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1.
Nat Rev Urol ; 17(4): 201-213, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32157202

RESUMO

Testicular germ cell tumours (TGCTs) are the most frequent cancer type in young men and originate from the common precursor germ cell neoplasia in situ (GCNIS). For decades, clinical management of patients with TGCT has relied on classic serum tumour markers: α-fetoprotein, human chorionic gonadotropin subunit-ß and lactate dehydrogenase. In the past 10 years, microRNAs have been shown to outperform classic serum tumour markers in the diagnosis of primary tumours and in follow-up monitoring and prediction of relapse. miR-371a-3p is the most consistent marker and exhibits >90% diagnostic sensitivity and specificity in TGCT. However, miR-371a-3p cannot be used to diagnose GCNIS or mature teratoma. Future efforts must technically standardize the microRNA-based methods internationally and introduce miR-371a-3p as a molecular liquid biopsy-based marker for TGCTs in the clinic.


Assuntos
Biomarcadores Tumorais/metabolismo , MicroRNAs/metabolismo , Recidiva Local de Neoplasia/diagnóstico , Neoplasias Embrionárias de Células Germinativas/diagnóstico , Neoplasias Testiculares/diagnóstico , Assistência ao Convalescente , Biomarcadores Tumorais/genética , Gonadotropina Coriônica Humana Subunidade beta/metabolismo , Humanos , L-Lactato Desidrogenase/metabolismo , Biópsia Líquida , Masculino , Recidiva Local de Neoplasia/metabolismo , Neoplasias Embrionárias de Células Germinativas/genética , Neoplasias Embrionárias de Células Germinativas/metabolismo , Neoplasias Embrionárias de Células Germinativas/terapia , Seminoma/diagnóstico , Seminoma/genética , Seminoma/metabolismo , Seminoma/terapia , Sensibilidade e Especificidade , Teratoma/diagnóstico , Teratoma/genética , Teratoma/metabolismo , Teratoma/terapia , Neoplasias Testiculares/genética , Neoplasias Testiculares/metabolismo , Neoplasias Testiculares/terapia , alfa-Fetoproteínas/metabolismo
3.
Int J Radiat Oncol Biol Phys ; 106(2): 269-278, 2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-31654785

RESUMO

PURPOSE: The aim of this study was to determine the practice patterns and outcomes of intracranial germ cell tumors (IGCT) in adolescents and young adults according to different therapeutic approaches. METHODS AND MATERIALS: One-hundred twelve patients with IGCT aged 15 to 39 years were managed at either XX or the XY center from 1975 to 2015. The charts were retrospectively reviewed and data collected. RESULTS: Median duration of follow-up was 8.3 years. Ninety-four patients had germinomas, and 18 had nongerminomatous germ cell tumors (NGGCT). The primary disease sites were pineal gland (37 of 94 germinoma, 14 of 18 NGGCT) and suprasellar region (23 of 94 germinoma, 2 of 18 NGGCT). Eleven patients with germinoma (12%) and 2 patients with NGGCT (11%) had radiographic spinal metastases or positive lumbar cerebrospinal fluid cytology. Event-free survival (EFS) was 84% and overall survival (OS) was 90% at 10 years for germinoma; EFS was 71% and OS was 86% at 10 years for NGGCT. For patients with germinoma, 10-year EFS was 100% after craniospinal radiation therapy (CSRT) with chemotherapy (N = 10); 100% after whole-ventricular radiation therapy (WVRT), whole-brain radiation therapy (WBRT), or focal radiation therapy (FRT) with chemotherapy (N = 22); 90% after CSRT alone (N = 46); and 41% after WVRT, WBRT, or FRT alone (N = 16) (P < .0005). Ten-year OS was 100%, 100%, 90%, and 72%, respectively (P = .032). For patients with NGGCT, 10-year EFS was 80% after CSRT, WBRT, or WVRT plus chemotherapy (N = 10) versus 58% after FRT plus chemotherapy (N = 8) (P = .31); 10-year OS was 90% versus 58%, respectively (P = .16). CONCLUSIONS: We report excellent overall outcomes according to treatment approach in the largest study of IGCT in adolescents and young adults to our knowledge. EFS and OS were inferior after non-CSRT without chemotherapy in germinoma.


