Burned-out Testes Seminoma without Distant Metastasis

摘要

While complete regression of a primary testicular tumor with progressive growth of metastases is well recognized in cases of non-seminomatous germ cell tumors, this phenomenon is rarely reported with seminoma. We report a case of a spontaneously regressed testicular seminoma without accompanying metastatic lesions. A 33-year-old man had suffered from persistent scrotal induration and transient testicular pain of the left testicle for one month when he visited our hospital. He had undergone left orchiopexy for undescended testes in his early childhood. Serum levels of Alpha-fetoprotein, beta-human chorionic gonadotropin, and lactate dehydrogenase were all within normal limits. After 4 weeks of antibiotics treatment with cephalexin monohydrate, the left testicular mass remained unchanged. The patient was subjected to left radical orchiectomy. Histological examination revealed a fibrotic tumor with a small area of seminoma undergoing spontaneous regression. Postoperative imaging showed no concomitant metastatic lesions. Adjuvant radiation therapy was provided. The patient was free of disease at 2 years follow-up after surgery. We recommend that long term follow-up of patients with undescended testes, even if atrophic, is necessary for early detection of possible testicular tumors.