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1.
World J Urol ; 37(7): 1415-1420, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30341450

RESUMO

PURPOSE: To analyze and compare preoperative patient characteristics and postoperative results in men with stress urinary incontinence (SUI) selected for an adjustable male sling system or an artificial urinary sphincter (AUS) in a large, contemporary, multi-institutional patient cohort. METHODS: 658 male patients who underwent implantation between 2010 and 2012 in 13 participating institutions were included in this study (n = 176 adjustable male sling; n = 482 AUS). Preoperative patient characteristics and postoperative outcomes were analyzed. For statistical analysis, the independent T test and Mann-Whitney U test were used. RESULTS: Patients undergoing adjustable male sling implantation were less likely to have a neurological disease (4.5% vs. 8.9%, p = 0.021), a history of urethral stricture (21.6% vs. 33.8%, p = 0.024) or a radiation therapy (22.7% vs. 29.9%, p = 0.020) compared to patients that underwent AUS implantation. Mean pad usage per day (6.87 vs. 5.82; p < 0.00) and the ratio of patients with a prior incontinence surgery were higher in patients selected for an AUS implantation (36.7% vs. 22.7%; p < 0.001). At maximum follow-up, patients that underwent an AUS implantation had a significantly lower mean pad usage during daytime (p < 0.001) and nighttime (p = 0.018). Furthermore, the patients' perception of their continence status was better with a subjective complete dry rate of 57.3% vs. 22.0% (p < 0.001). CONCLUSIONS: Patients selected for an AUS implantation showed a more complex prior history and pathogenesis of urinary incontinence as well as a more severe grade of SUI. Postoperative results reflect a better continence status after AUS implantation, favoring the AUS despite the more complicated patient cohort.


Assuntos
Slings Suburetrais , Incontinência Urinária por Estresse/cirurgia , Esfíncter Urinário Artificial , Procedimentos Cirúrgicos Urológicos Masculinos/métodos , Idoso , Estudos de Coortes , Humanos , Masculino , Medidas de Resultados Relatados pelo Paciente , Seleção de Pacientes , Radioterapia/estatística & dados numéricos , Estudos Retrospectivos , Índice de Gravidade de Doença , Resultado do Tratamento , Estreitamento Uretral/epidemiologia
2.
Urologe A ; 54(5): 676-83, 2015 May.
Artigo em Alemão | MEDLINE | ID: mdl-25987333

RESUMO

During the past decades several efforts had been undertaken to treat erectile dysfunction by vascular surgery. Today one option survived: Implantation of Penile Prostheses. A lot of improvements of the material and the process quality lead to very good long term results. Patients with severe erectile dysfunction can be recommended in good conscience for implant surgery.


Assuntos
Disfunção Erétil/cirurgia , Prótese de Pênis , Implantação de Prótese/métodos , Procedimentos Cirúrgicos Urológicos/métodos , Terapia Combinada/instrumentação , Terapia Combinada/métodos , Disfunção Erétil/diagnóstico , Humanos , Masculino , Desenho de Prótese , Resultado do Tratamento
3.
Anticancer Res ; 32(1): 341-9, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22213325

RESUMO

Testicular germ cell tumours (TGCTs) are the most common malignancy in young men aged 18-35 years. They are clinically and histologically subdivided into seminomas and non-seminomas. 1,25-Dihydroxyvitamin D (1,25(OH)(2)D(3)) is the active form of vitamin D and exerts its actions via a specific intracellular vitamin D receptor (VDR). Several investigations in the recent years have revealed, in addition to a physiological occurrence of the VDR in various tissues, VDR expression in different human malignancies. Furthermore, 1,25(OH)(2)D(3) plays an important role in the regulation of cell proliferation and differentiation. In different normal and malignant cell types, antiproliferative and pro-differentiating effects of 1,25(OH)(2)D(3) are described. We investigated whether TGCT express the VDR, wether differences exist between the histological subtypes and if vitamin D has a function on the proliferation of tumour cells. Furthermore, we investigated the potential function of the vitamin D-regulated genes nuclear receptor co-repressor 1(NCOR1), nuclear receptor co-repressor 2 (NCOR2), thyroid receptor interacting protein 15 (TRIP15), Growth Arrest and DNA Damage (GADD45), MAP kinase-activated protein kinase 2 (MAPKAPK2), Cytochrome P450, family 24, subfamily A, polypeptide 1 (CYP24A1) and Cytochrome P450, family 27, subfamily B, polypeptide 1 (CYP27B1) in the pathogenesis of TGCT. We demonstrate, for the first time, that primary TGCT as well as TGCT cell lines, express VDR mRNA and protein. Vitamin D and VDR may play a role in the pathogenesis of TGCTs. Furthermore, vitamin D inhibits proliferation of TGCT cell-lines, potentially via an increase in expression of GADD45. Our data suggest that vitamin D could play a role in antitumour therapy.