Assuntos
Neoplasias Encefálicas/terapia , Neoplasias Embrionárias de Células Germinativas/terapia , Adolescente , Adulto , Antineoplásicos/uso terapêutico , Biomarcadores Tumorais/sangue , Biomarcadores Tumorais/líquido cefalorraquidiano , Biópsia/estatística & dados numéricos , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/mortalidade , Institutos de Câncer , Gonadotropina Coriônica Humana Subunidade beta/sangue , Gonadotropina Coriônica Humana Subunidade beta/líquido cefalorraquidiano , Radiação Cranioespinal , Intervalo Livre de Doença , Feminino , Germinoma/diagnóstico , Germinoma/mortalidade , Germinoma/secundário , Germinoma/terapia , Humanos , Estimativa de Kaplan-Meier , Masculino , Recidiva Local de Neoplasia , Neoplasias Embrionárias de Células Germinativas/diagnóstico , Neoplasias Embrionárias de Células Germinativas/mortalidade , Neoplasias Embrionárias de Células Germinativas/secundário , Glândula Pineal , Pinealoma/diagnóstico , Pinealoma/mortalidade , Pinealoma/terapia , Padrões de Prática Médica , Dosagem Radioterapêutica , Estudos Retrospectivos , Neoplasias da Coluna Vertebral/diagnóstico , Neoplasias da Coluna Vertebral/mortalidade , Neoplasias da Coluna Vertebral/secundário , Neoplasias da Coluna Vertebral/terapia , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/mortalidade , Neoplasias Testiculares/secundário , Neoplasias Testiculares/terapia , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem , alfa-Fetoproteínas/análise , alfa-Fetoproteínas/líquido cefalorraquidiano
4.
Urology ; 135: 28-31, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31628969

RESUMO

OBJECTIVE: To address information overload for trainees, a concise electronic case-based urology learning program (CBULP) was developed. Previous qualitative assessments suggested CBULP's potential efficacy/utility. Herein we assess CBULP more stringently by evaluating test performance before/after reviewing a CBULP curriculum covering core concepts in testicular cancer. METHODS: Eleven of 33 CBULP testicular cancer cases were strategically selected for this curriculum. A 26 question multiple-choice test was developed to assess fundamental knowledge about testis cancer tumor biology and evaluation/management. Pretest was administered to PGY4/PGY1 residents at 2 pilot urology-training programs, and medical students interested in Urology. Participants were given 4 weeks to review the curriculum and the test was then repeated. A control group (4 PGY1s) was administered the pretest and repeat test in an analogous manner without provision of the CBULP curriculum. RESULTS: Twenty individuals took the pretest (7 medical students, 8 PGY1s, and 5 PGY4s), and 17 (85%) took the post-test (5 medical students, 8 PGY1s, and 4 PGY4s,). As expected, PGY4s performed significantly better than the other 2 groups on the pre- and post-test. However, significant improvement in test performance was seen across all groups that utilized the CBULP curriculum (P <.02), with highest increase demonstrated by PGY1 residents (4.75 more questions correct, P = .002). The control arm did not demonstrate significant improvement (P = .20). CONCLUSION: Significant improvement in test performance was observed after completion of the CBULP testicular series. This study suggests that CBULP can be an efficacious and clinically useful educational resource for urologic residents and students interested in the field.


Assuntos
Currículo , Educação de Graduação em Medicina/métodos , Internato e Residência/métodos , Neoplasias Testiculares/diagnóstico , Urologia/educação , Adulto , Competência Clínica , Instrução por Computador/métodos , Educação de Graduação em Medicina/estatística & dados numéricos , Avaliação Educacional/estatística & dados numéricos , Humanos , Internato e Residência/estatística & dados numéricos , Masculino , Avaliação de Programas e Projetos de Saúde , Estudantes de Medicina/estatística & dados numéricos , Neoplasias Testiculares/patologia , Neoplasias Testiculares/terapia
5.
J Urol ; 203(5): 949-956, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31845841

