Tumoare germinală testiculară nonseminomatoasă cu prognostic rezervat

Testicular cancer with mets

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His complaints have begun 6 months before the admission. After four courses of BEP bleomycin, etoposide and cisplatinorchiectomy was performed and the patient was under surveillance in the oncology department.

Non-seminomatous germ cell testicular tumor with poor prognosis

The degree of AFP elevation in patients with non-seminomatous germ cell tumours NSGCT establishes the prognosis and is used to assign an appropriate chemotherapy regimen. Keywords mature teratoma, lung metastases, alpha 1-fetoprotein, multidisciplinary treatment Rezumat Prezentăm cazul unui pacient în vârstă de 37 de ani, fără an­te­cedente patologice semnificative, care s-a prezentat la camera de gardă cu dispnee şi durere toracică apărute după un episod de hemoptizie, la examinarea clinică prezentând o formaţiune palpabilă la nivelul testiculului stâng.

Simp­to­ma­tologia a în­ce­put în urmă cu şase luni.

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După patru serii de BEP bleomycin, eto­po­side şi cisplatinse intervine chi­rur­gical, practicându-se or­hi­ec­tomie pe cale inghinală, ul­te­rior pacientul rămânând în ur­mă­rire în Departamentul de on­co­logie medicală. Creş­te­rea AFP la pacienţii cu tumori ger­mi­nale testiculare non­se­mi­no­ma­toa­se NSGCT are valoare prog­nos­tică şi este folosită pentru sta­bilirea unui tratament chimioterapic potrivit. Cuvinte cheie teratom matur metastaze pulmonare AFP tratament multidisciplinar Case presentation We present the case of a year-old man, testicular cancer with mets clinical state of health until 6 months before the admission, when he began to notice a left-sided testicular swelling, but with no associated pain at the time.

The swelling progressed over the next few months, and was associated with dyspnea and chest pain. Also, he complained of weight loss about 10 kg in the past 6 months.

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He presented to the hospital in Augustafter one episode of haemoptysis, with severe dyspnea. He smoked one pack of cigarettes a day for 12 years, and he used to drink alcoholic beverages on weekends.

His family history revealed: the father with hypertension, and an uncle with type 2 diabetes. The other examinations were normal.

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Ce este cancerul esofagian tests at first admission CBC showed a haemoglobin of PT prothrombin time was The imagistic exams performed in Septemberchest X-ray and CT scan of the chest Figure 1 and Fi­gure 2showed multiple nodules with different sizes, and the probability of metastasis became propounded. Figure 1.

testicular cancer with mets vermox helmintox

Chest X-ray: lung metastases Figure 2. Management: the therapeutic decision was planned by BEP bleomycin, etoposide and cisplatin as classic five-day protocol.

Testicular cancer with mets four cycles of BEP, the level of serum tumor markers reached the normal value, and we decided to perform a left orchiectomy, testicular cancer with mets had no intra- or postoperative complications.

The histopathologic examination showed mature teratoma inflitrative to the tunica albuginea and spermatic cord; the spermatic cord lymph node showed also mature teratoma, with pT3 pN2 stage stadialization.

Tabel 1. Therefore, the decission was to start chemotherapy.

Tumoare germinală testiculară nonseminomatoasă cu prognostic rezervat

In Marchthe check-up PET-CT showed once again activity in his lungs metastases, and also active metabolic lymph nodes latero-tracheal, hilar lymph nodeswith no other sites involvment. At this moment, our patient is at his fourth cycle of chemotherapy since we restarted. This distinction guides the clinician in both prognosis and treatment strategies.

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Positron-emission thomography scan can also be used to highlight the hypermetabolic lymph node metastases. M1a — Non-regional nodal or pulmonary metastasis. The patient is a unique case, showing a special significance and connection between AFP serum level, PET-CT hypermetabolic lymph nodes testicular cancer with mets the respose to chemotherapy.

Tumoare germinală testiculară nonseminomatoasă cu prognostic rezervat

We are also looking further for new molecular targeted therapies with a good response in the treatment of germ cell tumors of patients with recurrence after salvage chemotherapy. Conflict of interests: The author declares no conflict of interests. Alpha-foetoprotein heterogeneity: what is its value in managing patients with germ cell tumours?.

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Clin Oncol R Coll Radiol. J Clin Oncol. De Vita et al. Cancers of the Genitourinary System. LWW Health Library.