„Burned-out“ tumour of a testis with metastasis to retroperitoneal lymph node

Česká verzia

Authors: Karol Kajo ¹; Michal Kajo ¹; Katarína Macháleková ¹; Július Palaj ²; Iveta Mečiarová ³; Peter Zuzák ⁴; Emil Tvrdík ⁵
Authors place of work: Ústav patológie SZU a OÚSA, s. r. o., Bratislava ¹; Klinika onkologickej chirurgie OÚSA, s. r. o., a LF UK, Bratislava ²; Alpha medical patológia, s. r. o., Bratislava ³; Interná onkologická klinika OÚSA a TU, Bratislava ⁴; sv. VINCENT, s. r. o., Prievidza ⁵
Published in the journal: Ces Urol 2014; 18(2): 138-143
Category: Case report

Summary

The term “burned-out tumour” refers to a rare clinical entity that represents a complete spontaneous regression of previously untreated testicular cancer with metastases in the retroperitoneum, mediastinum, lymph nodes, lung or liver. We describe the case of a 55-year-old patient with pain in the right lumbar region, in which the CT scan disclosed a tumour mass in the retroperitoneum (sized 70 × 55 × 90 mm), and ultrasonography revealed structural changes in the lower pole of the right testicle. First, the patient underwent a right-sided orchiectomy with histological finding of a scar in the testicle without distinct tumour changes, followed by radical resection of the retroperitoneal tumour, which histology proved to be a metastasis of seminoma in the lymph node. Consequently, the histology in the testis was re-evaluated and determined to be a completely regressed testicular tumour – “burned-out tumour.” Subsequently, patient underwent adjuvant chemotherapy. The pathogenesis of “burned-out” tumours are comprises mainly of immunological factors, ischemia represents another, although less probable cause. Prognosis of “burned-out” tumours in cases of seminomatous germ cell tumours is comparable with those of primary testicular tumours.

Key words:
“burned-out”, regression, seminoma, testis, tumour.

Zdroje

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