RESUMO

PURPOSE: Leydig cell tumors are rare but they are the most common nongerm cell testicular tumors. Only limited evidence exists for reliably differentiating between benign and malignant Leydig cell tumors and for optimally managing the different types and stages of this rare disease. In this review we synthesize the available evidence on the clinical presentation and clinicopathological characteristics associated with Leydig cell tumor malignancy and management. MATERIALS AND METHODS: We analyzed published case series data on Leydig cell tumors. The association between clinicopathological variables and the presence of metastatic disease was assessed using regression analyses. RESULTS: We included 357 reports, reviewing available data from 1,375 patients (median age 34 years). Testis sparing surgery was performed in 463 patients. Local recurrence after testis sparing surgery occurred in 8 of 121 (7%) patients with available followup information. Metastases were found in 101 patients and were most often located in the retroperitoneal lymph nodes (60%), lungs (38%) and/or liver (29%). The multivariable models with or without multiple imputation predicting metastatic disease included older age, larger tumor size, presence of any adverse factor (larger tumor diameter, necrosis, angiolymphatic invasion, pleomorphism, high mitotic index, atypia) and any protective factor (Reinke crystals, lipofuscin pigments, gynecomastia) with model AUCs of 0.93. Durable remission after resection of metastases or use of platinum based chemotherapy was rarely seen. CONCLUSIONS: Our risk tables using clinicopathological parameters can help identify patients with malignant tumors. These patients should undergo disease staging and be followed or receive further treatment. In some patients with metastatic disease surgical and systemic treatment might result in disease control.


Assuntos
Tumor de Células de Leydig/terapia , Neoplasias Testiculares/terapia , Terapia Combinada , Saúde Global , Humanos , Tumor de Células de Leydig/diagnóstico , Tumor de Células de Leydig/epidemiologia , Masculino , Morbidade/tendências , Fatores de Risco , Taxa de Sobrevida/tendências , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/epidemiologia , Resultado do Tratamento
6.
Int Braz J Urol ; 46(1): 101-107, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31851466

RESUMO

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.


Assuntos
Linfócitos , Neoplasias Embrionárias de Células Germinativas/sangue , Neutrófilos , Seminoma/sangue , Neoplasias Testiculares/sangue , Adulto , Idoso , Biomarcadores Tumorais/sangue , Humanos , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Neoplasias Embrionárias de Células Germinativas/diagnóstico , Neoplasias Embrionárias de Células Germinativas/cirurgia , Orquiectomia , Período Pós-Operatório , Cuidados Pré-Operatórios , Valores de Referência , Reprodutibilidade dos Testes , Estudos Retrospectivos , Seminoma/diagnóstico , Seminoma/cirurgia , Sensibilidade e Especificidade , Estatísticas não Paramétricas , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/cirurgia , Adulto Jovem
7.
PLoS One ; 14(12): e0225942, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31851716

RESUMO

BACKGROUND: Testicular germ cell tumor (TGCT) patients and survivors have excess mortality compared to the general male population, but relative survival (RS) has been scarcely studied. We investigated causes of excess mortality and their impact on RS among men diagnosed with TGCT in Norway, 1953-2015. METHODS AND FINDINGS: Using registry data (n = 9541), standardized mortality ratios (SMRs) and RS were calculated. By December 31st, 2015, 816 testicular cancer (TC) and 1508 non-TC deaths had occurred (non-TC SMR: 1.36). Within five years of TGCT diagnosis, 80% were TC deaths. Non-TC second cancer (SC) caused 65% of excess non-TC deaths, of which 34% from gastric, pancreatic or bladder cancer. SC SMRs remained elevated ≥26 years of follow-up. In localized TGCT diagnosed >1979, SC SMRs were only elevated after seminoma. Cardiovascular disease caused 9% and other causes 26% of excess non-TC deaths, of which 58% from gastrointestinal and genitourinary disorders. RS continuously declined with follow-up. TGCT patients diagnosed >1989 had superior five-year TC-specific RS (98.3%), lower non-TC SMR (1.21), but elevated SMRs for several SCs, infections, Alzheimer's disease, genitourinary disease and suicide. A limitation was lack of individual treatment data. CONCLUSIONS: RS declines mainly from TC deaths <5 years after TGCT diagnosis. Later, excess SC mortality becomes particularly important, reducing RS even ≥26 years. Radiotherapy; standard adjuvant seminoma treatment 1980-2007, is likely an important contributor, as are chemotherapy and possibly innate susceptibilities. Vigilant long-term follow-up, including psychosocial aspects, is important. Further research should focus on identifying survivor risk groups and optimizing treatment.


