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1.
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
2.
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
3.
Bull Cancer ; 106(10): 896-902, 2019 Oct.
Artigo em Francês | MEDLINE | ID: mdl-31466695

RESUMO

Metastatic testicular germ cell tumors are rare entities with a high cure rate owing to their major chemosensitivity. Current guidelines should be strictly followed to ensure maximal cure rate. Germ cell tumor treatment requires multidisciplinary skills and is based on cisplatin-based chemotherapy. The current challenge for these patients with favorable prognosis is to limit over- or under-treatment. Centralization of care for patients with these rare cancers is a key point to achieve the best chance of cure.


Assuntos
Neoplasias Embrionárias de Células Germinativas/secundário , Neoplasias Embrionárias de Células Germinativas/terapia , Neoplasias Testiculares/secundário , Neoplasias Testiculares/terapia , Antineoplásicos/uso terapêutico , Cisplatino/uso terapêutico , Terapia Combinada/métodos , Humanos , Masculino , Neoplasias Embrionárias de Células Germinativas/classificação , Neoplasias Embrionárias de Células Germinativas/patologia , Orquiectomia , Prognóstico , Neoplasias Testiculares/classificação , Neoplasias Testiculares/patologia
4.
Bull Cancer ; 106(10): 868-874, 2019 Oct.
Artigo em Francês | MEDLINE | ID: mdl-31350015

RESUMO

OBJECTIVES: To describe the epidemiological, clinical and therapeutic aspects of primary urological cancers in semi-urban areas in Burkina Faso. PATIENTS AND METHOD: A descriptive study was conducted over the period from 1 January 2008 to 31 December 2017 in the General Surgery Department of the Tenkodogo Regional Hospital, located in the east of Burkina Faso. All patients over 15 years of age who were diagnosed with primary urological cancer were included. RESULTS: A total of 160 patients were included. One hundred and thirty-one patients were male (81.9%). The sex ratio was 4.5. The average age of the patients was 58.9 years (standard deviation: 18 years). We found 73 cases of prostate cancers (45.6%), 53 bladder cancers (33.1%), 17 kidney cancers (10.6%), 11 testicular cancers (6.9%) and 6 cancers of the male external genitalia (3.7%). The histological types of prostate cancer were adenocarcinoma (88%) and neuroendocrine carcinoma (12%). Thirty-seven prostate cancers (50.7%) were diagnosed at the T3 stage and 12 others (16.4%) at the T4 stage. Prostate cancer treatment was only medical in 23 patients; surgical treatment was indicated in 50 other patients. The 5-year survival was 85%. Sixteen patients (30.2%) had metastatic bladder cancer at the time of diagnosis. The treatment of vesical cancers has been palliative in 50 cases.


Assuntos
Recursos em Saúde , Neoplasias Urológicas/epidemiologia , Neoplasias Urológicas/terapia , Adenocarcinoma/epidemiologia , Adenocarcinoma/patologia , Adenocarcinoma/terapia , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Burkina Faso/epidemiologia , Países em Desenvolvimento , Neoplasias das Glândulas Endócrinas/epidemiologia , Neoplasias das Glândulas Endócrinas/patologia , Neoplasias das Glândulas Endócrinas/terapia , Feminino , Humanos , Neoplasias Renais/epidemiologia , Neoplasias Renais/patologia , Neoplasias Renais/terapia , Masculino , Pessoa de Meia-Idade , Neoplasias da Próstata/epidemiologia , Neoplasias da Próstata/patologia , Neoplasias da Próstata/terapia , Distribuição por Sexo , Taxa de Sobrevida , Neoplasias Testiculares/epidemiologia , Neoplasias Testiculares/patologia , Neoplasias Testiculares/terapia , Neoplasias da Bexiga Urinária/epidemiologia , Neoplasias da Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/terapia , Neoplasias Urológicas/patologia , Adulto Jovem
5.
Urol Clin North Am ; 46(3): 315-331, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31277727

RESUMO

Germ cell tumors (GCTs) of the testis are cured with the successful integration of surgery, chemotherapy, and/or radiation therapy in most cases. The favorable results are a consequence of improved risk stratification, risk-adapted chemotherapy, reduced morbidity of treatment, and appropriate integration of multimodal therapy. The success of these approaches depends on accurate staging with imaging studies of the testis, retroperitoneum, and thorax. This article reviews the indications for imaging and performance characteristics of modalities in the diagnosis, staging, surveillance, and follow-up of patients with GCTs. We also highlight the current guideline recommendations for imaging in treatment of patients with GCTs.


