ABSTRACT
The records of 44 patients with pure testicular seminoma treated from 1981 to 1989 were reviewed. Twenty-one patients (48%) had stage I disease; 16 patients (36%) stage IIA; 4 patients (9%) stage IIB and 3 patients (7%) stage III. A previous history of cryptorchism was present in 7 patients (16%); testicular trauma in 9 patients (20%); orchiepididymits in 1 patient (2%) and genitourinary malformation in 1 patient (2%). Typical seminoma was observed in 43 patients (98%) and anaplastic seminoma in the remaining one (2%). There were no patients with spermatocytic seminoma. An elevated level of beta-human chorionic gonadotropin persisting after orchiectomy was found in 6 patients (14%). Syncytiotrophoblastic giant cells were identified after serial sections of the surgically resected tissue in two patients. Levels of this serum marker returned to normal values after primary treatment in all patients. Overall survival for all patients is 96% at 8 years. This corresponds to 100% for stages I, IIA and IIB and to 33% (1/3) for state III. Two patients (5%) presented recurrent disease in extralymphatic territories. Both of them were successfully rescued with proper therapy. Treatment was generally well tolerated and toxicity was mild to moderate.
Subject(s)
Dysgerminoma/radiotherapy , Testicular Neoplasms/radiotherapy , Adolescent , Adult , Combined Modality Therapy , Dysgerminoma/pathology , Dysgerminoma/therapy , Follow-Up Studies , Humans , Male , Middle Aged , Neoplasm Staging , Orchiectomy , Retrospective Studies , Testicular Neoplasms/pathology , Testicular Neoplasms/therapyABSTRACT
Se revisaron las historias clínicas de 44 pacientes con diagnóstico de seminoma puro de testículo tratados entre 1981 y 1989. Veintiún pacientes (48%) fueron clasificados como estadio Iñ 16 pacientes (36%) como estadio IIAñ 4 pacientes (9%) estadio IIB y 3 pacientes (7%) estadio III. Tenían antecedentes de criptorquidia 7 pacientes (16%); de traumatismo testicular 9 pacientes (20%); orquiepididimitis 1 paciente (2%) y de malformación del aparato urogenital 1 pacientes (2%). El seminoma era típico en 43 pacientes (98%) y de variedad anaplásica en el paciente restante (2%). No hobu casos de seminoma espermatocítico. En 6 pacientes (14%) se halló un invel elevado de subunidad beta de gonadotropina coriónica humana persistente luego de la orquiectomía. Se identificaron en 2 de ellos células gigantes del sinciciotrofoblasto por medio de cortes seriados del espécimen quirúrgico. En todos los casos los niveles de este marcador sérico retornaron a valores normales luego del tratamiento primario radiante y/o quimioterápico. La sobrevida global para la totalidad de los pacientes es 96% a 8 años. Esto corresponde a un 100% para estadios I, IIA y IIB y 33% (1/3) para estadio III. No hubo fallas al tratamiento dentro de los campos de irradiación. Solamente 2 pacientes (5%) presentaron enfermedad recurrente en territorios extralinfáticos. Ambos fueron tratados exitosamente. La terapia fue en general bien tolerada y la toxicidad fue leve a moderada