Assuntos
Neoplasias Embrionárias de Células Germinativas/mortalidade , Neoplasias Testiculares/mortalidade , Causas de Morte , Comorbidade , História do Século XX , História do Século XXI , Humanos , Masculino , Neoplasias Embrionárias de Células Germinativas/diagnóstico , Neoplasias Embrionárias de Células Germinativas/epidemiologia , Neoplasias Embrionárias de Células Germinativas/história , Noruega/epidemiologia , Vigilância da População , Sistema de Registros , Taxa de Sobrevida , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/epidemiologia , Neoplasias Testiculares/história
8.
BMC Surg ; 19(1): 167, 2019 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-31711457

RESUMO

BACKGROUND: Abdominal cocoon is a rare peritoneal lesion and is difficult to diagnose because of its lack of special clinical manifestations. Until now, there is no case report of abdominal cocoon combined with cryptorchidism and seminoma. CASE PRESENTATION: A case of abdominal cocoon with cryptorchidism and seminoma was diagnosed and treated in our hospital. The patient had no symptoms except occasional abdominal pain. He underwent laparoscopy because of bilateral cryptorchidism and seminoma in the right testis. During the surgery, he was diagnosed with abdominal cocoon due to the thick fibrous tissues which was tightly adhered and encased part of intestine like a cocoon. Enterolysis and bilateral cryptochiectomy were performed after the diagnosis and nutritional and symptomatic support was provided after the surgery. The patient recovered well and was discharged soon. The postoperative pathological examination confirmed the presence of bilateral cryptorchidism and seminoma in the patient's right testis. CONCLUSION: There are only a handful of cases where a patient has both abdominal cocoon and cryptorchidism. Since the etiologies of both diseases remain unknown, further research is required to investigate effective diagnosis and treatment for the diseases and explore the potential connection between the two diseases.


Assuntos
Criptorquidismo/diagnóstico , Seminoma/diagnóstico , Neoplasias Testiculares/diagnóstico , Dor Abdominal/diagnóstico , Dor Abdominal/etiologia , Adulto , Criptorquidismo/complicações , Criptorquidismo/cirurgia , Diagnóstico Diferencial , Humanos , Laparoscopia/métodos , Imagem por Ressonância Magnética , Masculino , Escroto , Seminoma/complicações , Seminoma/cirurgia , Neoplasias Testiculares/complicações , Neoplasias Testiculares/cirurgia , Ultrassonografia , Procedimentos Cirúrgicos Urológicos Masculinos/métodos
9.
Pan Afr Med J ; 33: 282, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692859

RESUMO

Paratesticular liposarcomas (PLS) is a very uncommon pathology type of paratesticular sarcomas, with less 200 similar cases reported to date in the English literature. There are a few cases regarding giant paratesticular liposarcoma measuring over 10 cm. We present an unusual case with a giant well differentiated PLS of the left testis extended to the pelvic cavity. We report the case of a 55-year-old man who presented with large left groin mass. The patient underwent left orchiectomy following a cure of a scrotal hernia. Histological and immunohistochemical findings were suggestive of a well-differentiated liposarcoma of spermatic cord. The surgical margins were positive. Metastatic work-up, which included CT of the thorax, abdomen and pelvis, did not reveal any distant metastasis in thorax but there is a left pathological external iliac lymph nodes and a left lateroplevic lipomatous mass extended to the iliac fossa and left parietocolic gutter up to the umbilicus measuring 15x7x17 cm. Our patient refused treatment. A review of the literature revealed that there are fewer cases of giant well differentiated paratesticular liposarcoma extended to the pelvic cavity were reported. This study focuses on the clinical characteristics and treatment of this rare type of tumours.


Assuntos
Neoplasias dos Genitais Masculinos/diagnóstico , Lipossarcoma/diagnóstico , Cordão Espermático/patologia , Neoplasias Testiculares/diagnóstico , Neoplasias dos Genitais Masculinos/patologia , Neoplasias dos Genitais Masculinos/cirurgia , Humanos , Lipossarcoma/patologia , Lipossarcoma/cirurgia , Masculino , Margens de Excisão , Pessoa de Meia-Idade , Orquiectomia , Neoplasias Testiculares/patologia , Neoplasias Testiculares/cirurgia
10.
Curr Med Sci ; 39(5): 702-706, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31612386

RESUMO

It has been reported that c-KIT ligand (KITLG) gene polymorphisms may be associated with testicular germ cell tumors (TGCT). Owing to mixed and inconclusive results, we conducted a systematic review and meta-analysis to summarize and clarify this association. A systematic search of studies on the association between KITLG gene polymorphisms and TGCT susceptibility was conducted in databases. Odds ratios and 95% confidence intervals were used to pool the effect size. Six articles were included in our systematic review and meta-analysis. Compared with adenine (A), KITLG rs995030 guanine (G) might be associated with increased risk of TGCT. There are insufficient data to fully confirm the association between KITLG rs4474514 and TGCT susceptibility. Well-designed studies with larger sample size and more subgroups are required to validate the risk identified in the current meta-analysis.


