-up, six had clinically indolent disease,
one showed resolution after adjuvant chemotherapy, one pursued an
aggressive course, and one died of other causes. These findings indicate
that well-differentiated papillary mesothelioma is a rare variant of
mesothelioma with a variable clinical prognosis that is etiologically
related to asbestos exposure in some cases.
UI - 11678751
AU - Adshead J; Khoubehi B; Wood J; Rustin G
TI -
Testicular implants and patient satisfaction: a questionnaire-based
study of men after orchidectomy for testicular cancer.
SO - BJU Int 2001 Oct;88(6):559-62
AD - Department of Urology, Watford NHS Trust, Linda Jackson Centre and
Department of Medical Oncology, Mount Vernon Hospital, Middlesex, UK.
OBJECTIVES: To assess the satisfaction of men with their testicular
implants after undergoing orchidectomy for testicular cancer, and to
determine their reasons for accepting or declining a prosthesis.
PATIENTS AND METHODS: In all, 424 men who had undergone radical
orchidectomy and were part of the testicular cancer follow-up programme
were sent an anonymous questionnaire comprising 10 questions covering
two main areas. First, the reasons for accepting or declining an implant
and second (if they received an implant) their satisfaction with the
size, position, feel, shape and overall comfort; 234 men (55%)
responded. RESULTS: About a third (71 men) accepted an implant, a third
declined and a third were not offered the choice. Of the men who replied
91% felt that it was extremely important to be offered an implant at the
time of surgery. Of the 71 who received an implant, 19 (27%) were
dissatisfied and felt that they had an average or poor cosmetic result.
The reasons for this dissatisfaction are presented and discussed.
CONCLUSIONS: All men undergoing orchidectomy should be offered a
testicular implant, irrespective of age. Sample implants in all sizes
should be available in the outpatient department. This will give men
realistic expectations and allow them to choose a suitable size of
implant. The dimensions of the available implants should be improved to
create a more elliptical prosthesis, to avoid dissatisfaction with the
shape. Adequate fixation to the base of the scrotum is important to
avoid the 'high riding' implant.
UI - 11689598
AU - Oshima A; Kitagawa T; Ajiki W; Tsukuma H; Takenaka S; Iura A
TI -
Survival of testicular cancer patients in Osaka, Japan.
SO - Jpn J Clin Oncol 2001 Sep;31(9):438-43
AD - Department of Cancer Control and Statistics, Osaka Medical Center for
Cancer and Cardiovascular Diseases, Osaka, Japan.
BACKGROUND: Testicular cancer is one of those cancers for which the
prognosis has improved remarkably since the introduction of effective
chemotherapy. METHODS: Study subjects were 709 testicular cancer
patients who were registered to the population-based Osaka Cancer
Registry (OCR) as diagnosed between 1975 and 1992. The testicular cancer
patients diagnosed/treated in the Osaka Medical Center for Cancer and
Cardiovascular Diseases (OMCC) were also analyzed for comparison.
RESULTS: The 5-year relative survival was 75.2% for the total of 709
patients and 77.9% for those diagnosed during 1990-92. These figures
were much lower than those for patients in the USA and in Europe. In
contrast, the 5-year survival of the 113 patients diagnosed in the OMCC
during 1975-93 was 91.5% and similar to those in the USA and in Europe.
CONCLUSIONS: The present study suggests that there are problems in the
speed and extent of diffusion of effective chemotherapy for testicular
cancer in Osaka.
UI - 11683938
AU - Berney DM; Shamash J; Pieroni K; Oliver RT
TI -
Loss of CD30 expression in metastatic embryonal carcinoma: the effects
of chemotherapy?
SO - Histopathology 2001 Oct;39(4):382-5
AD - Department of Histopathology and Morbid Anatomy, St Bartholomew's
Hospital, London, UK. D.Berney@bartsandthelondon.nhs.uk
AIMS: CD30 has been shown to be consistently strongly expressed in
embryonal carcinomas. Our aim was to examine changes in CD30 expression
in embryonal carcinomas before and after treatment with chemotherapy.
METHODS AND RESULTS: One hundred and eighteen retroperitoneal lymph node
dissections from patients with metastatic germ cell tumours were
reviewed. Seventeen contained embryonal carcinoma deposits. In nine
cases, the matching pre-chemotherapy orchidectomy specimens were
available. The cases were immunohistochemically stained for CD30. All
nine pre- chemotherapy orchidectomy specimens showed embryonal carcinoma
and stained strongly positively for CD30. However, only four out of nine
of the matched post-chemotherapy retroperitoneal lymph node dissection
specimens and a total of six out of 17 (35%) with embryonal carcinoma
deposits stained for CD30. Ten seminomas were negative for CD30. Loss of
CD30 did not appear to influence the relapse rate of the patients.
