National Cancer Institute®
Last Modified: January 1, 2002
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.
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. firstname.lastname@example.org
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.
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.
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.
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.
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. email@example.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.
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.
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.
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.
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.
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. firstname.lastname@example.org
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
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
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. email@example.com
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. firstname.lastname@example.org
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. email@example.com
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. firstname.lastname@example.org
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. email@example.com
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. firstname.lastname@example.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