Journal article
Delayed Orchiectomy at Postchemotherapy Retroperitoneal Lymph Node Dissection Due to Laterality of Retroperitoneal Metastatic Pattern Consistent with Testicular Primary : Assessment of Pathologic Findings
Urology (Ridgewood, N.J.), Vol.71(5), pp.911-914
2008
DOI: 10.1016/j.urology.2007.12.085
PMID: 18342916
Abstract
Objectives: It has been estimated that extragonadal germ cell tumors (EGCTs) constitute 3% to 5% of germ cell neoplasms. An interesting clinical scenario occurs when a patient with a presumed EGCT and normal testicular examination and ultrasound findings has a retroperitoneal metastatic pattern consistent with either a right or left-sided testicular primary. We reviewed the pathologic data of patients presenting with these clinical findings after delayed orchiectomy at postchemotherapy retroperitoneal lymph node dissection (PC-RPLND).
Methods: We identified 14 patients with apparent EGCT who had undergone simultaneous orchiectomy at PC-RPLND at our institution from July 1979 to July 2002 because of a lateralizing pattern of retroperitoneal metastases concerning for a testicular primary. Of the 14 patients, 3 had completely normal testicular ultrasound findings after chemotherapy and 11 had minimal ultrasound findings not consistent with a testicular tumor.
Results: Two (14%) of the PC orchiectomy specimens contained mature teratoma and eight (57%) contained necrosis and/or focal fibrosis. Thus, 10 (71%) of 14 patients undergoing PC orchiectomy at PC-RPLND because of metastatic disease laterality had evidence of a testicular primary.
Conclusions: Most (71%) patients with a presumed EGCT who underwent PC orchiectomy because of lateralizing retroperitoneal metastases had histologic evidence of a testicular primary (20% teratoma, 80% focal necrosis or fibrosis). If the retroperitoneal pattern of metastatic tumor spread is consistent with a primary testicular tumor, we offer PC orchiectomy to patients with apparent EGCT at PC-RPLND, even if the PC testicular examination and ultrasound findings are normal.
Details
- Title: Subtitle
- Delayed Orchiectomy at Postchemotherapy Retroperitoneal Lymph Node Dissection Due to Laterality of Retroperitoneal Metastatic Pattern Consistent with Testicular Primary : Assessment of Pathologic Findings
- Creators
- James A BROWN - Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana, United StatesRichard BIHRLE - Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana, United StatesRichard S FOSTER - Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana, United States
- Resource Type
- Journal article
- Publication Details
- Urology (Ridgewood, N.J.), Vol.71(5), pp.911-914
- Publisher
- Elsevier Science; New York, NY
- DOI
- 10.1016/j.urology.2007.12.085
- PMID
- 18342916
- ISSN
- 0090-4295
- eISSN
- 1527-9995
- Language
- English
- Date published
- 2008
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Urology
- Record Identifier
- 9984051585002771
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