Assuntos
Neoplasias Embrionárias de Células Germinativas/diagnóstico por imagem , Neoplasias Testiculares/diagnóstico por imagem , Biomarcadores Tumorais/sangue , Humanos , Masculino , Estadiamento de Neoplasias , Neoplasias Embrionárias de Células Germinativas/patologia , Neoplasias Embrionárias de Células Germinativas/terapia , Vigilância da População , Neoplasias Testiculares/patologia , Neoplasias Testiculares/terapia
6.
Urol Clin North Am ; 46(3): 341-351, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31277729

RESUMO

The presence of cancer in the testis, as well as the therapies used to treat testis cancer, can impair fertility potential for affected men. Fertility preservation is an important aspect of survivorship care and should be offered to all patients before initiating treatment. The only established means of fertility preservation in men is cryopreservation of sperm. Methods for fertility preservation in prepubertal boys are still experimental. Physicians treating men with testicular cancer should be familiar with the available options. This article outlines testicular cancer and its treatment's effects on fertility, fertility preservation options, and barriers to accessing this specialized care.


Assuntos
Preservação da Fertilidade/métodos , Infertilidade Masculina/etiologia , Neoplasias Testiculares/complicações , Neoplasias Testiculares/terapia , Fatores Etários , Criopreservação , Humanos , Masculino
7.
Urol Clin North Am ; 46(3): 353-362, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31277730

RESUMO

Experience demonstrates multiple paths to cure for patients with clinical stage I testicular cancer. Because all options should provide a long-term disease-free rate near 100%, overall survival is no longer relevant in decision making, allowing practitioners to factor in quality of life, toxicity, cost, and impact on compliance. Surveillance for clinical stage I seminoma and clinical stage I nonseminoma has become the preferred option. The contrarian view is that a risk-adapted approach should persist, with surveillance for low-risk individuals and active therapy high-risk individuals. However, results obtained in unselected patients provide a strong argument against the need for such an approach.


Assuntos
Neoplasias Embrionárias de Células Germinativas/patologia , Neoplasias Embrionárias de Células Germinativas/terapia , Neoplasias Testiculares/patologia , Neoplasias Testiculares/terapia , Biomarcadores Tumorais/metabolismo , Intervalo Livre de Doença , Custos de Cuidados de Saúde , Humanos , Masculino , Estadiamento de Neoplasias , Qualidade de Vida
8.
Urol Clin North Am ; 46(3): 363-376, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31277731

RESUMO

There are several treatment approaches for stage II germ cell tumors (GCTs), and a thorough understanding of the staging classification and histologic differences in tumor biology and therapeutic responsiveness is critical to determine an effective, multimodal management strategy that involves urologists, medical oncologists, and radiation oncologists. This article discusses contemporary management strategies for stage II GCTs, including chemotherapy, radiotherapy, retroperitoneal lymph node dissection (RPLND), and surveillance. Patient selection, histology, and extent of lymphadenopathy drive management, and, as both treatment and detection strategies continue to emerge and be refined, the management of patients with stage II GCT continues to evolve.


Assuntos
Neoplasias Embrionárias de Células Germinativas/patologia , Neoplasias Embrionárias de Células Germinativas/terapia , Neoplasias Testiculares/patologia , Neoplasias Testiculares/terapia , Intervalo Livre de Doença , Custos de Cuidados de Saúde , Humanos , Excisão de Linfonodo , Metástase Linfática , Masculino , Estadiamento de Neoplasias , Qualidade de Vida
9.
Urol Clin North Am ; 46(3): 419-427, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31277736

RESUMO

Growing teratoma syndrome (GTS) is a rare clinical phenomenon in patients with nonseminomatous germ cell cancer defined by growing metastatic mass during ongoing or directly after completed chemotherapy with timely decreasing tumor markers and postpubertal teratoma exclusively after resection. GTS was first described in 1982, and few reports have been published. The limited number of studies and the resulting lack of exact knowledge about development, differentiation, and treatment of GTS leaves several clinical problems regarding treatment and follow-up unsolved. This review provides an overview of clinical diagnosis and disease management and an approach to explain the molecular development of GTS.


