小児精巣卵黄嚢腫瘍の2例

Abstract

1歳5ヵ月, 2歳の精巣卵黄嚢腫瘍の2例.過去10年間の報告例56例を検討した結果, stage 1では全例再発なく, 精巣摘除および経過観察でよいと思われた.stage 2, stage 3では化学療法により完治した症例もあり, 化学療法を優先させるべきと思われた

Two cases of yolk sac tumor of the testis are presented. The patients were 17 months and 24 months old. The children were inflicted with painless swelling of their left scrotal content. alpha-Fetoprotein levels were elevated at presentation but decreased within normal limits after orchiectomy. Chest X-rays and CT scans were negative. The cases were diagnosed as stage I. Fifty six cases of testicular yolk sac tumor in children have been reported in Japan since 1981. There were no recurrent stage I cases. One patient with stage II and 3 patients with stage III died despite chemotherapy, while three children with stage II or stage III disease survived more than 36 months after a positive response to chemotherapy. We conclude that prepubertal stage I yolk sac tumor is treated best initially by orchiectomy alone. Aggressive chemotherapy has a major role in salvage of stage II or stage III patients.