A testicular Sertoli cell tumor is a very rare, usually benign, testicular neoplasm. Of the total number of reported Sertoli cell tumors, only 30 cases were malignant. Usually, these patients have a history of a slowly growing scrotal mass and gynecomastia. These neoplasms vary greatly in size and in their microscopic appearances. A radical inguinal orchiectomy is the initial treatment, with the efficacy of chemotherapy or radiotherapy being controversial. They have an aggressive metastatic behavior and a poor prognosis. Herein, the case of 67-year-old man with a malignant Sertoli cell tumor is reported.
Aged ; Drug Therapy ; Gynecomastia ; Humans ; Male ; Orchiectomy ; Prognosis ; Radiotherapy ; Sertoli Cell Tumor* ; Testicular Neoplasms ; Testis*

Adolescent ; Diagnosis, Differential ; Disorders of Sex Development ; Female ; Humans ; Male ; Neoplasms, Germ Cell and Embryonal ; pathology ; radiotherapy ; surgery ; Seminoma ; pathology ; Testicular Neoplasms ; pathology ; radiotherapy ; surgery

BACKGROUNDPrimary malignant germ cell tumors (GCTs) of mediastinum are rare neoplasms. We introduce our institutional experience in managing patients with primary malignant GCTs of the mediastinum, focusing on the analysis of therapeutic modalities.

METHODSA retrospective review was done in 39 consecutive patients with mediastinal malignant GCTs treated in our institution between 1991 and 2007.

RESULTSA total of 39 patients were enrolled in this study with a median age of 27 years. The 5-year overall survival (OS) and progression-free survival (PFS) rates of the whole population were 60.2% and 57.7%, respectively. Stratified by the histology, 18 patients (46.2%) had seminoma and 21 patients (53.8%) had nonseminomatous germ cell tumors (NSGCTs). The 5-year OS rate of patients with seminoma was 87.4% as compared with 36.7% in patients with NSGCTs (P = 0.0004). The 5-year PFS rate was also significantly higher in seminoma patients (87.4% vs. 31.6%, P = 0.003). For 19 patients with NSGCTs managed with multi-modality treatment, chemotherapy exposure appeared to impact the prognosis. The 5-year OS rate was 44.9% in patients with chemotherapy exposure as compared with 20.0% in patients without it (P = 0.43).

CONCLUSIONOur study confirmed the significance of systemic chemotherapy in the treatment of primary mediastinal GCTs.

Adolescent ; Adult ; Disease-Free Survival ; Female ; Humans ; Male ; Mediastinal Neoplasms ; drug therapy ; radiotherapy ; Middle Aged ; Neoplasms, Germ Cell and Embryonal ; drug therapy ; radiotherapy ; Retrospective Studies ; Seminoma ; drug therapy ; radiotherapy ; Testicular Neoplasms ; Young Adult

It is estimated that in 2010, 1 in every 250 adults will be a childhood cancer survivor. Today, oncological surgery, radiotherapy and chemotherapy achieve relatively high rates of remission and long-term survival, yet are often detrimental to fertility. Quality of life is increasingly important to long-term survivors of cancer, and one of the major quality-of-life issues is the ability to produce and raise normal children. Developments in the near future in the emerging field of fertility preservation in cancer survivors promise to be very exciting. This article reviews the published literature, discusses the effects of cancer treatment on fertility and presents the options available today thanks to advances in assisted-reproduction technology for maintaining fertility in male and female patients undergoing this type of treatment. The various diagnostic methods of assessing the fertility potential and the efficacy of in vitro fertilization (IVF) after cancer treatment are also presented.
Adult ; Child ; Female ; Fertility ; Humans ; Infertility ; prevention & control ; Male ; Neoplasms ; drug therapy ; radiotherapy ; surgery ; Ovarian Neoplasms ; pathology ; Ovary ; pathology ; Survivors ; Testicular Neoplasms ; pathology ; Testis ; pathology