Assuntos
Teratoma/patologia , Teratoma/terapia , Neoplasias Testiculares/patologia , Neoplasias Testiculares/terapia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biomarcadores Tumorais/análise , Terapia Combinada , Diagnóstico Diferencial , Progressão da Doença , Humanos , Metástase Linfática , Masculino , Estadiamento de Neoplasias , Neoplasia Residual/patologia , Neoplasia Residual/terapia , Prognóstico , Neoplasias Retroperitoneais/secundário , Neoplasias Retroperitoneais/terapia , Síndrome
10.
Urol Clin North Am ; 46(3): 439-448, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31277738

RESUMO

Germ cell tumors (GCT) are the most common cancer in men between 15 and 35 years of age and the incidence has increased during the past several decades. This article reviews the current knowledge on high-dose chemotherapy (HDCT) and stem cell transplant for salvage treatment of patients with relapsed metastatic GCT. Furthermore, the authors attempt to dissect the controversy of using standard-dose versus high-dose therapy as initial salvage and identify patients who are most likely to benefit from HDCT and peripheral blood stem cell transplant.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Neoplasias Embrionárias de Células Germinativas/terapia , Transplante de Células-Tronco , Neoplasias Testiculares/terapia , Terapia Combinada , Humanos , Masculino , Recidiva Local de Neoplasia/terapia , Neoplasias Embrionárias de Células Germinativas/patologia , Terapia de Salvação , Neoplasias Testiculares/patologia , Transplante Autólogo
11.
Urol Clin North Am ; 46(3): 449-457, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31277739

RESUMO

Two clusters of microRNAs have been discovered highly expressed by seminoma and nonseminoma germ cell tumors. They are secreted in blood of patients with testicular germ cell tumors and can be extracted from the serum or plasma and quantified by real-time-polymerase chain reaction. Results have confirmed the feasibility of the technique and demonstrated that sensitivity and specificity of those microRNAs in detecting viable germ cell tumors are higher than with current methods. If operation characteristics are confirmed in larger studies, those microRNAs will be valuable to manage equivocal clinical scenarios characterized by high uncertainty and high risk of over-treatment or under-treatment.


Assuntos
Biomarcadores Tumorais/sangue , MicroRNAs/sangue , Neoplasias Embrionárias de Células Germinativas/sangue , Neoplasias Testiculares/sangue , Humanos , Masculino , Estadiamento de Neoplasias , Neoplasias Embrionárias de Células Germinativas/patologia , Neoplasias Embrionárias de Células Germinativas/terapia , Sensibilidade e Especificidade , Neoplasias Testiculares/patologia , Neoplasias Testiculares/terapia
13.
Ann Hematol ; 98(10): 2463-2465, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31240468
14.
Bull Cancer ; 106(10): 915-922, 2019 Oct.
Artigo em Francês | MEDLINE | ID: mdl-31126677

RESUMO

GOAL: Long-term evaluation of the incidence of sexual dysfunction from patients who were treated by orchidectomy, chemotherapy, and retroperitoneal lymphadenectomy for testicular cancer. METHODS: In 2018, patients who were treated in two academic hospitals by orchiectomy, chemotherapy, and retroperitoneal lymphadenectomy, and were in complete remission, were included. The patients included in this study filled the survey, which covered aspects of their sexuality (the Male Sexual Health Questionnaire) and answered additional questions, which evaluated psychological impact and modification of their sexuality since the management of their cancer. RESULTS: Twenty patients have been included, 70% of the patients treated for non-seminomatous germ cell tumor. Mean age was 36.4years±12.1 and the average duration of follow-up was 59months±34. Sexual dysfunction was found in 50% of the patients. Only 10% of the patients could preserve satisfying sexual activity during their treatment. Since the end of their treatment, 16%, 21% and 37% of patients respectively declared high libido loss, lower tumescent erections and persistence of anejaculation. In the end, nearly 70% of these patients wished a dedicated consultation with an urologist with subspecialty in andrology, in order to obtain further information during their care course. DISCUSSION: These patients have shown multicomponent sexual dysfunction. They could benefit from a new healthcare pathway implying early involvement of andrologist network.


Assuntos
Antineoplásicos/administração & dosagem , Excisão de Linfonodo/efeitos adversos , Orquiectomia/efeitos adversos , Complicações Pós-Operatórias/etiologia , Disfunções Sexuais Fisiológicas/etiologia , Neoplasias Testiculares/terapia , Adulto , Andrologia , Coito , Ejaculação , Humanos , Libido , Masculino , Neoplasias Embrionárias de Células Germinativas/terapia , Ereção Peniana/fisiologia , Complicações Pós-Operatórias/epidemiologia , Disfunções Sexuais Fisiológicas/epidemiologia , Disfunções Sexuais Psicogênicas/etiologia
15.
Chirurgia (Bucur) ; 114(2): 300-306, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31060665