Assuntos
Biomarcadores Tumorais/metabolismo , Neoplasias Embrionárias de Células Germinativas/metabolismo , Neoplasias Embrionárias de Células Germinativas/patologia , Receptores de Calcitriol/metabolismo , Neoplasias Testiculares/metabolismo , Neoplasias Testiculares/patologia , Adulto , Biomarcadores Tumorais/genética , Western Blotting , Proliferação de Células , Humanos , Técnicas Imunoenzimáticas , Masculino , RNA Mensageiro/genética , Reação em Cadeia da Polimerase em Tempo Real , Receptores de Calcitriol/genética , Transdução de Sinais , Vitamina D/análogos & derivados , Vitamina D/farmacologia
4.
J Pathol ; 213(1): 72-81, 2007 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-17590861

RESUMO

Testicular germ cell tumours (TGCT) represent the most common malignancy in young males. We reported previously that two prototype members of the mitogen-activated protein kinase (MAPK) family, the MAPK ERK kinase (MEK) and extracellular signal-regulated kinase (ERK), are inactive in malignant testicular germ cells and become active after drug stimulation, leading to apoptosis of tumour cells. In this study, we asked whether the protein phosphatase PP2A, a known inhibitor of the MEK-ERK pathway, participates in the proliferation and/or apoptosis of primary TGCT (n = 48) as well as two TGCT cell lines (NTERA and NCCIT). Quantitative RT-PCR, immunohistochemistry, western blot analyses and phosphatase assay indicate that primary TGCT as well as TGCT cell lines express PP2A and that PP2A is active in TGCT cell lines. The inhibition of PP2A by application of two PP2A inhibitors, cantharidic acid (CA) and okadaic acid (OA), results in a significant increase in caspase-3-mediated apoptosis of TGCT cell lines. Thereby, PP2A inhibition was accompanied by phosphorylation and activation of MEK and ERK. Functional assays using the MEK inhibitor PD98059 demonstrated that the phosphorylation of MEK and ERK was required for the induction of caspase-3-mediated apoptosis of malignant germ cells. Thus, our data suggest that inhibition of PP2A mediates its apoptosis-inducing effect on TGCT through activation of the MEK-ERK signalling pathway that leads to caspase-3-mediated apoptosis of tumour cells. In addition our results support previous observations that PP2A exerts an anti-apoptotic effect on malignant tumour cells.


Assuntos
Neoplasias Embrionárias de Células Germinativas/enzimologia , Proteína Fosfatase 2/análise , Neoplasias Testiculares/enzimologia , Adulto , Idoso , Apoptose/efeitos dos fármacos , Western Blotting/métodos , Cantaridina/farmacologia , Caspase 3/metabolismo , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Ativação Enzimática , MAP Quinases Reguladas por Sinal Extracelular/metabolismo , Flavonoides/farmacologia , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Quinases de Proteína Quinase Ativadas por Mitógeno/metabolismo , Proteínas Quinases Ativadas por Mitógeno/antagonistas & inibidores , Proteínas Quinases Ativadas por Mitógeno/metabolismo , Ácido Okadáico/farmacologia , Fosforilação , Proteína Fosfatase 2/antagonistas & inibidores , Proteína Fosfatase 2/metabolismo , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Coloração e Rotulagem
6.
Ann Oncol ; 17(2): 276-80, 2006 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-16254023

RESUMO

BACKGROUND: The aim was to investigate the use of single agent carboplatin in patients with seminoma stage IIA/B. PATIENTS AND METHODS: In a prospective phase II trial, single agent carboplatin at a dose of AUC 7 mg.min/ml every 4 weeks for three cycles in stage IIA (n=51) or four cycles in stage IIB (n=57) was given to 108 patients with previously untreated seminoma stage IIA/B. Patients with residual masses of >or=3 cm were scheduled to receive secondary surgery. RESULTS: A complete response (CR) was achieved by 88/108 (81%) patients, 17/108 (16%) achieved a partial response (PR), two of 108 (2%) showed no change, and one patient progressed. In all patients with PR the residual disease was

