Embryonal carcinoma of testis in elderly men

A rare case of pure embryonal carcinoma of the testis in a 63-year-old man is presented. The literature on germ cell tumours in men 60 years of age and older is also presented.     

Embryonal carcinoma of abdominal testis

Two cases are reported of embryonal carcinoma of an abdominal testis, one a large tumor with a massive retroperitoneal metastasis. Several months after removal of the testicle and roentgen-ray therapy both patients are in good health and present no evidences of metastasis or recurrence.Roentgen therapy is of proved value in embryonal testicular tumors.Local operation plus radiation is contrasted with the radical operation.     

Embryonal carcinoma of testis presenting as epididymal mass in an infant

Epididymal masses in infants and children are rare. The majority of them are benign. We report on the management of a child with embryonal carcinoma of the testis which presented as an Epddymal mass.     

Embryonal carcinoma producing DU-PAN-2 with burned-out phenomenon in the testis

A burned-out testicular tumor with lung and lymph node metastases presented high serum levels of DU-PAN-2. However, the serum levels of CA19-9, alpha-fetoprotein, beta-human chorionic gonadotropin, and sialyl Lewis X were normal. A biopsy of the cervical lymph nodes revealed embryonal carcinoma. Four courses of chemotherapy, including cisplatin, etoposide, and bleomycin, normalized the level of DU-PAN-2, and the metastatic lesions disappeared. This is the second reported case of an embryonal carcinoma producing DU-PAN-2. The secretor and Lewis gene typings, which affect the normal serum ranges of CA19-9 and DU-PAN-2, were determined.     

Embryonal carcinoma of the testis associated with prostate cancer in a 72-year-old man

A 72-year-old Japanese man presented with a painless swollen left scrotal mass with elevated levels of serum alpha-fetoprotein and prostate specific antigen. The patient underwent high orchiectomy under diagnosis and a final pathological examination revealed embryonal carcinoma of the left testis. A systematic needle prostate biopsy under guidance of transrectal ultrasound revealed prostate cancer (Gleason score, 8) on the left lobe (T2aN0M0). Systemic chemotherapy was given for retroperitoneal lymph node metastasis of testicular cancer and hormonal therapy (LH-RH analog) was given for prostate cancer. The patient was well with no evidence of metastasis from the testicular cancer or prostate cancer and with no elevation of serum alpha-fetoprotein or prostate specific antigen 26 months after the orchiectomy.     

睾丸胚胎性癌及其病理特征(附4例报告)

报告1990～1995年收治的睾丸胚胎性癌4例，占同期收治睾丸肿瘤的8．9％。发病年龄低（平均31．5岁），病程2～3个月。肿瘤位于左侧1例，右侧3例，其中1例伴有对侧睾丸精原细胞瘤。病理组织学图像复杂，能模拟4个以上的胚层结构，转移早，属高度恶性肿瘤。诊断主要根据病理检查，取组织活检能获得可靠诊断。治疗以早期手术为主，并辅以化疗。认为临床对此应提高认识，凡睾丸肿大均应考虑为肿瘤。     

Embryonal rhabdomyosarcoma arising in a mature teratoma of the testis: a case report

We report a case of embryonal rhabdomyosarcoma present in the primary excision of an intratesticular purely mature teratoma. Testicular mature and immature teratomas are usually associated with other germ cell tumors. Nongerminal malignancies that tend to occur in gonadal and extragonadal teratomas are often epithelial. Sarcomas of all types are less frequent but embryonal rhabdomyosarcomas are encountered predominantly. This sarcomatous element can be present in the primary excision or it can appear after chemotherapy in the metastases. Usually, prognosis is dependent on the degree of aggressiveness of the sarcomatous component. A review of the literature reveals that it is unusual for an embryonal rhabdomyosarcoma to develop on purely mature teratoma. We report a case in the testicle. During followup metastases arise rapidly from the purely embryonal rhabdomyosarcomatous component. The accurate diagnosis of this unusual sarcomatous component is of paramount importance because of the implications for therapy.     

Uroflowmetry in elderly men

Summary In the evaluation of lower-urinary-tract symptoms, uroflowmetry has played a major role for decades due to its noninvasiveness and simplicity to perform. However, several pitfalls have to be taken into account as mentioned in this review. They include artifacts, circadian changes, observer variation, minimal volume, association with infravesical obstruction, relevant variables, reference values, and clinical applicability. Thus, uroflow should be interpreted with proper caution.     