Assuntos
Predisposição Genética para Doença , Neoplasias Embrionárias de Células Germinativas/diagnóstico , Neoplasias Embrionárias de Células Germinativas/genética , Polimorfismo de Nucleotídeo Único , Fator de Células-Tronco/genética , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/genética , Grupo com Ancestrais do Continente Asiático , Grupo com Ancestrais do Continente Europeu , Expressão Gênica , Humanos , Masculino , Neoplasias Embrionárias de Células Germinativas/etnologia , Neoplasias Embrionárias de Células Germinativas/patologia , Razão de Chances , Neoplasias Testiculares/etnologia , Neoplasias Testiculares/patologia
11.
JNMA J Nepal Med Assoc ; 57(216): 127-129, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31477948

RESUMO

There are various causes of primary amenorrhea in phenotypically females such as, complete androgen insensitivity syndrome, pure gonadal dysgenesis, 17b-hydroxysteroid dehydrogenase deficiency, or mixed gonadal dysgenesis. Primary amenorrhea in a phenotypically female is commonly encountered in Androgen Insensitivity Syndrome. In patients with Androgen Insensitivity Syndrome, with intra-abdominal testis there is high chances of developing testicular tumour, among them Sertoli cell tumour and seminoma being the most common types. Leydig cell tumour in androgen insensitivity syndrome, is very rare and malignant leydig cell tumour is even further rarer. There are few cases reported in the literature of malignant leydig cell tumour with complete androgen insensitivity. Here we are reporting a case of 65 years married elderly patient with malignant leydig cell tumour with complete androgen insentivity syndrome. Keywords: complete androgen insensitivity syndrome; leydig cell tumour; testicular feminization.


Assuntos
Síndrome de Resistência a Andrógenos/diagnóstico , Tumor de Células de Leydig/diagnóstico , Neoplasias Testiculares/diagnóstico , Idoso , Feminino , Humanos , Tumor de Células de Leydig/patologia , Masculino , Fenótipo , Neoplasias Testiculares/patologia
12.
Urologe A ; 58(11): 1331-1337, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31559444

RESUMO

INTRODUCTION: Malignant testicular germ cell tumors are the most common tumor disease in young men, affecting not only the period of his reproductive phase but also creating a complex life situation. Therapy includes the risk of development of second neoplasia and sequelae. However, particularly in this age group, knowledge about this disease and risk factors is sparse, and preventive examinations are not available or are not or insufficiently used. MATERIALS AND METHODS: In order to evaluate the state of knowledge on testicular tumors in adolescents, a knowledge survey was conducted at 6 high schools in Hamburg from January to April 2019 among pupils of grades 11 and 12. This was carried out with a questionnaire comprising 15 items, which was analyzed and also evaluated on a gender-specific basis. Only fully completed questionnaires were considered. RESULTS: The overall proportion of correctly answered questions was 60.04%. Broken down by gender, the proportion was 60.18% for female pupils and 59.14% for male pupils, while the gender ratio was 52.2 and 47.8% for female pupils. Special questions on testicular tumors were answered correctly by 59.71% of the female students and 54.8% of the male students, while general questions on the structure and function of the male sexual organs were answered 4.51% better by the male students with 64.9%. These were statistically significant in both cases. CONCLUSION: The survey shows a gender-specific knowledge deficit on testicular tumors, which is more pronounced among boys. As intensified knowledge transfer on this topic alone is insufficient, a preventive examination should be established especially for boys. This would enable individual, risk-commensurate and needs-adapted monitoring and early detection of testicular tumor disease, but also of other health issues in male adolescents.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Neoplasias Embrionárias de Células Germinativas/diagnóstico , Estudantes/psicologia , Neoplasias Testiculares/diagnóstico , Adolescente , Humanos , Masculino , Comportamento Sexual , Inquéritos e Questionários , Neoplasias Testiculares/prevenção & controle , Adulto Jovem
13.
Pan Afr Med J ; 33: 85, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31489063

