Background: According to the last EAU Guidelines about testicular cancer, surgical resection of residual masses after chemotherapy in NSGCT is indicated in the case of visible residual masses and when serum levels of tumor markers are normal or normalizing. If markers are not normalized and when several chemotherapeutic regimens have failed to cure metastatic disease, resection of residual tumors (so called "desperation surgery") should be offered to these patients.
Methods: We are going to present the case of a 30-year-old patient, affected by metastatic NSGCT. According to the prognostic-based staging system for metastatic germ cell cancer, our patient was in the poor prognosis group. The retroperitoneal mass involved all major vascular structures and still caused a bilateral obstruction of the upper urinary tract. Histological examination after radical orchiectomy revealed embryonal carcinoma and immature teratoma. The patient underwent a four-cycle VIP chemotherapy and then salvage chemotherapy with four cycles of TIP. After chemotherapy, the patient still presented large multiple metastatic localizations. Tumor markers were reduced but not normalized. The patient was then proposed for the resection of residual tumor. The residual mass could not be dissected from the left renal pedicle, so the left nephrectomy was unavoidable. The mass was hardly detached from vena cava and aorta. A bilateral iliac and retroperitoneal lymphadenectomy was performed. At the end of the procedure, the retroperitoneal space was completely free.
Results: Post-operative hospital stay was regular. A CT scan performed 3 months after the procedure did not show any residual lesion in the retroperitoneum. Three and six months later, the patient underwent the residual tumor resection of the right mediastinum and then of the left mediastinum and supraclavear metastases. Afterwards the patient underwent an EP consolidation chemotherapy. The patient is alive, 12 months after the retroperitoneal surgery.
Conclusions: Our experience confirms that resection of residual tumors is safe and feasible also in cases of very large abdominal disease.
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http://dx.doi.org/10.5301/RU.2011.8629 | DOI Listing |
Eur J Surg Oncol
January 2025
Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan. Electronic address:
Background: The efficacy of local control for pancreatic cancer liver metastases (PCLM), including surgical treatment, remains controversial, with no consensus on the management and clinical significance of disappearing liver metastases (DLMs). This study aimed to evaluate the clinical implications of DLMs in treating PCLM after multi-agent chemotherapy, utilizing contrast-enhanced imaging modalities.
Methods: A retrospective analysis was conducted on patients who underwent curative resection for pancreatic cancer with synchronous or metachronous liver metastases between 2014 and 2023.
Neurosurgery
January 2025
Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Background And Objectives: Jugular paragangliomas (JPG) pose a surgical challenge because of their vascularity and complex location. Stereotactic radiosurgery (SRS) offers a minimally invasive management for patients with JPG. Our aim was to evaluate outcomes of Gamma Knife radiosurgery (GKRS) for the treatment of JPG over the long term.
View Article and Find Full Text PDFClin Genitourin Cancer
December 2024
Esenler Maternity and Child Diseases Hospital, Department of Urology, Istanbul, Turkey.
Introduction: Bladder cancer is common in men. The number of recurrences is one of the risk factors for progression and poor prognosis in nonmuscle invasive bladder cancer (NMIBC). We aimed to investigate whether bladder outlet obstruction (BOO) has an effect on bladder cancer recurrence in patients with nonmuscle invasive bladder cancer.
View Article and Find Full Text PDFAsian Pac J Cancer Prev
January 2025
Department of Pathology, Phramongkutklao College of Medicine, Thailand.
Objective: To determine the correlation among five different types of tumor regression grading (TRG) systems. Test-retest reliability analyses were conducted at two time points to assess the internal validity and consistency of these five TRG systems.
Methods: A test-retest study was performed in 34 pathologically confirmed rectal adenocarcinoma specimens.
J Clin Endocrinol Metab
January 2025
Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc UCL, Bruxelles, Belgium.
Introduction: Equivocal or negative pituitary magnetic resonance imaging (MRI) findings raise a significant challenge in the management of persistent or recurrent Cushing's disease (CD), compromising the chances of success of a further transsphenoidal surgery (TSS). The aim of our study was to determine the diagnostic utility of 11C-methionine (MET) positron emission tomography coupled with computerized tomography (PET/CT) in localizing the residual or relapsing corticotroph adenoma.
Methods: We retrospectively analyzed the results of 11C-MET PET/CT performed in two tertiary medical centers between May 2002 and November 2023 in 22 patients with a persisting or recurrent CD after initial TSS and equivocal or negative pituitary MRI findings.
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