ABSTRACT
A primary testicular carcinoid tumor with teratoma metastasized to the para-aortic lymph node. After inguinal orchiectomy, serum and urinary levels of 5-hydroxyindoleacetic acid (5-HIAA) were found to be elevated. Chemotherapy consisting of cisplatin, etoposide and bleomycin was not effective on the metastatic lesions. Retroperitoneal lymphadenectomy normalized the levels of 5-HIAA. The patient is alive without recurrence 25 months after the retroperitoneal lymphadenectomy.
Subject(s)
Carcinoid Tumor/surgery , Teratoma/surgery , Testicular Neoplasms/surgery , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Aorta, Abdominal , Carcinoid Tumor/diagnosis , Humans , Lymph Node Excision , Lymphatic Diseases , Lymphatic Metastasis , Male , Middle Aged , Orchiectomy , Teratoma/diagnosis , Testicular Neoplasms/diagnosisABSTRACT
INTRODUCTION: To evaluate the role of serum carbohydrate antigen 19-9 (CA19-9) in the prognosis and follow-up evaluation of patients with urothelial carcinoma, the authors studied the association of the serum level and positive rate with clinical features such as infiltration and metastasis in 164 patients admitted to the authors' department. PATIENTS AND METHODS: This study included 164 cases of patients with urohelial carcinoma. The absolute value of the serum CA19-9 level and its positive rate were tested. Simple variant analysis and logistic regression analysis were used for estimation of statistical significance. Kaplan-Meier's test and Cox's proportional hazard model were used for analysis of survival. RESULTS: Significant differences in the serum CA19-9 levels were found with regard to the following parameters: the presence or absence of metastasis, clinical stage, depth of invasion, and degree of differentiation. The positive rate displayed a significant difference only for the presence or absence of metastasis. With regard to the presence of metastasis, serum CA19-9 was a significant risk factor along with depth of invasion in logistic regression analysis. Comparison of the survival rate indicated the prognosis to be significantly poor in the positive group and serum CA19-9 was regarded to be a prognostic risk factor in analysis via the regression model. CONCLUSIONS: Serum CA19-9 is thought to serve as a significant marker for advanced cancer and tumors with highly malignant potential and is useful for predicting prognosis of the disease.