RESUMO

Introduction: Testicular self-examination (TSE) is a screening technique that involves inspection of the appearance and palpation of the testes to detect any changes from the normal. Globally, the incidence of cancer has increased among which is testicular cancer (TC). Data on this topic among male secondary school adolescents in Uganda is limited therefore this study sought to assess the knowledge and practice of testicular self-examination among secondary students at Ntare School, Mbarara District in south western Uganda. The objective of the study is to assess the knowledge and practice of testicular self-examination among secondary students at Ntare School in Mbarara district, south western Uganda. Methods: We conducted a descriptive cross-sectional quantitative study among 165 students. Recruitment was made using simple random sampling technique. Respondents were selected among advanced level (A' level) male students studying at Ntare School in Mbarara district, south western Uganda. Structured self-administered questionnaires were used for data collection. Results: Of the male students, 41.8% reported to have knowledge about TSE and only 23.6% practiced TSE. Most students rated their knowledge of TSE to be below 5 (from 1-10). Of the 39 students who admitted performing TSE, only 16 did so as recommended (monthly). Conclusion: The knowledge and practice of TSE were low among adolescent secondary school boys in Ntare School in Mbarara District, south western Uganda. This suggests that these students are unaware of the value of this personal health promotion tool which is fundamental in early diagnosis of testicular cancer.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Autoexame/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Neoplasias Testiculares/diagnóstico , Adolescente , Adulto , Estudos Transversais , Educação em Saúde/métodos , Promoção da Saúde/métodos , Humanos , Masculino , Instituições Acadêmicas , Inquéritos e Questionários , Uganda , Adulto Jovem
14.
Anticancer Res ; 39(9): 4911-4916, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31519595

RESUMO

BACKGROUND/AIM: The occurrence of somatic transformation in germ cell tumour (GCT) is rare, with increased incidence in teratomatous tumours. The aim of this study was to understand the clinical outcomes of patients with metastatic GCT with somatic transformation. MATERIALS AND METHODS: A retrospective study was conducted in two tertiary cancer centres in London. Between 1998 and 2016, 30 cases of somatic transformation in GCT treated at the Mount Vernon Cancer Centre and St. Bartholomew's Hospital were identified. The median age at diagnosis was 34 years (range=18-56 years). The histological diagnosis at transformation was rhabdomyosarcoma, sarcomatoid yolk sac, sarcoma (non-specified), clear cell carcinoma, adenocarcinoma and primitive neuro ectodermal tumour (PNET). RESULTS: The 5-year survival rate of all patients was 47%, and that of patients with testicular primary (n=26 patients) was 37%. CONCLUSION: Somatic transformation component in testicular GCTs is generally considered to be an adverse prognostic factor, however, a reasonable 5-year overall survival rate (87.5%) was observed in patients who present with this at first diagnosis.


Assuntos
Transformação Celular Neoplásica/genética , Mutação , Neoplasias Embrionárias de Células Germinativas/genética , Neoplasias Embrionárias de Células Germinativas/secundário , Neoplasias Testiculares/genética , Neoplasias Testiculares/secundário , Adolescente , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Suscetibilidade a Doenças , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Embrionárias de Células Germinativas/diagnóstico , Neoplasias Embrionárias de Células Germinativas/terapia , Retratamento , Análise de Sobrevida , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/terapia , Resultado do Tratamento , Adulto Jovem
15.
Hinyokika Kiyo ; 65(6): 215-218, 2019 Jun.
Artigo em Japonês | MEDLINE | ID: mdl-31501388

RESUMO

A 56-year-old man presented with a painless swelling of the left scrotum. Cytologic examination of blood stained hydrocele fluid suggested malignancy. Left high orchiectomy was performed under the suspicion of malignant tumor of the tunica vaginalis testis. The final pathologic report revealed malignant mesothelioma of the tunica vaginalis testis. There is no evidence of recurrence after 114 months followup. It is important to perform en bloc resection for this disease to prevent recurrence.