CONCLUSIONS: Loss of CD30 expression occurs frequently in metastatic
embryonal carcinomas after chemotherapy. This finding has implications
in the use of CD30 in the diagnosis of metastatic non-seminomatous germ
cell tumours and suggests that chemotherapy may alter the
immunophenotype of embryonal carcinoma while retaining its
characteristic histological appearances.
UI - 11692607
AU - Oyama H; Ogawa M; Mikuriya H; Kido A; Hayashi H
TI -
[Adenomatoid tumor of testicular tunica albuginea: a case report]
SO - Hinyokika Kiyo 2001 Sep;47(9):661-3
AD - Department of Urology, National Nishi-Saitama Chuou Hospital.
Adenomatoid tumors are uncommon neoplasms of the paratesticular tissues.
We report a case of an adenomatoid tumor of the testicular tunica
albuginea. A 54-year-old man presented with a painless right
intrascrotal mass. Serum levels of HCG-beta and AFP were within normal
limits. Scrotal ultrasonography showed an oval-shaped low echoic lesion
located on the surface of the testis. The patient underwent right
partial orchiectomy. Histological examination revealed adenomatoid tumor
of the tunica alubuginea testis. Adenomatoid tumors of the testicular
tunica alubuginea are rare. Examination of tumor markers, ultrasound
studies and diagnoses of frozen sections can prevent needless
orchiectomy.
UI - 11683977
AU - Hayashi T; Iida S; Taguchi J; Miyajima J; Matsuo M; Tomiyasu K; Matsuoka
TI -
K; Noda S
Primary carcinoid of the testis associated with carcinoid syndrome.
SO - Int J Urol 2001 Sep;8(9):522-4
AD - Department of Urology, Kurume University School of Medicine, Kurume,
Japan.
Testicular carcinoid is a rare disease accounting for less than 1% of
all testicular neoplasms. It rarely manifests symptoms of carcinoid
syndrome. Recent reports have noted that only 1.1-3.1% of testicular
carcinoid tumors are complicated by carcinoid syndrome. In general,
large tumor size and the presence of carcinoid syndrome are features
associated with a malignant course. In the present case, pathological
findings revealed pure carcinoid of the testis without metastasis.
Moreover, watery diarrhea due to carcinoid syndrome disappeared and the
serum serotonin level normalized following orchiectomy. The patient was
followed up for 12 months with whole body computed tomography scan and
assessment of serotonin levels. To date, there is no evidence of tumor
recurrence. These findings suggest that monitoring serum serotonin
levels may be useful as a marker during follow up of this type of tumor.
UI - 11689521
AU - Stang A; Ahrens W; Bromen K; Baumgardt-Elms C; Jahn I; Stegmaier C;
TI -
Krege S; Jockel KH
Undescended testis and the risk of testicular cancer: importance of
source and classification of exposure information.
SO - Int J Epidemiol 2001 Oct;30(5):1050-6
AD - Institute for Medical Informatics, Biometry and Epidemiology, University
Hospital of Essen, Hufelandstr. 55, 45122 Essen, Germany.
andreas.stang@uni-essen.de
BACKGROUND: The strength of the association between undescended testis
and testicular cancer varies considerably across studies. Here we report
the effect of various classifications of self-reported history of
undescended testis and different data sources on the estimates of the
risk of testicular cancer from a case-control study. METHODS: We
performed a population-based case-control study including 269 testicular
cancer cases and 797 controls matched on age and region. Medical history
was assessed by interviews (index persons) and mailed questionnaires
(mothers). We used conditional logistic regression to calculate odds
ratios (OR) and kappa coefficients to assess agreement between different
sources of information. RESULTS: Odds ratios for testicular cancer
ranged between 2.4 and 5.4 based on the sons' self-reports and between
1.1 and 1.9 based on the mothers' reports. The agreement between the
sons and mothers on undescended, gliding or retractile testis was fair
(kappa 0.53) and was good when these conditions were treated by surgery
(kappa 0.89). The rating of a history of undescended testis by two
urologists was fair (kappa 0.54). CONCLUSIONS: The questionnaire design,
the classifications of undescended testis and data sources have an
important impact on the OR for the association of undescended testis and
testicular cancer. These factors may partially explain the heterogeneity
of the OR for this association in case-control studies relying on
self-reports.
UI - 11707869
AU - Visco C; Medeiros LJ; Mesina OM; Rodriguez MA; Hagemeister FB;
TI -
McLaughlin P; Romaguera JE; Cabanillas F; Sarris AH
Non-Hodgkin's lymphoma affecting the testis: is it curable with
doxorubicin-based therapy?
SO - Clin Lymphoma 2001 Jun;2(1):40-6
AD - Department of Lymphoma and Myeloma, The University of Texas M.D.
Anderson Cancer Center, Houston, TX 77030, USA.