Forty-six patients with testicular tumor were treated at our hospital From 1971 to 1990. There were 25 children (13 yolk sac tumors, 10 teratomas, 1 teratocarcinoma and 1 acute lymphocytic leukemia) and 21 adults(11 seminomas, 4 non-seminomatous germ cell tumors and 6 non-germ cell tumors). Testicular lumors with clinical evidence of cryptorchidism were 4 seminomas and 2 non seminomts. Serum AFP or HCG were observed in 8 patients of 8 seminomas, 1 of 5 teratomas, 7 of 9 yolk sac tumors and 4 or 5 non-seminomatous germ cell tumors(NSGCT). Four stage 1 seminomas and 1 NSGCT were tumor free of 2 years after radical orchiectomy and 2 of 4 seminomas were received prophylactic radiotherapy. Two stage II seminomas and 1 NSGCF treated with PVB nomas and radiotherapy were tumor free of 2 years but stage III seminomas and NSGCT died during chemotherapy. All stage 1 yolk sac tumors and teratomas were tumor Free of 2 years by surveillance only following radical orchiectomy but stage II and III yolk sac tumors died during chemotherapy. We have suggested that poor result of stage III testicular tumors can be attributed to few cases with more aggressive and more toxic chemotherapy in the unfavorable prognosis disease(advanced extent) and poor compliance of patient of therapy.
Child ; Compliance ; Cryptorchidism ; Drug Therapy ; Endodermal Sinus Tumor ; Germ Cells ; Humans ; Male ; Neoplasms, Germ Cell and Embryonal ; Noma ; Orchiectomy ; Prognosis ; Radiotherapy ; Seminoma ; Teratocarcinoma ; Teratoma ; Testicular Neoplasms ; Testis*

To develop a more appropriate therapeutic strategy for treatment of nonpulmonary visceral metastatic testicular seminoma based on the International Germ Cell Consensus Classification, we reviewed the medical records of patients with nonpulmonary visceral metastatic testicular seminoma who were treated over a 20-year period. Only 15 (2.2%) of the 686 cases of testicular seminoma were nonpulmonary visceral metastatic seminoma. The median age of patients was 38 years (range, 22-53 years). Ten (67%) of the patients had an initial diagnosis of supradiaphragmatic or visceral metastatic disease. In addition to nonpulmonary visceral metastasis, all patients had lymph node metastasis as well, the majority of which involved the retroperitoneal lymph nodes. The median and mean progression-free survival durations after chemotherapy for advanced disease were 19 months and 63.7 months, respectively. Six patients (40%) survived, five relapsed after radiation therapy and four died of chemorefractory disease not dependent on the specific regimen. Although the number of cases reviewed in this study was small, we conclude that the choice of chemotherapeutic regimen among the current treatments for nonpulmonary visceral metastatic seminoma of testis primary does not present a different outcome. Therefore, multimodality therapies using new strategies or new agents are well indicated.
Adult ; Antineoplastic Agents, Combined/administration & dosage* ; Bone Neoplasms/secondary ; Bone Neoplasms/radiotherapy ; Bone Neoplasms/drug therapy ; Combined Modality Therapy ; Human ; Lung Neoplasms/secondary ; Lung Neoplasms/radiotherapy ; Lung Neoplasms/drug therapy ; Lymphatic Metastasis ; Male ; Middle Age ; Retroperitoneal Neoplasms/secondary* ; Retroperitoneal Neoplasms/radiotherapy ; Retroperitoneal Neoplasms/drug therapy* ; Retrospective Studies ; Seminoma/secondary* ; Seminoma/radiotherapy ; Seminoma/drug therapy* ; Testicular Neoplasms/pathology*

PURPOSE: To analyze treatment outcome and side effects of adjuvant radiotherapy using radiotherapy fields and doses which have evolved over the last two decades in a single institution. MATERIALS AND METHODS: Forty-one patients received radiotherapy after orchiectomy from 1996 to 2007. At our institution, the treatment field for stage I seminoma has changed from dog-leg (DL) field prior to 2003 to paraaortic (PA) field after 2003. Fifteen patients were treated with the classic fractionation scheme of 25.5 Gy at 1.5 Gy per fraction. Other patients had been treated with modified schedules of 25.05 Gy at 1.67 Gy per fraction (n=15) and 25.2 Gy at 1.8 Gy per fraction (n=11). RESULTS: With a median follow-up of 112 months, the 5-year and 10-year survival rates were 100% and 96%, respectively, and 5-year and 10-year relapse-free survival rates were both 97.1%. No in-field recurrence occurred. Contralateral seminoma occurred in one patient 5 years after treatment. No grade III-IV acute toxicity occurred. An increased rate of grade 1-2 acute hematologic toxicity was found in patients with longer overall treatment times due to 1.5 Gy per fraction. The rate of grade 2 acute gastrointestinal toxicity was significantly higher with DL field than with PA field and also higher in the 1.8-Gy group than in the 1.5-Gy and 1.67-Gy groups. CONCLUSION: Patients with stage I seminoma were safely treated with PA-only radiotherapy with no pelvic failure. Optimal fractionation schedule needs to be explored further in order to minimize treatment-related toxicity.
Adult ; Disease-Free Survival ; Dose Fractionation ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local/pathology ; Radiotherapy, Adjuvant/adverse effects ; Seminoma/*radiotherapy ; Testicular Neoplasms/*radiotherapy ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate a therapeutic method for male infertility caused by radiotherapy after surgical treatment of spermatocytoma.