Assuntos
Mesotelioma , Neoplasias Testiculares , Humanos , Masculino , Mesotelioma/cirurgia , Pessoa de Meia-Idade , Orquiectomia , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/cirurgia , Testículo/patologia
16.
Hinyokika Kiyo ; 65(8): 347-350, 2019 Aug.
Artigo em Japonês | MEDLINE | ID: mdl-31501405

RESUMO

We present a case of unclassified sex cord-stromal testicular tumor with lung metastasis. A 48-year-old man consulted our hospital for left testicular enlargement that began 3 years ago. Computed tomography revealed a heterogeneously enhanced left testicular tumor 11 cm in diameter and a 5 mm metastatic lung tumor. The human chorionic gonadotropin (hCG) level was elevated (141.6 mU/ml), whereas the levels of α-fetoprotein (AFP) and LDH were normal. The external genitalia were normal and gynecomastia was not observed. Left high orchiectomy followed by 3 cycles of BEP chemotherapy (bleomycin, etoposide, and cisplatin) every 4 weeks was performed. The pathology of the excised specimen was unclassified sex cordstromal testicular tumor containing hCG-positive cells. On immunohistochemistry, the tumor cells were partly positive for AE1/AE3, hCG, and calretinin. Vimentin was diffusely positive, but OCT3/4, SALL4, GATA3, and CK7 were negative. After BEP treatment, the metastatic lung lesion disappeared. Unclassified sex cord-stromal testicular tumor is a rare disease and its treatment has not been established. Thus, further accumulation of cases is needed.


Assuntos
Tumores do Estroma Gonadal e dos Cordões Sexuais , Neoplasias Testiculares , Protocolos de Quimioterapia Combinada Antineoplásica/provisão & distribução , Bleomicina , Gonadotropina Coriônica/sangue , Cisplatino , Etoposídeo , Humanos , Masculino , Pessoa de Meia-Idade , Orquiectomia , Tumores do Estroma Gonadal e dos Cordões Sexuais/diagnóstico , Tumores do Estroma Gonadal e dos Cordões Sexuais/tratamento farmacológico , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/tratamento farmacológico
17.
Bull Cancer ; 106(10): 903-914, 2019 Oct.
Artigo em Francês | MEDLINE | ID: mdl-31495441

RESUMO

Germ-cell tumors are the most common solid tumors in young men. The follow-up of these patients is very important in their management. In stage I testicular cancer, surveillance is the standard for low-risk disease. In addition to the early detection of relapse, follow-up should be directed towards prevention, detection and treatment of late toxicity, and secondary malignancies. Follow up consists in physical examination, laboratory analysis and radiological imaging. Recently, guidelines recommend risk-adapted surveillance strategy, with a reduction of CT scans numbers, due to the recognition of the risk of ionizing radiation exposure. However, efforts to maintain adequate compliance with follow up are required.


Assuntos
Recidiva Local de Neoplasia/prevenção & controle , Neoplasias Embrionárias de Células Germinativas/prevenção & controle , Segunda Neoplasia Primária/diagnóstico , Neoplasias Testiculares/prevenção & controle , Adulto , Humanos , Masculino , Recidiva Local de Neoplasia/diagnóstico , Recidiva Local de Neoplasia/patologia , Neoplasias Embrionárias de Células Germinativas/diagnóstico , Neoplasias Embrionárias de Células Germinativas/patologia , Neoplasias Induzidas por Radiação/diagnóstico , Neoplasias Induzidas por Radiação/prevenção & controle , Cooperação do Paciente , Exposição à Radiação/prevenção & controle , Prevenção Secundária , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/patologia , Tomografia Computadorizada por Raios X , Adulto Jovem
18.
Exp Mol Pathol ; 110: 104293, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31381875