Assuntos
Antineoplásicos/uso terapêutico , Carboplatina/uso terapêutico , Seminoma/tratamento farmacológico , Neoplasias Testiculares/tratamento farmacológico , Adulto , Idoso , Antineoplásicos/administração & dosagem , Carboplatina/administração & dosagem , Esquema de Medicação , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Recidiva , Seminoma/prevenção & controle , Análise de Sobrevida , Neoplasias Testiculares/prevenção & controle
7.
Urologe A ; 44(9): 1024-30, 2005 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-16075198

RESUMO

Patients with germ cell tumours of the testis can have an extremely favourable chance of cure when compared to other malignancies. Therapeutic problems may arise with recurrent disease. High tumour burden can result when relapses are diagnosed too late and the prognosis will deteriorate, consecutively, even in spite of intensified therapeutic endeavours. Apart from early detection of recurrent disease, the follow-up schedule of germ cell cancer aims to identify and manage treatment-related morbidities, e.g. vascular problems and second neoplasms, respectively. Follow-up examinations should be tailored to the individual situation taking into account the particular risk of relapse based on histology, stage and treatment previously applied. In light of the rarity of the disease and according to the complexity of managing this malignancy, follow-up should be conducted by particularly experienced institutions.


Assuntos
Assistência ao Convalescente/métodos , Recidiva Local de Neoplasia/diagnóstico , Recidiva Local de Neoplasia/terapia , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/terapia , Humanos , Masculino , Cuidados Paliativos/métodos , Guias de Prática Clínica como Assunto , Padrões de Prática Médica , Prognóstico , Medição de Risco/métodos , Fatores de Risco , Assistência Terminal/métodos , Resultado do Tratamento
8.
Urologe A ; 44(6): 674-7, 2005 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-15809856

RESUMO

Foreign bodies in the urinary tract represent a possible cause for genitourinary disease. A huge variety of objects are inserted into the urinary tract for therapeutic, autoerotic, or psychiatric reasons and the symptoms for foreign bodies can be rather unspecific. Dysuria, hematuria, and urinary tract infection can suggest the presence of intravesical foreign bodies. Symptomatic urinary retention is more seldom and the causal foreign bodies are mostly iatrogenically applied. We present a unique case of maggots self-inserted into the urinary tract for autoerotic reasons causing symptomatic urinary retention with fornix rupture.


Assuntos
Corpos Estranhos/complicações , Corpos Estranhos/diagnóstico , Larva , Transtornos Parafílicos/complicações , Retenção Urinária/diagnóstico , Retenção Urinária/etiologia , Sistema Urinário/lesões , Acidentes , Animais , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Parafílicos/diagnóstico , Ruptura/diagnóstico , Ruptura/etiologia
9.
J Clin Oncol ; 23(1): 58-69, 2005 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-15625360

RESUMO

PURPOSE: Gene expression profiles of seminoma were compared with nonseminoma to get insights into tumorigenesis. MATERIALS AND METHODS: Eleven testicular tumor biopsies (five pure seminoma, six nonseminoma; pT1N0M0 to pT2N2M1) and biopsies from unaffected sites were analyzed once per patient using a macroarray (1,176 genes). On the same patients, six genes were validated using real-time quantitative (RTQ) polymerase chain reaction (PCR). Additionally, in a separate cohort of 19 patients, 24 genes selected from the macroarray were measured using RTQ-PCR. RESULTS: (1) The agreement in gene expression was 94% between the two methods and two different patient cohorts. (2) Two features in gene expression were independent of the tumor entity: Most changes of gene expression occurred in five functional groups like "cell cycle" and "apoptosis." Genes within these groups were almost similarly (> 80%) up- or downregulated. (3) Nonseminoma were characterized by downregulated genes (75%), but in seminoma, upregulated genes (64%) prevailed. Furthermore, 64.4% of those genes that were differentially expressed in both tumor entities were usually upregulated in seminoma but downregulated in nonseminoma. A reverse pattern was found in 24.4% of such genes. Eleven percent of these genes showed a similar up- or downregulation in gene expression in both tumor entities. CONCLUSION: Seminoma in this preliminary study can be differentiated from nonseminoma due to almost opposing gene expression profiles (89% of the significantly differentially expressed genes) and are in line with the histological discrimination of both tumor entities. Underlying mechanisms and implications regarding the origin and tumor progression of both entities are discussed.