RESUMO

Introduction: We report a rare case of testicular teratoma combined with a neuroendocrine tumour, emphasizing the difficulty of the following aspects: the clinical and laboratory diagnosis, the treatment options and the evolution of patients suffering from this disease. Case presentation: The patients with testicular neuroendocrine tumours represent a rarity, considering that as of 2017, only 22 cases had been reported in the literature. The case operated on in our clinic presents an association between a testicular teratoma and a neuroendocrine tumour. A 39-year-old patient was admitted in our Department for a non-painful abdominal tumour and concomitant testicular tumour. The serum tumour markers (-human chorionic gonadotropin, -phetoprotein and lactate dehydrogenase) were within normal limits. Lung and bone metastases were diagnosed CT scan. The histopathological diagnosis consisted of immunohistochemical study of the orchidectomy specimen as well as of the bioptic material from bone marrow puncture. Conclusions: The diagnosis of testicular carcinoids is based on immunohistochemistry study. Radical orchidectomy is the only potentially curative treatment for this type of malignancy. Adjuvant chemotherapy determined size reduction of the lung and bone metastases and the disappearance of the lymph node metastases.


Assuntos
Tumores Neuroendócrinos/terapia , Neoplasias Retroperitoneais/terapia , Teratoma/terapia , Neoplasias Testiculares/terapia , Adulto , Antineoplásicos/administração & dosagem , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/secundário , Neoplasias Ósseas/terapia , Quimioterapia Adjuvante , Humanos , Imuno-Histoquímica , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/secundário , Neoplasias Pulmonares/terapia , Metástase Linfática , Masculino , Tumores Neuroendócrinos/diagnóstico por imagem , Tumores Neuroendócrinos/secundário , Orquiectomia , Radioterapia , Neoplasias Retroperitoneais/diagnóstico por imagem , Neoplasias Retroperitoneais/secundário , Teratoma/diagnóstico por imagem , Teratoma/secundário , Neoplasias Testiculares/diagnóstico por imagem , Neoplasias Testiculares/patologia , Resultado do Tratamento
17.
J Urol ; 202(2): 272-281, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31059667

RESUMO

PURPOSE: Testis cancer is the most common solid malignancy in young males. The purpose of this guideline is to provide a useful reference on the effective evidence-based treatment of early stage testicular cancer. METHODS: The systematic review utilized to inform this guideline was conducted by a methodology team at the Johns Hopkins University Evidence-based Practice Center. The methodology team searched using PubMed®, Embase®, and the Cochrane Central Register of Controlled Trials (CENTRAL) from January 1980 through August 2018. The evidence review team also reviewed relevant systematic reviews and references provided by the panel to identify articles that may have been missed by the database searches. RESULTS: When sufficient evidence existed, the body of evidence was assigned a strength rating of A (high), B (moderate), or C (low). Such evidence-based statements are provided as Strong, Moderate, or Conditional Recommendations. In instances of insufficient evidence, additional guidance is provided as Clinical Principles and Expert Opinions. CONCLUSIONS: This guideline attempts to improve a clinician's ability to evaluate and treat patients with testicular cancer, but higher quality evidence in future trials will be essential to improve level of care for these patients.


Assuntos
Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/terapia , Algoritmos , Humanos , Masculino , Estadiamento de Neoplasias , Revisão Sistemática como Assunto , Neoplasias Testiculares/patologia
18.
Int Braz J Urol ; 45(3): 629-633, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30912892

RESUMO

Most patients with testicular germ cell tumor present with a painless scrotal mass. We report a 19-year-old patient who presented with neurological complains. Rapid clinical progression to coma was noted during the staging work up. A diagnosis of testicular mixed germ cell tumor with multiorgan metastasis (lymph node, lung, liver and brain) was made. Patients with brain metastasis should receive chemotherapy alone or combined with surgery or radiotherapy. Because the clinical symptoms deteriorated quickly, surgery was used upfront followed by chemotherapy and radiotherapy for the brain tumor. After the first stage of treatment, the clinical symptoms, tumor markers and imaging findings were improved. The residual brain tumor was eliminated by chemotherapy, and only sparse degenerated tumor cells were noted in the brain tissue. Longer follow up is required to assess the impact of our treatment strategy.