RESUMO

The accurate classification and proper identification of testicular germ cell tumors is imperative for treatment selection and clinical prognosis. Although such distinction can often be achieved by microscopic morphology alone, ancillary tests may at times be needed. T-cell factor 7 L1 (TCF7L1, also known as TCF3), a component of the Wnt signaling pathway, plays important roles in embryonic stem cell self-renewal and lineage specification. Here we examined the immunohistochemical expression and diagnostic utility of TCF7L1 in testicular germ cell tumors. Fifty cases of testicular germ cell tumors were collected, including 23 seminomas, 6 embryonal carcinomas, 1 teratoma, 1 choriocarcinoma, and 19 mixed germ cell tumors. The components of the mixed germ cell tumors were seminoma (n = 3), embryonal carcinoma (n = 18), yolk sac tumor (n = 9), teratoma (n = 15), and choriocarcinoma (n = 4). On immunohistochemistry of TCF7L1, only nuclear staining was considered positive. Staining was graded as negative (<5% of tumor cells stained), minimal (5-25% positive), focal (26-50%), and diffuse (>50%). All non-seminomatous components (n = 54) exhibited distinct nuclear expression of TCF7L1 (54/54; 100%). In contrast, no TCF7L1 expression was detected in the majority of seminomatous tumor component (24/26; 92%). Two seminomas (2/26; 8%) exhibited minimal weak nuclear staining (5% and 10%, respectively) for TCF7L1. In conclusion, TCF7L1, highly expressed in non-seminomatous testicular germ cell tumors, might be used as a marker for diagnosis of testicular germ cell tumors, two therapeutically different entities, for better patient management.


Assuntos
Biomarcadores Tumorais/metabolismo , Neoplasias Embrionárias de Células Germinativas/diagnóstico , Seminoma/diagnóstico , Neoplasias Testiculares/diagnóstico , Proteína 1 Semelhante ao Fator 7 de Transcrição/metabolismo , Adulto , Diagnóstico Diferencial , Humanos , Imuno-Histoquímica , Masculino , Neoplasias Embrionárias de Células Germinativas/metabolismo , Seleção de Pacientes , Seminoma/metabolismo , Neoplasias Testiculares/metabolismo
19.
BMJ Case Rep ; 12(8)2019 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-31413056

RESUMO

WHO first recognised extranodal NK/T-cell lymphoma (ENKTCL) in 2001, thanks to technical advances in anatomopathology and immunohistochemistry. It is divided into nasal and extranasal subgroups depending on the primary site. Primary isolated NK/T-cell lymphoma of the testis is rare. Typical recurrence sites of primary testicular NK/T-cell lymphoma are the gastrointestinal tract, lymph nodes, skin, spleen and central nervous system. Nasal relapses of a primary NK/T-cell lymphoma of the testis are very rare and according to our knowledge, no other case has been reported yet in the literature. The authors report the case of a 35-year-old Caucasian man relapsing twice in the nasal cavity 1 year after initial diagnosis and treatment of a primary isolated, stage IE, ENKTCL of the testis. We report the clinical and radiological presentation of the nasal relapses and the different modalities of treatment that were applied. Sinonasal relapses of an isolated primary NK/T-cell lymphoma of the testis are very rare. ENKTCL is a very aggressive entity, even at an early stage, therefore, requiring a multimodal treatment approach including chemotherapy and radiotherapy. New strategies to treat this disease are needed.


Assuntos
Linfoma Extranodal de Células T-NK/diagnóstico , Recidiva Local de Neoplasia/diagnóstico , Neoplasias Nasais/diagnóstico , Neoplasias Testiculares/diagnóstico , Adulto , Terapia Combinada , Diagnóstico Diferencial , Humanos , Linfoma Extranodal de Células T-NK/patologia , Linfoma Extranodal de Células T-NK/terapia , Masculino , Metástase Neoplásica , Recidiva Local de Neoplasia/diagnóstico por imagem , Recidiva Local de Neoplasia/terapia , Neoplasias Nasais/diagnóstico por imagem , Neoplasias Nasais/secundário , Neoplasias Nasais/terapia , Tomografia por Emissão de Pósitrons , Neoplasias Testiculares/patologia , Neoplasias Testiculares/terapia , Tomografia Computadorizada por Raios X
20.
Pan Afr Med J ; 33: 55, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31448017

RESUMO

Paratesticular rhabdomyosarcoma is a rare tumor. Treatment is based on multimodal therapy as well as on surgery, chemotherapy and radiotherapy. This study and literature review highlight the diagnostic and therapeutic approaches to treat paratesticular rhabdomyosarcoma.


Assuntos
Rabdomiossarcoma/diagnóstico , Neoplasias Testiculares/diagnóstico , Terapia Combinada , Humanos , Masculino , Rabdomiossarcoma/patologia , Rabdomiossarcoma/terapia , Neoplasias Testiculares/patologia , Neoplasias Testiculares/terapia , Adulto Jovem
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