精巣腫瘍寛解後βhCGが長期低値陽性を示した2例

Abstract

症例1は45歳男性で, 左精巣腫瘍, NSGCT(成熟奇形腫, 胎児性癌, 卵黄嚢腫瘍)に対し, 高位精巣摘除術と化学療法PEB3コース, PE2コースを行った結果, 腫瘍の著明な縮小, AFPおよびhCGの陰性化を認めた.しかし, βhCGは低値で変動した.TIP2コースと末梢血幹細胞移植併用大量化学療法1コースを行ったが.βhCGは変化を認めなかった.無治療経過観察とし, 16ヵ月後現在, βhCGは低値変動しているが, 再発は認めない.症例2は19歳男性で, 左精巣腫瘍, NSGCT(胎児性癌, セミノーマ)に対し, 高位精巣摘除術と化学療法PEB3コースを行ったが, βhCGは低値で変動した.3ヵ月後に, 後腹膜リンパ節郭清術を行い, 残腫瘍は壊死組織であった.無治療経過観察とし, 160ヵ月後現在, βhCGは低値変動しているが, 再発は認めない

Some patients with testicular cancer exhibit low human chorionic gonadotropin (hCG) levels even after successful treatment. We report 2 patients with testicular cancer (2 non-seminomatous germ cell tumors [NSGCTs]) and low betahhCG levels with no recurrence after successful treatment. The first patient is a 45-year-old man with pulmonary and retroperitoneal lymph node metastases. During the first chemotherapy the hCG level decreased but remained at a low level. Salvage chemotherapy had no effect on the hCG level, but a low betahCG level persisted for 16 months. The second case is a 19-year-old man with testicular cancer with retroperitoneal lymph node metastases. The patient underwent an operation for residual masses after chemotherapy. Pathological findings showed necrotic tissue, and a low betahCG level persist for 160 months. A low hCG level does not necessarily meen residual malignancy. Patients with a low hCG level should be monaged carefully avoiding needless treatment.