The relationship of neutrophil to lymphocyte ratio with testicular cancer

ABSTRACT Purpose: To assess the relationship between testicular germ cell tumors (TGCT) and neutrophil to lymphocyte ratio (NLR) and to determine whether this ratio can be used as a serum tumor marker. Material and Methods: Sixty-one patients with testicular germ cell tumors were included into the study. Patients were grouped as localized and non-localized. Histologically patients were categorized as seminoma and nonseminomatous germ cell tumors. Complete blood cell count was measured the day before surgery and at the postoperative 1st month. Preoperative and postoperative mean NLR values were compared. Results: Thirty-six patients (59%) had seminomas and 25 patients (41%) had nonseminomatous testicular cancer. Forty-five patients (73.8%) had localized and 16 patients (26.2%) had non-localized testicular cancer. There was a statistically significant difference between preoperative and postoperative mean NLR of the localized patients (p=0.001) but no such difference was detected for non-localized patients (p=0.576). Nineteen patients with localized seminomas had normal preoperative serum tumor markers. There was a significant difference between preoperative and postoperative mean NLR in this group of patients (p=0.010). Twenty-six patients with localized tumors had preoperative increased serum tumor markers which normalized after orchiectomy. Mean NLR of these patients significantly decreased from 3.10±2.13 to 1.62±0.59 postoperatively (p=0.010). Conclusions: NLR appears to be a useful marker for TGCT. It is successful in predicting localized and non-localized disease in early postoperative period.

Novel homozygous mutation in a colombian patient with persistent müllerian duct syndrome: expanded phenotype

ABSTRACT The anti-Müllerian hormone triggers the regression of uterus and fallopian tubes in male embryos; if there are problems in the synthesis or action of this protein, Müllerian structures persist in an otherwise phenotypic male. The most frequent clinical presentation of Persistent Mullerian Duct syndrome is cryptorchidism and inguinal hernia. The few cases reported in adults are incidental findings or inguinal hernias. However, we present an adult male with history of bilateral cryptorchidism with unsuccessful orchidopexy, who presents with a large abdominal mass with the finding of a seminomatous tumor and persistence of Müllerian structures, in whom the variant c.916delC (p.Leu306Cysfs*29) in the AMHR2 gene not previously reported was documented.

Stage IIA and IIB testicular seminoma treated post-orchiectomy with radiation therapy versus other approaches: a population-based analysis of 241 patients

Objectives To evaluate post-orchiectomy utilization of radiation therapy (RT) versus other management approaches in stage IIA and IIB testicular seminoma patients. Materials and Methods Two hundred and forty-one patients with stage IIA and IIB testicular seminoma were identified between 1988 and 2003 using the Surveillance, Epidemiology, and End Results (SEER) database. Results Median follow-up was 10 years. Patients with stage IIA disease underwent RT more frequently than those with stage IIB disease (72% vs. 46%, respectively; P<0.001). There was no significant change in RT utilization for stage IIA or IIB disease between 1988 and 2003 (P = 0.89). Conclusions Between 1988 and 2003, stage IIA patients underwent RT more often than stage IIB patients in the United States. There was no significant change in RT utilization for stage IIA or IIB disease during this time period. Based on reports describing excellent progression-free survival with cisplatin-based chemotherapy, this approach has increased in popularity since 2003 and may eventually become the most popular treatment approach for both stage IIA and IIB testicular seminoma. .

Spermatocytic seminoma associated with undifferentiated sarcoma: A rare case report.

The presence of sarcomatous element transforms the usually innocuous spermatocytic seminoma into a highly aggressive neoplasm. We report a case of spermatocytic seminoma with undifferentiated sarcomatous component in a 43-year-old male, presented with testicular mass since two and a half years. Orchidectomy was performed and after 9 months, the patient presented with recurrent scrotal mass with bilateral pulmonary metastases.

Paracoccidioidomicosis cutanea asociada a seminoma / Paracoccidiodomycosis cutaneous associated with seminoms

Paciente de 35 años, oriundo de Paraguay, con una masa palpable indolente en el hemiabdomen derecho, que fue extirpada con diagnóstico de seminoma. Además, presentaba una lesión ulcerosa en la región escápulovertebral izquierda, cuyo examen micológico directo y cultivo fueron compatibles con Paracoccidioides brasiliens. No se hallaron otras manifestaciones cutáneomucosas relevantes radiografía de torax normal. Desde el punto de vista dermatológico recibió itraconazol con evolución favorable de la lesión. Se interpretó como paracoccidioidomicosis crónica, clinicamente unifocal cutánea, asociada a seminoma clásico

Seminoma estadio 1: ¿radioterapia u observación? / Seminoma stage 1: radiotherapy or observation?

La mayoría de los pacientes son seminoma estadio I son tratados con orquiectomía y radioterapia a los ganglios retroperitoneales. Esto se debe a que el seminoma es extraordinariamente sensible a la radioterapia y los resultados son excelentes, con una sobrevida libre de enfermedad de alrededor del 99 por ciento. Sin embargo, recientemente algunos oncólogos han propuesto tratar los enfermos solamente con orquiectomía y observación. Es fundamental para esta nueva modalidad de tratamiento que los enfermos que presenten progresión de la enfermedad puedan ser tratados oportunamente y adecuadamente con radioterapia o quimioterapia

Seminoma de mediastino relato de um caso e revisäo da literatura / Mediastinal seminoma case report and review of the literature

