最近2年間に経験した睾丸腫瘍12例の臨床的観察

Abstract

1984年1月より2年間の睾丸胚細胞性腫瘍12例の臨床的観察を行った.平均年齢は35.2歳, 組織別内訳はseminomaのみ8例, non-seminomatous germ cell tumor (NSGT)が4例であった.Stage別内訳は, 1が7例, 2Aが3例, 2Bが2例であった.seminomaのうちstage 1および2Aには腸骨リンパ節と傍大動脈リンパ節に放射線照射を行なった.bulkyな腫瘤を有する2Bのseminoma症例にはPVB療法にリンパ節郭清を合わせ行った.cis-diamminedichlorplatinumを中心とした化学療法は著明な腫瘍縮小効果を有した.NSGT中stage 1は2例で, 1例は高位除睾術のみで経過を観察し, 他の1例は除睾術後化学療法を行なった.stage 2Aには化学療法にリンパ節郭清を行なった.摘出睾丸重量が100 g以上の症例で血清LDHが高値を示す傾向にあった.1987年1月現在, 再発例はなかった

Twelve cases of testicular cancer were treated at our Department of Urology between 1984 and 1985. The mean age of the patients was 35.2 years old. Eight of them were pure seminoma in histology, other cases were non-seminomatous germ cell tumors (NSGT). Seven cases were of stage I testicular cancer, 3 cases were of stage IIA, and 2 cases were of stage IIB. Patients with stages I and IIA seminoma were given radiation to the ipsilateral iliac and bilateral paraaortic caval nodes to the crura of the diaphragma. Two patients with stage IIB seminoma were treated with PVB therapy and retroperitoneal lymph node resection. Chemotherapy containing CDDP was effective to reduce the tumor size. Two cases were of stage I NSGT, one case was treated with high orchiectomy only, and the other case was treated with chemotherapy after high orchiectomy. Chemotherapy and retroperitoneal lymph node resection were given to two patients with stage IIA NSGT. Abnormally elevated values of lactate dehydrogenase were observed in cases with a primary tumors weight larger than about 100 g. Six of the 8 cases of pure seminoma had slightly elevated beta-human chorionic gonadotropin levels. Two cases with bilateral testicular cancer were found among the 12 cases so that necessity of meticulous palpation of remaining testis was felt. Recurrent change was not observed in any of the 12 cases so that testicular cancer is considered to be an almost curable disease.