睾丸腫瘍の後腹膜リンパ節転移について

Abstract

Retroperitoneal lymph node dissection for the 40 patients with testicular tumor has been done for the past 9 years, and the 19 patients of them revealed the retroperitoneal involvement. From the results of surgical findings, 4 metastatic types of the testicular tumors to the retroperitoneal lymph nodes were classified. Type I : Involvement of the primary nodes of the testis which were located at the renal pedicle and/or periaortocaval area superior to the bifurcation of aorta. Type II : Involvement of the testis with secondary metastasis to the non-primary periaortocaval nodes of the testis and the iliac nodes. Type III : Involvement of the primary nodes of the testis with metastasis to the primary nodes of the epididymis located at the external iliac area. Type IV: Involvement of the primary nodes of the epididymis. Of the 19 patients who had the retroperitoneal involvements; 11 patients (58%) were in type I; 5 patients (26%) were in type II; 2 patients (10%) were in type III; one patient (5%) was in type IV. In all cases with metastasis to the primary nodes of epididymis, the invasion of tumor to the epididymis was found and the stage of primary tumor was T3. The bilateral metastases to the retroperitoneal lymph nodes were found in 5 of the 19 cases (26%). The percentage of retroperitoneal involvement were higher in cases of non seminomatous tumor than in seminoma. In cases of the primary tumor less than 100 g, the retroperitoneal involvement was not found in all of the 5 cases of seminoma and found in 6 of the 11 cases (55%) of non seminomatous tumor. In cases of the primary tumor more than 200 g, the retroperitoneal involvement was found in all of the 4 cases of non seminomatous tumor and found in 4 of the 7 cases (57%) of seminoma.