Tumor thrombus arising from the superior vena cava and extending into the right atrium in a patient with advanced testicular germ cell tumor

A 24-year-old man was referred to our hospital with a painless mass on the left side of his neck. Ultrasonography detected right testicular tumor and computerized tomography scanning revealed a left supraclavicular lymph node mass and bulky retroperitoneal lymph node mass. He initially underwent rig...

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Détails bibliographiques
Publié dans:Hinyokika kiyo. Acta urologica Japonica. - 1962. - 55(2009), 6 vom: 09. Juni, Seite 371-5
Auteur principal: Miyake, Makito (Auteur)
Autres auteurs: Fujimoto, Kiyohide, Matsushita, Chie, Chihara, Yoshitomo, Tanaka, Masahiro, Hirayama, Akihide, Hirao, Yoshihiko, Uemura, Hirotsugu
Format: Article
Langue:Japanese
Publié: 2009
Accès à la collection:Hinyokika kiyo. Acta urologica Japonica
Sujets:Case Reports English Abstract Journal Article Review Chorionic Gonadotropin, beta Subunit, Human
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Résumé:A 24-year-old man was referred to our hospital with a painless mass on the left side of his neck. Ultrasonography detected right testicular tumor and computerized tomography scanning revealed a left supraclavicular lymph node mass and bulky retroperitoneal lymph node mass. He initially underwent right high orchiectomy, combination chemotherapy and retroperitoneal lymph node dissection for advanced testicular non-seminomatous germ cell tumor. Six years later, late relapse was detected in the lung. After complete remission of the lung metastasis with chemotherapy, the serum alpha-fetoprotein began to increase because of superior vena caval thrombus extending into the right atrium. Emergency surgical excision was performed successfully using extracorporeal circulation to prevent pulmonary embolism and the resected specimen pathologically revealed adenocarcinoma interpreted as teratoma malignant transformation. Adjuvant chemotherapy consisting of paclitaxel, ifosfamide and nedaplatin were administered for subsequent slight elevation of serum F-human chorionic gonadotropin beta, resulting in successful normalization again. Later, he suddenly died of cerebral infarction without any evidence of recurrence 138 months after his initial presentation. We report herein an extremely uncommon case of advanced testicular germ cell tumor with development of superior vena caval thrombus extending into the right atrium
Description:Date Completed 20.08.2009
Date Revised 10.07.2009
published: Print
Citation Status MEDLINE
ISSN:0018-1994