Leptomeningeal carcinomatosis in aggressive germ non-seminoma testicular tumor: A case report and review of literature

摘要

Testicular cancer (TC) is the most common tumor of young males and its incidence has approximately doubled worldwide over the past 40 years, without a comprehensible etiology for the observed increase [1,2]. Both environmental and genetic factors are likely to be involved [2]. Germ cell tumors (GCTs) are malignancies derived from primitive stem-cells and are divided into two categories based on histology: tumors included pure seminoma and tumors with some component of non-seminoma (NS), such as ter-atoma, embryonal carcinoma, choriocarcinoma and yolk sac tumor. GCTs are curative diseases, with cure rates of over 80% [3]. However, 28% of patients with metastatic NSGCTs have poor-risk features that result in cure rates of only about 50% at 5 years [3]. Negative prognostic features are the non-seminoma histology together with mediastinal primary site, the presence of non-pulmonary visceral metastases, or severe increase of serum tumor markers alphafetoprotein (AFP), human chorionic gonadotropin (HCG), and lactate dehydrogenase (LDH). However the presence of a mediastinal primary site and the presence of central nervous system (CNS) metastases appear to confer the greatest risk of mortality.