This study was designed to determine response, outcome, and patterns of
failure of patients with non-Hodgkin's lymphoma who presented with a
testicular mass. Consecutive patients presenting to M.D. Anderson Cancer
Center between 1969 and 1999 treated with doxorubicin-based regimens and
with radiotherapy and/or intrathecal therapy were considered for this
study. We identified 43 patients whose median age was 61 years. Ann
Arbor stage (AAS) was I in 22 patients, II in 7 patients, III in 1
patient, and IV in 13 patients. All 43 patients had intermediate-grade
lymphomas according to the Working Formulation, and all 31 tumors
assessed immunophenotypically were large B-cell lymphoma according to
the World Health Organization classification. The International
Prognostic Index score was > or = 2 in 18 patients (42%). Thirty-four
patients achieved complete remission, 19 of whom relapsed, and 5 failed
initial therapy. At 10 years, progression-free survival (PFS) was 20%
+/- 9% and survival was 33% +/- 9%. Progression-free survival for
patients with AAS I/II vs. III/IV was 36% +/- 13% vs. 0%, respectively
(P = 0.004). At 10 years, the actuarial probability of failure in the
central nervous system was 34% +/- 9% and was 21% +/- 9% in
contralateral testis. Using the intent-to-treat method, patients
receiving cyclophosphamide/doxorubicin/ vincristine/prednisone (CHOP),
with additional scrotal radiotherapy and intrathecal methotrexate, had a
5-year PFS of 91% +/- 9% vs. 30% +/- 15% vs. 41% +/- 12% for those
receiving only one or neither of these additional modalities (P =
0.053). Doxorubicin-based regimens alone appear unable to cure most
patients with lymphoma involving the testis, but CHOP with prophylactic
intrathecal therapy and adjuvant scrotal radiotherapy appears promising.
This should be confirmed with prospective clinical trials and longer
follow-up.
UI - 11707851
AU - Seymour JF; Solomon B; Wolf MM; Janusczewicz EH; Wirth A; Prince HM
TI -
Primary large-cell non-Hodgkin's lymphoma of the testis: a retrospective
analysis of patterns of failure and prognostic factors.
SO - Clin Lymphoma 2001 Sep;2(2):109-15
AD - Leukaemia/Lymphoma Service, Department of Haematology, The Peter
MacCallum Cancer Institute, Melbourne, Australia.
jseymour@petermac.unimelb.edu.au
We have analyzed 25 patients with primary testicular large-cell
non-Hodgkin's lymphoma managed at our institution from 1972-1998. The
median age was 69 years, with bilateral testicular involvement in 16%.
The disease stage was I in 56%, II in 32%, and IV in 12%. Twenty-four
patients received further therapy after orchiectomy, including
chemotherapy in 18 and radiation therapy in 11 (encompassing regional
nodes in 8 and the contralateral testis in 6), with 5 patients receiving
both modalities. The complete remission rate was 88%, but a continuous
pattern of recurrence is evident up to 10 years, when only 23% of
patients are predicted to be in ongoing remission. The dominant sites of
first failure were extranodal (91%), with prominent involvement of the
contralateral testis and cerebral parenchyma. The 10-year overall
survival rate is 32%, and the median overall survival is 4.4 years.
Within the entire cohort, adverse prognostic factors for treatment
failure were serum albumin < or = to 3.5 g/dL (P = 0.02), advanced age,
advanced stage, and lack of anthracycline-containing chemotherapy (each
P < or = to 0.3). Among patients with locoregional disease, albumin < or
= to 3.5 g/dL (P = 0.08), no anthracycline-containing chemotherapy (P =
0.15), and fewer than 6 cycles of chemotherapy (P = 0.03) remained
predictive. Based on this analysis, we are prospectively evaluating a
treatment program for patients with testicular non-Hodgkin's large-cell
lymphoma comprising (1) 6 cycles of anthracycline-based chemotherapy,
(2) prophylactic radiation therapy to the contralateral testis, and (3)
central nervous system prophylaxis with both intrathecal chemotherapy
and systemic high-dose methotrexate.
UI - 11707852
AU - Batchelor T; Leahy N; Kaufman D
TI -
High-dose methotrexate for isolated central nervous system relapse in
patients with testicular non-Hodgkin's lymphoma.
SO - Clin Lymphoma 2001 Sep;2(2):116-9; discussion 120-2
AD - Brain Tumor Center, Department of Neurology, Massachusetts General
Hospital, Boston, MA 02114, USA. tbatchelor@partners.org
Four consecutive patients with testicular non-Hodgkin's lymphoma who
initially achieved a complete response to treatment with standard
combination therapy later developed isolated central nervous system
(CNS) relapses. At the time of CNS relapse, staging evaluations were
negative for lymphoma outside the nervous system in al
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