Cristina Corina Pop Radu*
Background: Orchitis tumor incidence is rare, about 2% of male malignancies. The pathology of tumoral orchitis has a maximum incidence between the ages 20-35, in children being more frequent the embryonal carcinoma and teratoma, in adult are met all types and in elderly predominates the seminoma. About 25% has endocrine secretory capacity. The incidence of gynaecomastia in adult men is reported as being 35-65%, depending on the criteria for diagnosing gynaecomastia and the age group. However, only 2% of men presenting with gynaecomastia are founded to have testicular tumours. Case Report: We present the case of a 27 years old patient, diagnosed two years ago with testicular tumor. In diagnosis, the first sign was the unilateral gynaecomastia then neoplastic transformation of the left testicle was noted. The diagnosis was confirmed by ultrasound exam and tumoral markers (β human chorionic gonadotrophin over 5000 mUI/mL; alpha-fetoprotein at 12.3 UI/mL; lactate dehydrogenase at 1840 U/L). Left orchiectomy was performed. The pathological report showed a mixed tumor with germinal cells: embryonal carcinoma, teratoma and choriocarcinoma. The patient refuse adjuvant therapy and two months postoperatively pulmonary and vertebral metastasis were revealed. He followed radiotherapy, chemotherapy and neurosurgical treatment with complete remission. Conclusion: We emphasize the importance of complete physical exam and testicular ultrasonography in any case of suspicion of testicular tumor. The multidisciplinary approach and treatment allows good results in advanced testicular tumors.
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