Obecnie w przypadku pierwotnego guza zarodkowego przestrzeni zaotrzewnowej bez zmian patologicznych w jądrze z potwierdzeniem tego w badaniu USG i fizykalnym nie ma potrzeby przeprowadzania (profilaktycznej) orchidektomii po tej samej stronie. Brak jest dowodów na korzyści osiągane przez pacjenta z takiego postępowania. Po leczeniu chirurgicznym i systemowym wymaga on natomiast wieloletniej obserwacji onkologicznej i kontrolnych USG moszny.

ABSTRACT

Seminoma of the retroperitoneal space in a 35-year-old man – a case report

The authors present the case of a 35-year-old man with a tumour of the retroperitoneal space. Histopathologically, the tumour corresponded to a classic seminoma. Ultrasonography of the scrotum in the man showed no testicular tumour. The tumour of the retroperitoneal space was considered the primary location of the tumour. The patient underwent a laparotomy in which the retroperitoneal space tumour was resected non-radically. The patient underwent postoperative chemotherapy according to a regimen of bleomycin, etoposide, cisplatin with good response and tolerance. A follow-up CT scan after ten months of follow-up showed no local recurrence or distant metastases. The authors discuss the management of seminoma with atypical localisation. According to data from a review of the world literature, seminoma as a primary tumour of the retroperitoneal space is very rare.

Piśmiennictwo

1. Giona S, Barber N, Ali A. The Epidemiology of Testicular Cancer. Brisbane (AU): Exon Publications 2022;9:107-16

2. Baird DC, Meyers GJ, Hu JS. Testicular Cancer: Diagnosis and Treatment. Am Fam Physician 2018;97(4):261-8

3. Olszewski W. Narządy płciowe męskie i drogi wyprowadzające mocz. [W:] Kumar Vinay, Abbas A, Aster J (red.). Robbins Patologia X. Edra Urban & Partner, Wrocław 2019

4. Hu B, Daneshmand S. Retroperitoneal Lymph Node Dissection as Primary Treatment for Metastatic Seminoma. Adv Urol 2018;2018:7978958

5. Gîngu CV, Mihai M, Baston C, et al. Primary retroperitoneal seminoma – embryology, histopathology and treatment particularities. Rom J Morphol Embryol 2016;57(3):1045-50

6. Lane RH, Stephens DH, Reiman HM. Primary retroperitoneal neoplasms: CT findings in 90 cases with clinical and pathological correlation. Am J Roentgenol 1989;152:83-9

7. Klein EA. Tumor markers in testis cancer. Urol Clin North Am 1993;20(1):67-73

8. Richie J, Steele G. Neoplasms of the testis. [In:] Wein AJ, Kavoussi LR, Novick AC, et al. (eds.). Campbell-Walsh urology. Saunders Elsevier, Philadelphia 2007

9. Surabhi S, Mohanty P, Das P, et al. Mohapatra, Debahuti; Sahoo, Pradyumna Kumar. Retroperitoneal germ cell tumor, primary or secondary: A diagnostic conundrum. MGM J Med Sciences 2023;10(2):359-62

10. Petros P, Anastasios A, Geraghty J, et al. Retroperitoneal seminoma with ‘burned out’ phenomenon in the testis. Int J Urol 2005;12(1):115-6

11. Ojea Calvo A, Rodríguez AA, Pérez GD, et al. Extragonadal germ cell tumour with “burned-out” phenomenon in the testis. Actas Urol Esp 1999;23(10):880-4

12. Hittmair A, Rogatsch H, Hobisch A, et al. CD30 expression in seminoma. Hum Pathol 1996;27(11):1166-71

13. Scholz M, Zehender M, Thalmann GN, et al. Extragonadal retroperitoneal germ cell tumor: evidence of origin in the testis. Ann Oncol 2002;13(1):121-4

14. Gerl A, Clemm C, Kohl P, et al. Primary extragonadal germ cell tumors. Clinical manifestations, differential diagnosis and therapy. Med Klin (Munich) 1994;89(5):240-4

Do góry