Assuntos
Perfilação da Expressão Gênica , Seminoma/genética , Neoplasias Testiculares/genética , Adolescente , Adulto , Apoptose , Ciclo Celular , Regulação para Baixo , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Regulação para Cima
10.
Urologe A ; 43(12): 1514-20, 2004 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-15592708

RESUMO

According to the rules of the European Interdisciplinary Consensus, retroperitoneal lymph node dissection (RPLND) will be indicated less frequently in patients with nonseminomatous testis cancer. In clinical stage I it will be done only exceptionally and in stage II A only in marker-negative patients. In all other stages RPLND will be recommended as residual tumor resection and additionally in "growing teratoma syndrome" and in rare situations as "desperation surgery." It will be difficult in future using the minor operations to enter the learning curve. Only advanced situations will have to be managed by urological surgeons. These operations will have to be performed predominantly in specialised centres.


Assuntos
Excisão de Linfonodo/métodos , Excisão de Linfonodo/normas , Linfonodos/cirurgia , Neoplasias Embrionárias de Células Germinativas/secundário , Neoplasias Embrionárias de Células Germinativas/cirurgia , Padrões de Prática Médica/normas , Neoplasias Testiculares/cirurgia , União Europeia , Humanos , Metástase Linfática , Masculino , Peritônio/cirurgia , Cuidados Pré-Operatórios/métodos , Neoplasias Retroperitoneais/secundário , Neoplasias Retroperitoneais/cirurgia , Medição de Risco , Fatores de Risco
11.
J Clin Oncol ; 22(18): 3713-9, 2004 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-15365067

RESUMO

PURPOSE: To assess the role of residual tumor resection performed after high-dose chemotherapy (HDCT) in patients with relapsed or refractory germ cell tumors (GCT). PATIENTS AND METHODS: Between July 1987 and October 1999, postchemotherapy resections of residual tumors were performed in 57 patients who had been treated with HDCT for relapsed or refractory GCT and who had achieved a partial remission to this treatment. RESULTS: Complete resections of residual masses were achieved in 52 (91%) of 57 patients who were rendered disease free; in five (9%) of 57 patients, the resections were incomplete. Resection of a single site was performed in 39 (68%) of 57 patients, and the remaining 18 (32%) of 57 patients required interventions at two or more residual tumor sites. Necrosis was found in 22 (38%) of 57 patients, mature teratoma with or without necrosis was found in nine (16%) of 57 patients, and viable cancer with or without additional necrosis or mature teratoma was found in 26 (46%) of 57 patients. Viable cancer consisted either of residual germ cell or undifferentiated cancer in 22 (85%) of 26 patients, with additional non-GCT histologies in the remaining four patients. Patients with viable cancer had a significantly inferior outcome after surgery compared with patients with necrosis and/or mature teratoma even if all cancer was completely resected. Pulmonary lesions with a diameter of more than 2 cm were the only predictive variable for viable cancer in univariate analysis. CONCLUSION: Resections of all residual tumors should be attempted in patients with relapsed or refractory GCT and partial remissions after HDCT.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias do Mediastino/tratamento farmacológico , Neoplasias do Mediastino/cirurgia , Neoplasia Residual/cirurgia , Neoplasias Embrionárias de Células Germinativas/tratamento farmacológico , Neoplasias Embrionárias de Células Germinativas/cirurgia , Neoplasias Retroperitoneais/tratamento farmacológico , Neoplasias Retroperitoneais/cirurgia , Neoplasias Testiculares/tratamento farmacológico , Neoplasias Testiculares/cirurgia , Cisplatino/administração & dosagem , Estudos de Coortes , Intervalo Livre de Doença , Etoposídeo/administração & dosagem , Humanos , Ifosfamida/administração & dosagem , Masculino , Necrose , Paclitaxel/administração & dosagem , Estudos Retrospectivos
12.
Anticancer Res ; 20(6D): 5029-33, 2000.
Artigo em Inglês | MEDLINE | ID: mdl-11326662

RESUMO

We wanted to verity whether M2-PK is a useful marker in testicular cancer. In a prospective study of 20 consecutive patients, blood was drawn from the testicular and the cubital vein before semicastration and later. For the detection of M2-PK we used the Assay of ScheboTech. In the testicular vein M2-PK was 11.2 U/ml. In the cubital vein it was 6.2 U/ml before semicastration, increasing in the following days. There were no significant differences between testicular and cubital vein blood, between the non-metastasized patients and the metastasized stages and between the patients with seminoma and non-seminomatous tumors. There is no profit in the diagnosis of testicular cancer using Tu-M2-PK.


