Regression of metastatic seminoma in a patient referred for carcinoma of unknown primary origin Journal Article


Authors: Musser, J. E.; Przybycin, C. G.; Russo, P.
Article Title: Regression of metastatic seminoma in a patient referred for carcinoma of unknown primary origin
Abstract: Background. A 63-year-old man presented to an emergency department with abdominal and back pain. A 5 × 3 × 2cm para-aortic mass was found adjacent to the left kidney, but the location of the primary tumor could not be identified. He was referred to a tertiary center with a diagnosis of retroperitoneal carcinoma of unknown primary origin. Atrophy of the left testicle was noted. Review of the biopsy material obtained at the first presentation showed histology characteristic of seminoma, and imaging revealed the presence of small intratesticular lesions. Repeat CT showed complete resolution of the metastatic para-aortic mass. The patient underwent left orchiectomy and adjuvant radiation therapy, and showed no signs of disease 6 months later.Investigations. CT of the chest, abdomen and pelvis, measurement of serum tumor markers, upper gastrointestinal endoscopy, colonoscopy, PET-CT and percutaneous needle biopsy of the para-aortic mass at the first presentation; physical examination, review of biopsy specimen with immunohistochemical staining for tumor markers, testicular ultrasonography and repeat CT of the chest, abdomen and pelvis at the second presentation.Diagnosis. Metastatic seminoma with spontaneous regression of the metastatic lesion.Management. Radical orchiectomy and adjuvant radiation therapy. © 2010 Macmillan Publishers Limited. All rights reserved.
Keywords: immunohistochemistry; adult; treatment outcome; middle aged; histopathology; cancer localization; case report; cisplatin; cancer radiotherapy; disease free survival; radiotherapy, adjuvant; antineoplastic agent; laparotomy; carboplatin; melanoma; metastasis; computer assisted tomography; multiple cycle treatment; tumor volume; etoposide; diagnostic imaging; tumor marker; nephrectomy; testis disease; abdominal pain; backache; emergency ward; hematologic malignancy; kidney; blood sampling; colonoscopy; echography; computer assisted emission tomography; testicular neoplasms; single drug dose; bleomycin; retroperitoneal neoplasms; prostate adenocarcinoma; physical examination; cancer of unknown primary site; orchiectomy; gastrointestinal endoscopy; kidney biopsy; seminoma; percutaneous biopsy; retroperitoneal cancer; neoplasms, unknown primary; remission, spontaneous; exploratory laparotomy; hematolymphoid neoplasia; metastatic seminoma; retroperitoneal carcinoma of unknown primary origin; testis atrophy; upper gastrointestinal endoscopy
Journal Title: Nature Reviews Urology
Volume: 7
Issue: 8
ISSN: 1759-4812
Publisher: Nature Publishing Group  
Date Published: 2010-08-01
Start Page: 466
End Page: 470
Language: English
DOI: 10.1038/nrurol.2010.99
PUBMED: 20606623
PROVIDER: scopus
DOI/URL:
Notes: --- - "Export Date: 20 April 2011" - "Source: Scopus"
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  1. Paul Russo
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