Synchronous Seminoma of Testis and Renal Cell Carcinoma: A Rare Case Report.

Medicina (Kaunas)

Department of Genetics and Molecular Medicine, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania.

Published: September 2024

AI Article Synopsis

  • * A 36-year-old patient had both tumors, leading to the removal of a large testicular mass and subsequent surgeries for kidney and adrenal tumors, ultimately diagnosed through histological evaluations.
  • * After initial treatment with chemotherapy, the patient experienced progressive metastasis, prompting targeted therapy, indicating a genetic predisposition to having multiple primary tumors, which could be better understood through DNA sequencing.

Article Abstract

: Seminoma is the most common solid malignant tumour in young men. Clear-cell kidney carcinoma is the most common malignancy of the genitourinary tract. However, the synchronous occurrence of both of these tumours is rare. We present the case of a 36-year-old patient who presented to a medical facility at the end of 2019 with an enlarged right testicle. A unilateral orchofuniculectomy was performed, and a mass measuring 30 cm was removed. During histological examination, testicular seminoma pT2, R0, was diagnosed. An abdominal computed tomography (CT) scan showed a 6.4 cm × 6.8 cm × 6.7 cm tumour in the right kidney and a metastatic-like lesion in the right adrenal gland. A right nephrectomy and an adrenalectomy and paraaortic and paracaval lymphadenectomies were performed. A histological evaluation confirmed the presence of clear-cell renal carcinoma pT2aR0 G2, adrenal hyperplasia, and seminoma metastases in the removed lymph node. Chemotherapy with a Bleomycin, Etoposide, and Cisplatin (BEP) regimen was carried out. Three years after the last cycle of chemotherapy, a follow-up CT scan showed metastases in the left kidney, the right ischium, and the right lung. A well-differentiated clear-cell carcinoma G1 of the left kidney and metastasis of clear-cell carcinoma G2 in the right ischium were confirmed after the biopsy, and no tumour lesions were found in the lung tissue specimen. Treatment with targeted therapy with Sunitinib was started because the risk was favourable according to the Heng criteria. Genetic testing was performed, and the following genes were analysed: , , , , , , , and The testing did not reveal any pathogenic or potentially pathogenic mutations or sequence changes of unknown clinical significance in the genes analysed. : According to the authors, the occurrence of synchronous primary tumours is linked to one's genetic predisposition. DNA sequencing of tumour tissue could provide more information on the corresponding aetiopathogenesis.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11434273PMC
http://dx.doi.org/10.3390/medicina60091553DOI Listing

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