The Japanese Journal of Urology
Online ISSN : 1884-7110
Print ISSN : 0021-5287
ISSN-L : 0021-5287
CLINICAL STUDY OF BILATERAL METACHRONOUS TESTICULAR TUMORS WITH DIFFERENT HISTOLOGICAL FINDINGS
Masayuki MaruokaTakehiko MiyauchiTadao NagayamaTakeichirou Kuwahara
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1991 Volume 82 Issue 3 Pages 447-454

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Abstract

Seventy-seven patients with primary malignant testicular tumors were treated in our hospital. Twenty-five of them were given antineoplastic agents containing cis diamine dichlorplatinum (CDDP). In three long-term survivors, new malignant testicular tumors developed metachronously and had different histological findings from those of the initial tumors.
Case 1. A 28-year-old patient with a yolk sac tumor of the left testicle, stage IIIO, developed metastasis to the supraclavicular lymph nodes five years after radiation. Chemotherapy containing of VP-16 (837mg), CDDP (1050mg), vincristine (32mg), bleomycin (480mg), and actinomycin-D (16mg) achieved complete remissin. Four years 11 months later a seminoma of the contralateral testicle, stage I, was disclosed and he died of cancer 11 years and four months after the onset of the initial disease.
Case 2. A 30-year-old patient with testicular teratoma, stage IIIA, on the right side gained complete remission after a CDDP containing chemotherapy. One year and four months after the beginning of the CDDP use (1, 300mg totally as CDDP) a seminoma on the contralateral side, stage I, was detected. He died of cancer eight years and two months after his initial tumor was detected.
Case 3. A 37-year-old patient with combined tumor of seminoma and yolk sac tumor of the right testicle, stage IIIO, was free from disease for six years and five months under chemptherapy. At this point a seminoma, stage I, of the contralateral testicle was newly found and treated by radiation. He has been free from disease and his clinical period lasted for nine years and 11 months since the discovory of the initial tumor.
These three patients received large amounts of anti-neoplastic agents, including CDDP in common, for a considerrable period. a large amount of antineoplastic agents in a long-term use may be tumorigenetic in the intact testicle. Careful attention to the intact testicle is to be paid to detect such uncommon lesions in an early stage.

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