レイア・イマヌエル・マーティン
事例紹介:
17 歳の患者で、6 か月間にわたり左陰嚢腫瘤が継続的に増大しているが、後遺症はない。確定診断の 14 日前、夜間に悪寒を伴わない軽度の発熱があり、咳が止まらなかった。診断が終了してから 1 週間後、食欲が減退し、体重が減少した。身体検査では、鼠径リンパ節腫脹を伴う硬く、柔軟で、敏感ではない硬直した左陰嚢腫瘤が明らかになった。アルファ フェトプロテイン、ベータ HCG、LDH は全体的に上昇していた。CT フィルターでは、肺、縦隔領域、肝臓、膵臓に多数の増大した核が認められた。耐性患者は左上精巣摘出術を受け、組織病理学的検査で卵黄嚢腫瘍が明らかになった。BEP 療法 (ブレオマイシン、エトポシド、シスプラチン) による化学療法が開始された。4 回目の化学療法の最新の確定診断では、腫瘍マーカー値の顕著な低下が示された。 CT フィルターにより、吸引性腫瘍が除去され、肝臓と膵臓の尾部の腫瘤のサイズが縮小していることが明らかになりました。
結論：
卵黄嚢腫瘍は、過去数十年間に増加傾向にある、まれな若者の脅威です。診断と画像診断、および手術とシスプラチンベースの化学療法の進歩により、この病気は生存率の高い病気になりました。
導入：
Testicular tumors are uncommon in adolescence with larger part analyzed to be dangerous. Germ cell tumors (GCT), remarkably the most widely recognized of threatening gonadal tumor involves just 3% of pediatric malignant growths. Yolk sac tumor has been reported to have the most elevated rate among harmful GCT in kids. A yolk sac tumor is an uncommon, dangerous tumor of cells that line the yolk sac of the incipient organism. These cells ordinarily become ovaries or testicles; be that as it may, the reason for a yolk sac tumor is obscure. It is regularly found in kids before the ages of 1 to 2, however can happen all through life. The term yolk sac tumors envelops numerous sorts of tumors including germ cell tumors, teratomas, embryonal carcinoma, aysgermenomas, semenoma, and so forth. These tumors can happen in the testicles, ovaries, chest, mind and different pieces of the body. Testicular yolk sac tumors (otherwise called endodermal sinus tumor of the testis) is the most well-known youth testicular tumor (80%), with most cases happening before the age of two years. In grown-ups, unadulterated yolk sac tumor is incredibly uncommon, anyway blended germ cell tumor are usually observed. Totipotent cells, which later structure extraembryonic fetal films, offer ascent to yolk sac tumors. Perivascular structures called Schiller-Duval bodies can be found in half of tumors and are pathognomonic. AFP (alpha fetoprotein) is raised in >90% instances of yolk sac tumor. Perceptibly, the testis is supplanted by a coagulated mass. Minutely, a positive response for AFP is found in tumor cells. Planned radiologic portrayal of yolk sac tumor is troublesome, anyway a heterogeneous testicular mass favors non-seminomatous germ cell tumor (NSGCT), and at age <2 years, yolk sac tumor is the supported determination. Heterogeneous testicular mass sore with post-differentiate heterogeneous upgrade, with zones of drain/rot. In the event that the tumor is confined to the testis, and if the serum AFP isn't raised, orchiectomy is the favored treatment, with close development. In the event that backslide happens, chemotherapy is the treatment of decision. The lungs are the most well-known site of recurrence. Testicular tumors are exceptional in kids, involving around 1% to 2% of every single pediatric harm. Be that as it may, the rate of testicular tumors in youngsters is expanding, and related bleakness has multiplied during the most recent 40 years. Testicular yolk sac tumors represent 70% to 80% of prepubertal harmful testicular tumors and are the most widely recognized youth testicular disease. The anticipation of testicular yolk sac tumors is subject to early discovery and treatment. Pediatric patients with testicular yolk sac tumors generally present with an asymptomatic scrotal mass beginning phase (I) in the infection procedure. Assessment of the strong scrotal mass incorporates: scrotal ultrasound; chest, stomach, and pelvic registered tomography (CT); and assurance of serum tumor marker levels, for example, alpha-fetoprotein (AFP) and beta-human chorionic gonadotropin (β-hCG). A raised serum AFP level is firmly connected with yolk sac tumors in over 90% of patients. The treatment of testicular yolk sac tumors is subject to tumor stage and patient age. Resection and chemotherapy with or without retroperitoneal lymph hub dismemberment (RPLND) is frequently utilized for kids with raised or rising AFP levels as well as retroperitoneal lymphadenopathy.
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