Oa autores relatam caso de seminoma primário de mediastino em criança de 13 anos, do sexo masculino, sem sintomas clínicos. Exame tomográfico revelou massa cística no mediatino anterior de aproximadamente 10cm de diâmetro. Foi realizad cirurgia , com ressecçäo de tumor medindo 13x7x6cm, a maior parte representada por área cística unilocular. Microscopicamente, tratava-se de seminoma clássico, que, à semelhança dos originados nos testículos, apresentava hiperplasia linfóide e granulomas epitelióides; ao lado disso, havia formaçäo de corpúsculos de Hassal abortivos associados a intensa hiperplasia epitelial, cuja intensidade näo é relatada na literatura. Estes últimos aspectos sugerem fortemente que o seminoma tenha tido origem intratímica. Os autores chamam ainda a atençäo para a dificuldade de diagnóstico destes casos na biópsia de congelaçäo, podendo ser confundidos com timoma

Seminoma puro de resticulo en estadía Clinico I, tratado con orquiectomía radical como única conducta terapeútica: control y seguimiento de su evolución / Testicle pure seminoma in clinical stadium I treated with radical orquiectomy as the only therapeutic conduct: control and follow-up of its evolution

Los resultados de esta investigación constatan idéntica respuesta en los 2 protocolos terapeúticos utilizados: a) Orquiectomía radical sin cobaltoterapia, b) Orquiectomía radical más cobaltoterapia con dosis estándar. La sobrevida para los dos grupos del 100 por ciento a los 5 años. La incidencia de enfermedad y/o metástasis en seminoma puro en estado clínico I, varió entre el 10 y el 12 por ciento. De este estudio surge que el 88 por ciento de nuestros pacientes recibieron innecesariamente cobaltoterapia. La extirpación de matástasis retroperitoneal resultó más laboriosa en los pacientes que recibieron cobaltoterapia, debido a la fibrosis retroperitoneal. La quimioterapia más efectiva en los pacientes que no habían recibido cobaltoterapia previa. La cobaltoterapia no es inocua, sino que tiene una morbilidad causada por el efecto cascada de las radiaciones sobre las células, tejidos y órganos. La orquifuniculectomía radical y observación en el seminoma puro estadío I es una opción terapeútica y se reserva la cobaltoterapia adyuvante para aquellos pacientes en los que no se puede realizar seguimiento

Post orchiectomy management in stage II testicular seminoma.

Twenty eight patients with stage II A and twenty patients with stage II B testicular seminoma were treated at this institute between January 1982 and December 1988. The three year crude survival observed in this retrospective analysis was 82% and 75% respectively. Post orchiectomy infradiaphragmatic radiotherapy was the mainstay of the treatment. In stage II A 4 patients were administered adjuvant chemotherapy as well. Prophylactic Mediastinal Irradiation (PMI) was not employed as a routine in this subgroup. Eight patients (28%) relapsed (Mediastinal Nodes--4, Pulmonary--3, Scrotal--1). In stage II B twelve patients were treated with primary abdominal radiotherapy and of them 4 were delivered PMI as well. Induction chemotherapy was administered in remaining 8 patients. Seven patients (35%) relapsed (Pulmonary-4, Mediastinal Nodes-3). Mediastinal recurrence was noted only in those who were treated with abdominal radiotherapy alone. Though salvage chemotherapy proved successful in 5 of the seven patients (70%) with nodal relapse, none of the patients with extranodal relapse responded to subsequent chemotherapy. For stage II A we recommend abdominal radiotherapy alone and for stage II B Induction chemotherapy is advised keeping radiotherapy reserved for residual mass. We do not advocate PMI as a routine in stage II testicular seminoma as no survival benefit is observed.

Tomografía axial computada en la etapificación en tumores testiculares / Computarized tomography in the staging of testicular tumors

Se analiza una serie de 35 pacientes portadores de un tumor testicular (14 seminomas, 21 no seminomas) sometidos a TAC abdominal. La correlación clínico-radiológica versus etapificación post-linfoadenectomía lumboaórtica en los no seminoma muestra 4 de 10 casos subetapificados I y que correspondían a II-a. Se concluye que el TAC no identifica la enfermedad retroperitoneal mínima. Se desaconsejan los protocolos de sólo observación

Manejo del cáncer testicular avanzado / Management of the testicular cancer stage B-3 y C

Se presenta la experiencia obtenida, entre 1982-1987, en el tratamiento de 20 pacientes de un cáncer testicular en etapas B-3 y C, 5 tenían un seminoma y 15 un tumor no seminomatoso. Los pacientes en etapa C se dividieron en 2 grupos: C de bajo riesgo (4 pacientes) y C de alto riesgo (8 pacientes), estos últimos tenían metástasis pulmonar múltiples y/o enfermedad visceral diseminada. Todos los pacientes fueron tratados con un esquema de quimioterapia con cistoplatino, bleomicina y vinblastina y 13 de ellos sometidos posteriormente a una linfadenoctompia lumboaórtica y 2 además, a una resección de masa tumoral pulmonar residual. El 37,5 por ciento de los pacientes tenían enfermedad residual post-quimioterapia y de éstos, sólo el 60 por ciento tenían marcadores positivos previo a la intervención. Cuatro pacientes recibieron una quimioterapia de salvataje con cistoplatino, vinblastina y etopósido. La sobrevida libre de enfermedad a 3 años es de 88 por ciento en la etapa B-3, 75 por ciento en la etapa C de bajo riesgo y de 25 por ciento en la etapa C de alto riesgo. Los factores que afectan adversamente el pronóstico son: 1) la presencia de metástasis múltiples pulmonar y 2) la existencia de tumor residual. Estos datos apoyan el uso de una quimioterapia de salvataje, de una cirugía agresiva sobre masas residuales y destacan la importancia que juega lalinfadenectomía lumboaórtica en la detección de tumor residual