Renal effects of high-dose celecoxib in elderly men with Stage D2 prostate carcinoma

Aim: To prospectively study the clinical renal effects of daily high-dose celecoxib, a COX-2 inhibitor, in a cohort of elderly sick men (mean age 74.5 years) with advanced prostate cancer. Material and method: 44 men with advanced hormoneresistant prostate cancer participated in oncologic Phase II trials. All received celecoxib 400 mg bid for a median 6 months. Monthly laboratory measurement and blood pressure were monitored, and all cases of acute kidney injury (creatinine > 50% above baseline) and hyperkalemia (potassium > 5.5 mmol/l) were evaluated. Mean chemistries, BP, and estimated GFR (e-GFR) during treatment were compared to 6-month periods before and after treatment. Results: There was no change in e-GFR (pre, 78.1 ± 22 ml/min; during treatment, 76 ± 19 ml/min). Serum K rose (4.25 ± 0.4 mmol/l to 4.39 ± 0.3 mmol/l, p = 0.03), and bicarbonate fell (28.16 ± 0.2 to 26.18 ± 0.2 mmol/l, p < 0.01) with treatment. 15% of patients developed AKI, close to the incidence of AKI episodes in the pre- (9%) and post-treatment periods (13%). AKI was mild, short-lived, and reversible, except in a terminal patient who withdrew. All AKI occurred in states of renal hypoperfusion, and were not related to celecoxib alone. Hyperkalemia developed in 9% of patients. No patient developed new-onset proteinuria. Conclusion: High-dose celecoxib for 6 months was relatively well tolerated. e-GFR remained stable and there were minor electrolyte alterations. Although the AKI incidence was much higher than other studies, it was not much higher than in the pre- and post-treatment periods (high "background noise"). All AKI occurred in states of renal hypoperfusion, not unexpected for prostaglandin inhibitors.     

Papillary carcinoma of rete testis

A case of a rare papillary adenocarcinoma of the rete testis (or epididymis) with a solitary metastasis to a periaortic lymph node is reported. The favorable outcome over a three and one-third-year period after radical orchiectomy and retroperitoneal lymphadenectomy has been observed. We believe this is the first report of such a tumor being treated with lymphadenectomy.     

Infantile embryonal carcinoma of testis

Between 1968 and 1979 we treated 19 patients with infantile embryonal carcinoma of the testis. All 10 patients treated with orchiectomy plus chemotherapy (methotrexate, actinomycin D and cyclophosphamide) are well with no evidence of disease, whereas 2 of 4 who underwent orchiectomy alone and 2 of 5 treated with orchiectomy plus lymphadenectomy are dead. Infantile tumors with yolk sac elements have an apparent increase in hematogenous spread and, despite negative lymph nodes in the majority, a significant number have subsequent disseminated metastases. This suggests that infantile embryonal carcinoma is different from the adult type and implies that in clinical stage A disease retroperitoneal lymphadenectomy is unnecessary. The alpha-fetoprotein correlates with the presence of yolk sac tissue in biopsy and the radioimmunoassay level assists in monitoring the treatment.     

YRRM基因在男性不育病人精子生成中的表达研究

为研究ＹＲＲＭ基因在国人男性中的存在状况及在男性不育病人睾丸中的表达，应用ＹＲＲＭ１ｃＲＮＡ探针，与１２例无精子症病人睾丸组织ｍＲＮＡ进行原位杂交，结果提示ＹＲＲＭ基因可能参与精子生成早期减数分裂的调控。应用ＹＲＲＭ１和ＹＲＲＭ２基因的引物对１０例无精子症病人和１５例正常人的基因组ＤＮＡ进行ＰＣＲ扩增，未发现ＹＲＲＭ１缺失；病人及正常对照中均未发现ＹＲＲＭ２基因序列的存在，可能是ＹＲＲＭ基因的多态性在黄种人的特有表型     

Embryonal carcinoma with teratomatous elements in the region of the pineal gland

An embryonal carcinoma with teratomatous elements arising in the region of the pineal gland of an eight-year-old boy is reported. Radiation therapy, chemotherapy and surgical intervention failed, and he died 16 months after the onset of the symptoms. His clinical and autopsy findings are described.     

Continence interval in elderly incontinent men

Urinary incontinence is a serious management problem among elderly patients. The care and management of chronic care patients is more difficult in those having urinary incontinence. The level of care required is dependent on both the continence and incontinence behavior of the patient. The continence behavior in this study is presented as the time interval between episodes of involuntary urine loss. The continence interval in elderly inpatient men having severe incontinence was found to be significantly longer in patients having a larger measured cystometric bladder capacity as well as in patients having greater independence in activities of daily living. Significant variability in the continence interval was measured for each patient over a wide range of continence intervals and resulted in an irregular pattern of time between episodes of incontinence. The irregular continence intervals suggest an instability of the central nervous system sensory-motor regulatory mechanism of bladder control in the elderly.     

Nonfunctioning interstitial cell carcinoma of testis

The authors add an additional case to the 13 cases of malignant interstitial cell tumor of the testis previously reported in the literature. It has been thought that the hallmark of metastatic intertitial cell tumor of the testis is endocrinopathy secondary to production of hormones by the tumor. In the case reported here there were no clinical or chemical manifestations of any endocrinopathy, making this case unique.