Assuntos
Biomarcadores Tumorais/sangue , Piruvato Quinase/sangue , Neoplasias Testiculares/sangue , Seguimentos , Humanos , Masculino , Prognóstico , Estudos Prospectivos , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/enzimologia , Veias/enzimologia
13.
Angiogenesis ; 3(3): 231-40, 1999.
Artigo em Inglês | MEDLINE | ID: mdl-14517422

RESUMO

The high degree of vascularisation, accompanied by the low malignancy of human Leydig cell tumours, offers an interesting model to study the neovascularisation and structural stabilisation of the vascular wall. We report here that Leydig cell tumours are characterised by an increased level of vascular endothelial growth factor (VEGF) in testicular veins, the presence of VEGF mRNA and of its receptor, KDR, and an absence of detectable VEGF receptor Flt-1, in blood vessels of tumour marginal zones and of peri-tumour areas. This is in contrast to the capillaries within normal Leydig cell clusters which demonstrate both Flt-1 and KDR. Ultrastructural destabilisation of the vascular wall, evident as a lack of basement membrane and of peri-endothelial cells was also present in nearly 85% of blood vessels of the peri-tumour areas. In contrast, approximately 89% of the blood vessels of the tumour centre region demonstrated a stabilised vascular wall including basement membrane and peri-endothelial cells. Local application of VEGF(165) to the normal testicular tissue induced significant ultrastructural destabilisation in the capillary walls which only expressed KDR. These results suggest an autocrine role of VEGF on endothelial cells of tumour blood vessels in a region-specific manner and implicate that VEGF interactions with KDR, in the absence of Flt-1, may be involved in vascular destabilisation. In addition, the finding that most (79%) of Leydig tumour blood vessels are stabilised may account for the low malignant potential of these tumours.

14.
Urologe A ; 37(1): 2-7, 1998 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-9540176

RESUMO

The exact knowledge of the topographic anatomy of the urethra as well as the macro- and microcirculation of the penis [6] are the basics of reconstructive urethral surgery. Adherence to the fundamentals and principles of tissue transfer [5] are necessary to fascilitate conditions for successful treatment of the various disorders of the male urethra. Mutural description of the anatomy of the male urethra in conjunction with external male genitals is necessary because of developmental similarities as well as the close anatomical relationship. The arterial and venous blood supply of the urethra and the penis have to be taken into account if vascularized flaps from the penile skin or the prepuce are used in urethral reconstruction. The dual arterial and venous vascularity of the genital skin is of fundamental importance to a successful outcome of the operative treatment. The purpose of this article is, to summarize the relevant anatomical knowledge of reconstructive urethral surgery.


Assuntos
Pênis/anatomia & histologia , Uretra/anatomia & histologia , Adolescente , Artérias/anatomia & histologia , Artérias/cirurgia , Criança , Pré-Escolar , Humanos , Lactente , Masculino , Microcirurgia , Pênis/irrigação sanguínea , Pênis/cirurgia , Escroto/anatomia & histologia , Escroto/irrigação sanguínea , Escroto/cirurgia , Retalhos Cirúrgicos/fisiologia , Uretra/irrigação sanguínea , Uretra/cirurgia , Veias/anatomia & histologia , Veias/cirurgia
15.
Urologe A ; 37(1): 25-30, 1998 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-9540180

RESUMO

Strictures of the bulbous and membranous urethra up to 2.5 cm in length and after visual urethrotomy should be managed with an one-stage perineal anastomotic repair. With description of the surgical techniques the results of 41 patients, treated between 1977 and 1996, are presented. 28 patients had bulbomembraneous strictures as result from urethral disruption at the time of pelvic fracture. In 13 cases with bulbar strictures, 11 had been caused iatrogenously and 2 by infection. A successful outcome was achieved in over 90% (37 patients), equivalent to a maximum uroflow over 15 ml/s, an empty bladder after voiding and a radiographic wide anastomosis. Only 4 patients (9.8%) after surgery required an urethrotomy; two of them are dilated frequently.


