Pleural and Pulmonary Metastases from Nonseminomatous Germ Cell Tumors Successfully Managed by Extrapleural Pneumonectomy

Overview

Journal IJU Case Rep

Date 2021 Mar 15

PMID 33718813

Citations 1

Authors

Hinata Matsuda

Tomonori Minagawa

Hiroyuki Agatsuma

Takeshi Uehara

Haruhiko Utazu

Teruyuki Ogawa

Kazuo Yoshida

Osamu Ishizuka

Affiliations

Soon will be listed here.

Abstract

Introduction: Surgery for postchemotherapy residual nonseminomatous germ cell tumors may be difficult due to exceptional lesion size and location.

Case Presentation: A 47-year-old man presented with swelling and pain in the left scrotum. Computed tomography revealed a solid occupied lesion in the left scrotum with huge metastases in the left lung and pleura. Results of a left high inguinal orchiectomy indicated a pathological diagnosis of germ cell tumors of several histological types. The patient declined postoperative chemotherapy but returned to our department 10 months later with dyspnea. Serum tumor marker levels were restored to normal range by adjuvant chemotherapy. Thereafter, an extrapleural pneumonectomy was performed for the remaining tumors. He has since been asymptomatic without recurrence or dyspnea for over 5 years.

Conclusion: Extrapleural pneumonectomy is a valid treatment option for the management of huge pleural and pulmonary metastases of nonseminomatous germ cell tumors.

Citing Articles

Pleural and pulmonary metastases from nonseminomatous germ cell tumors successfully managed by extrapleural pneumonectomy.

Matsuda H, Minagawa T, Agatsuma H, Uehara T, Utazu H, Ogawa T IJU Case Rep. 2021; 4(2):89-91.

PMID: 33718813 PMC: 7924091. DOI: 10.1002/iju5.12250.

References

Matsuda H, Minagawa T, Agatsuma H, Uehara T, Utazu H, Ogawa T . Pleural and pulmonary metastases from nonseminomatous germ cell tumors successfully managed by extrapleural pneumonectomy. IJU Case Rep. 2021; 4(2):89-91. PMC: 7924091. DOI: 10.1002/iju5.12250. View

Hendry W, Norman A, Dearnaley D, Fisher C, Nicholls J, Huddart R . Metastatic nonseminomatous germ cell tumors of the testis: results of elective and salvage surgery for patients with residual retroperitoneal masses. Cancer. 2002; 94(6):1668-76. DOI: 10.1002/cncr.10440. View

Kataria S, Varshney A, Nagar M, Mandal A, Jha V . Growing Teratoma Syndrome. Indian J Surg Oncol. 2017; 8(1):46-50. PMC: 5236020. DOI: 10.1007/s13193-016-0568-3. View

Takagi K, Tsuchiya R, Watanabe Y . Surgical approach to pleural diffuse mesothelioma in Japan. Lung Cancer. 2001; 31(1):57-65. DOI: 10.1016/s0169-5002(00)00152-5. View

Cagini L, Nicholson A, Horwich A, Goldstraw P, Pastorino U . Thoracic metastasectomy for germ cell tumours: long term survival and prognostic factors. Ann Oncol. 1998; 9(11):1185-91. DOI: 10.1023/a:1008491807858. View

Miki T, Mizutani Y, Nonomura N, Nomoto T, Nakao M, Saiki S . Irinotecan plus cisplatin has substantial antitumor effect as salvage chemotherapy against germ cell tumors. Cancer. 2002; 95(9):1879-85. DOI: 10.1002/cncr.10918. View

Horwich A, Shipley J, Huddart R . Testicular germ-cell cancer. Lancet. 2006; 367(9512):754-65. DOI: 10.1016/S0140-6736(06)68305-0. View

Boukettaya W, Hochlaf M, Boudagga Z, Ezzairi F, Chabchoub I, Gharbi O . Growing Teratoma Syndrome After Treatment of a Nonseminomatous Germ Cell Tumor: A Case Report and a Review of Literature. Urol Case Rep. 2016; 2(1):1-3. PMC: 4733003. DOI: 10.1016/j.eucr.2013.11.007. View

Brunelli A, Kim A, Berger K, Addrizzo-Harris D . Physiologic evaluation of the patient with lung cancer being considered for resectional surgery: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013; 143(5 Suppl):e166S-e190S. DOI: 10.1378/chest.12-2395. View

10.

van Dijk M, Steyerberg E, Habbema J . Survival of non-seminomatous germ cell cancer patients according to the IGCC classification: An update based on meta-analysis. Eur J Cancer. 2006; 42(7):820-6. DOI: 10.1016/j.ejca.2005.08.043. View

11.

Gels M, Hoekstra H, Sleijfer D, Nijboer A, Molenaar W, Ebels T . Thoracotomy for postchemotherapy resection of pulmonary residual tumor mass in patients with nonseminomatous testicular germ cell tumors: aggressive surgical resection is justified. Chest. 1997; 112(4):967-73. DOI: 10.1378/chest.112.4.967. View

12.

Ferguson M, Watson S, Johnson E, Vigneswaran W . Predicted postoperative lung function is associated with all-cause long-term mortality after major lung resection for cancer. Eur J Cardiothorac Surg. 2013; 45(4):660-4. PMC: 4416119. DOI: 10.1093/ejcts/ezt462. View

13.

Liu D, Abolhoda A, Burt M, Martini N, Bains M, Downey R . Pulmonary metastasectomy for testicular germ cell tumors: a 28-year experience. Ann Thorac Surg. 1999; 66(5):1709-14. DOI: 10.1016/s0003-4975(98)00940-0. View