Introduction

Spermatocytic tumours are a rare subtype of testicular neoplasm and represent less than 1% of all testicular neoplasms. They generally display indolent biology and therefore commonly present as large testicular masses. Despite this, and in contrast to invasive germ cell tumours, spermatocytic tumours are rarely pT2 (i.e., rarely involve the tunica vaginalis or display lymphovascular invasion) and are almost exclusively confined to the testicle [1], such that orchidectomy is usually curative. It is estimated that <10% of cases metastasise, unless sarcomatoid differentiation is present [2]. However, metastatic spermatocytic tumours, when they occur, portend a poor prognosis, and there is a relative paucity of evidence informing management in the metastatic setting.

Metastectomy rarely yields long-term survival, and complete responses to chemotherapy and radiotherapy are rare [2]. There is no standard first-line approach, however, extrapolating from treatment paradigms from seminoma and non-seminoma, bleomycin, etoposide and cisplatin (BEP) represents a commonly used regimen, with variable responses demonstrated [2]. Second-line chemotherapeutic strategies are even less well studied. We describe a case of relapsed, metastatic spermatocytic tumour that had a favourable response to second-line chemotherapy after prior first-line BEP chemotherapy.

中文翻译：

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澳大利亚墨尔本大学 Peter MacCallum 癌症中心肿瘤内科本月最佳案例：通过挽救性全身化疗成功治疗复发性转移性精母细胞肿瘤

 介绍

精细胞肿瘤是睾丸肿瘤的一种罕见亚型，占所有睾丸肿瘤的不到 1%。它们通常表现出惰性生物学，因此通常表现为大的睾丸肿块。尽管如此，与侵袭性生殖细胞肿瘤相比，精细胞肿瘤很少为 pT2（即很少累及阴道膜或表现出淋巴血管侵犯），并且几乎完全局限于睾丸 [1]，因此睾丸切除术通常是有效的。据估计<10%的病例发生转移，除非存在肉瘤样分化[2]。然而，转移性精细胞肿瘤一旦发生，就预示着预后不良，并且相对缺乏指导转移性治疗的证据。

转移瘤切除术很少能实现长期生存，对化疗和放疗完全缓解的情况也很少见[2]。然而，没有标准的一线方法，从精原细胞瘤和非精原细胞瘤的治疗范例中推断，博来霉素、依托泊苷和顺铂 (BEP) 代表了一种常用的治疗方案，并显示出不同的反应[2]。二线化疗策略的研究甚至更少。我们描述了一个复发、转移性精细胞肿瘤的病例，该肿瘤在先前的一线 BEP 化疗后对二线化疗有良好的反应。