Assuntos
Anastomose Cirúrgica/métodos , Próstata/cirurgia , Uretra/cirurgia , Estreitamento Uretral/cirurgia , Adolescente , Adulto , Idoso , Criança , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Radiografia , Técnicas de Sutura , Resultado do Tratamento , Estreitamento Uretral/diagnóstico por imagem , Estreitamento Uretral/etiologia
18.
Eur Urol ; 31(4): 408-13, 1997.
Artigo em Inglês | MEDLINE | ID: mdl-9187899

RESUMO

OBJECTIVE: Human chorionic gonadotropin (HCG) elevations in the testicular vein (TV) are correlated with those in the cubital vein (CV). Their significance was tested regarding various prognostic parameters. METHOD: Within the framework of a large multicentre study to assess the prognosis of HCG-positive seminomas 726 eligible patients were recruited from 1986 to 1991. A total of 378 had elevated and 348 had normal HCG measured in the CV. In 144 patients samples were taken from the TV. Histological diagnosis of seminoma was confirmed by two reference pathologists. Three groups (group I: elevated HCG in CV and normal or elevated HCG in TV; group II: normal HCG in CV and elevated HCG in TV; group III: normal HCG in CV and normal or unknown HCG in TV) were compared in relation to the presence or absence of metastases, stage of the disease, size of the primary tumour, pT category, vascular invasion and lactate dehydrogenase. RESULTS: Of the TV serum samples, 85% were HCG-positive. Regression analysis revealed higher values in the TV compared to the CV according to the following equation: HCGTV = 520 + 1.12 x HCGCV, R = 0.766, with a mean variation of 14%. Patients in group I had significantly higher stages and larger primary tumours than patients with normal HCG in the CV, irrespective of the HCG values in the TV blood (groups II and III). Therefore, HCG is associated with tumour mass. No differences of statistical significance were found regarding T category, vascular invasion and lactate dehydrogenase. There were no differences between groups II and III. CONCLUSION: Only HCG values of the CV are associated with known adverse-prognostic factors of seminomas, such as metastases and size of the tumour. HCG in the TV adds no further information for the clinical assessment of patients with seminoma.


Assuntos
Gonadotropina Coriônica/sangue , Seminoma/sangue , Neoplasias Testiculares/sangue , Testículo/metabolismo , Áustria , Alemanha , Humanos , L-Lactato Desidrogenase/sangue , Estudos Longitudinais , Masculino , Invasividade Neoplásica , Prognóstico , Estudos Prospectivos , Estudos Retrospectivos , Seminoma/diagnóstico , Seminoma/patologia , Seminoma/cirurgia , Suíça , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/patologia , Neoplasias Testiculares/cirurgia , Testículo/irrigação sanguínea
19.
Laryngorhinootologie ; 75(10): 616-8, 1996 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-9035666

RESUMO

BACKGROUND: Germ cell tumors of the testis usually metastasize to retroperitoneal lymph nodes, lungs, and liver. Other lymphatic or organ metastases especially in the head and neck are rare. CASE REPORTS: The cases of two men, ages 21 and 35, are presented. In both cases, the histologic examination of cervical lymph node specimen lead to the correct tumor diagnosis of testicular cancer. Multimodal urooncologic therapy led to long-lasting complete remissions in both cases. CONCLUSIONS: In young men between 20 and 35 years of age with cervical metastases of tumors of unknown primary site, germ cell tumors must be suspected. Histologic findings of non-squamous epithelial metastases (seminoma, embryonal carcinoma, chorionic carcinoma, teratoma, yolk sack tumor, and their combined forms) with or without retroperitoneal, mediastinal, or lung metastases; elevated tumor markers (human-chorionic gonadotropin, alpha-feto-protein, placental alkaline phosphatase, lactate dehydrogenase); and palpable intratesticular mass lead to the correct tumor diagnosis. Early detection of the disease is essential for successful therapy and long-term remission.


Assuntos
Neoplasias de Cabeça e Pescoço/secundário , Neoplasias Embrionárias de Células Germinativas/secundário , Neoplasias Primárias Desconhecidas/patologia , Neoplasias Otorrinolaringológicas/secundário , Neoplasias Testiculares/patologia , Adulto , Diagnóstico Diferencial , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Linfonodos/patologia , Metástase Linfática , Masculino , Estadiamento de Neoplasias , Neoplasias Embrionárias de Células Germinativas/patologia , Neoplasias Otorrinolaringológicas/patologia
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