Assuntos
Neoplasias Encefálicas/secundário , Neoplasias Embrionárias de Células Germinativas/secundário , Convulsões/patologia , Neoplasias Testiculares/patologia , Neoplasias Encefálicas/terapia , Gonadotropina Coriônica Humana Subunidade beta/sangue , Humanos , L-Lactato Desidrogenase/sangue , Masculino , Neoplasias Embrionárias de Células Germinativas/diagnóstico por imagem , Neoplasias Embrionárias de Células Germinativas/terapia , Convulsões/diagnóstico por imagem , Neoplasias Testiculares/diagnóstico por imagem , Neoplasias Testiculares/terapia , Fatores de Tempo , Tomografia Computadorizada por Raios X , Adulto Jovem , alfa-Fetoproteínas/análise
19.
Future Oncol ; 15(12): 1347-1352, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30880465

RESUMO

Germ cell tumors represent 11% of the cancers diagnosed in adolescent males and are the most common solid tumors in adult men between the ages of 20 and 35. Pure seminoma accounts for around 50% of all testicular germ cell tumors. The prognostic classification of the International Germ Cell Cancer Collaborative Group for good-prognosis seminoma includes both nodal disease and pulmonary visceral metastases. In this article, we analyzed recent data on prognosis and outcome of good-prognosis seminoma to revise the traditional classification of the disease and improve tailored treatment.


Assuntos
Biomarcadores Tumorais/análise , Neoplasias Pulmonares/mortalidade , Seminoma/classificação , Neoplasias Testiculares/classificação , Intervalo Livre de Doença , Humanos , Neoplasias Pulmonares/secundário , Neoplasias Pulmonares/terapia , Masculino , Estadiamento de Neoplasias , Prognóstico , Medição de Risco , Seminoma/mortalidade , Seminoma/secundário , Seminoma/terapia , Neoplasias Testiculares/mortalidade , Neoplasias Testiculares/secundário , Neoplasias Testiculares/terapia , Testículo/patologia
20.
BMC Cancer ; 19(1): 244, 2019 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-30885154

RESUMO

BACKGROUND: Nonseminomatous germ cell tumors (NSGCTs) represent one of the main groups of germ cell tumors (GCTs), and they have a more invasive course than seminomatous GCTs. Human immunodeficiency virus (HIV) positivity is considered to be a risk factor for testicular seminoma patients, but reports about HIV-infected individuals with NSGCTs are rare. CASE PRESENTATION: We report a case of a retroperitoneal mixed extragonadal germ cell tumor in an HIV-infected man who has been diagnosed with bilateral cryptorchidism since birth. A 30-year-old man presented with a large heterogeneously mixed echo mass located in the right lower abdomen according to an abdominal ultrasound; he was HIV-positive and had a low CD4 count of 70 cells/ml in the followed test, which suggested severe immunosuppression, and ultrasound-guided biopsy histology revealed a malignant yolk sac tumor of the testis. First, the patient received combination antiretroviral therapy; then, to relieve his symptoms, an exploratory laparotomy and retroperitoneal neoplasm resection under general anesthesia were performed for subsequent treatment. The postoperative histopathological examination indicated that the patient exhibited malignant mixed GCTs of the undescended testis that were composed predominantly of yolk sac tumors with foci of embryonal cell carcinoma and seminoma; It is a rare type in various GCTs, especially in HIV-infected patients. After the operation, the patient underwent computed tomography follow-up scans at 1 week and 2 weeks, and the results showed that the size of the right inguinal mass gradually increased, which suggested a poor outcome. To limit the growth of the tumors, right inguinal mass resection under local anesthesia was performed 17 days after the initial operation, and pathological examination revealed mixed GCT metastasis. Subsequently, the patient received salvage chemotherapy with a regimen of cisplatin, etoposide, and ifosfamide. Unfortunately, the patient died 1 week after the first cycle of chemotherapy because of severe immunosuppression, a low platelet count and cancer cachexia. CONCLUSIONS: Because of severe immunosuppression, the treatment of advanced extragonadal NSGCTs in an HIV-infected patient resulted in a poor prognosis. This outcome should be considered in further research, and appropriate management for achieving long-term survival needs to be established.


Assuntos
Criptorquidismo/complicações , Infecções por HIV/complicações , Hospedeiro Imunocomprometido , Neoplasias Embrionárias de Células Germinativas/complicações , Neoplasias Retroperitoneais/complicações , Neoplasias Testiculares/complicações , Adulto , Fármacos Anti-HIV/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Quimioterapia Adjuvante/métodos , Criptorquidismo/patologia , Criptorquidismo/terapia , Evolução Fatal , Infecções por HIV/tratamento farmacológico , Infecções por HIV/virologia , Humanos , Masculino , Neoplasias Embrionárias de Células Germinativas/diagnóstico , Neoplasias Embrionárias de Células Germinativas/terapia , Neoplasias Embrionárias de Células Germinativas/virologia , Prognóstico , Neoplasias Retroperitoneais/diagnóstico , Neoplasias Retroperitoneais/terapia , Neoplasias Retroperitoneais/virologia , Terapia de Salvação/métodos , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/terapia , Neoplasias Testiculares/virologia , Testículo/patologia , Testículo/cirurgia
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