METHODSA case of azoospermia caused by radiotherapy after surgical treatment of spermatocytoma was reported and the Chinese medicine Jiaweishuiluerxiandan was used as a major therapy for 3 years.

RESULTSThe patient's health condition was improved dramatically two years after being treated by the Chinese medicine but no sperm was found in his semen. However, three years after the treatment, his spermatozoon density was recovered from zero to 2.0 x 10(6)/ml with normal morphology. His sperm was subsequently used for intracytoplasmic sperm injection, which made his spouse pregnant successfully, and an healthy male infant was born by caesarean birth.

CONCLUSIONChinese medicine is a successful try at treating male infertility caused by radiotherapy after surgical treatment of spermatocytoma. For those who have failed to get their sperm frozen before surgery, Chinese medicine is a choice for remediation.

Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Oligospermia ; drug therapy ; etiology ; Phytotherapy ; Pregnancy ; Radiotherapy ; adverse effects ; Seminoma ; radiotherapy ; surgery ; Sperm Count ; Testicular Neoplasms ; radiotherapy ; surgery ; Treatment Outcome

PURPOSE: This study evaluated the demographics and semen parameters of males with cancer who banked their sperm prior to chemotherapy. MATERIALS AND METHODS: This is a retrospective study of 66 cases referred for sperm banking prior to initiation of chemotherapy over a 15-year period (1999~2014). Patients who had previously received cancer treatment including chemotherapy or radiotherapy were not included in this study. RESULTS: We studied a total of 66 cancer patients referred for cryopreservation of sperm prior to chemotherapy. The mean age of the patients at the time of banking was 32.0+/-7.9 years (range, 19~58 years). The types of cancer were testicular cancer (31 cases, 47.0%), non-Hodgkin's disease (10 cases, 15.1%), Hodgkin's disease (5 cases, 7.6%), leukemia (8 cases, 12.1%), gastrointestinal malignancy (5 cases, 7.6%), and musculoskeletal malignancy (5 cases, 7.6%). There were significant differences in sperm concentration and viability among the various types of cancer, but no significant difference in semen volume or sperm motility and morphology. CONCLUSIONS: In this study we found that sperm quality could decrease even before chemotherapy. Because chemotherapy can also negatively affect spermatogenesis, sperm cryopreservation prior to treatment should be strongly recommended for cancer patients of reproductive age.
Cryopreservation* ; Demography ; Drug Therapy* ; Hodgkin Disease ; Humans ; Infertility, Male ; Korea ; Leukemia ; Male ; Radiotherapy ; Retrospective Studies ; Semen ; Semen Analysis* ; Sperm Banks ; Sperm Motility ; Spermatogenesis ; Spermatozoa* ; Testicular Neoplasms

Clinical observations and histopathologic behaviors of testicular tumors were made on 39 cases who were admitted to the Department of Urology, Seoul National University Hospital, during the period from January, 1966 to December, 1979. The results are summarized as follows; 1) Among the 4220 cases of male inpatients, 718 (17. 0%) were G. U tract tumors and 39(0. 92%) were testicular tumors. 2) Age distribution was between 8 months and 72 years old, showing the highest incidence under the 5 year-old age group (38%). 3) Twenty one cases (53. 8%) arose on the right and eighteen cases (46. 2%) on the left. 4) Twenty two cases (56. 4%) visited the hospital within 6 months after the onset of the symptoms and 30 cases (77. 1%) within 1 year. 5) The presenting symptoms were painless scrotal mass (79. 5%). painful scrotal mass (7.7%) and metastatic symptoms (12. 8%) 6) Three cases (7.7%) arose from undescended testis. 7) Twelve cases (30. 8%) had already metastasis when first seen. 8) We had measured the level of serum A. F. P. by gel agar precipitation method or radioimmunoassay in 18 cases. Normal levels of A. F. P. were seen it seminoma and nongerminal testicular tumor. Of 11 cases with no metastatic non-seminomatous germinal cell tumor, 5 had elevated serum A. F. P. All the 3 cases with metastatic non-seminomatous germinal cell tumor had elevated serum A. F. P 9) These patients were managed by surgery, radiotherapy and chemotherapy. Serum and urine H. C. G. was checked during chemotherapy on 1 case for the evaluation of response to chemotherapy.
Agar ; Age Distribution ; Aged ; Child, Preschool ; Cryptorchidism ; Drug Therapy ; Humans ; Incidence ; Inpatients ; Male ; Neoplasm Metastasis ; Radioimmunoassay ; Radiotherapy ; Seminoma ; Seoul ; Testicular Neoplasms* ; Urology