Septal spermatoma?

Septal seminoma is also known as seminoma. It is a common germ cell tumor. It is a tumor that is parasitic in the fetus or is discovered after it is formed in the infant. If you are unfortunately diagnosed with septal seminoma, it is best to go to the urology department for an examination and receive treatment under the guidance of a doctor based on the results of the examination. Most septal seminoma can be treated with surgery, and radiotherapy after surgery can effectively prevent tumor recurrence.

(I) Diagnosis

When primary seminoma is discovered, the tumor often forms a large, solid mass. The size can vary from a few centimeters to 20 cm. Symptoms are usually non-specific. Common symptoms are chest pain, dyspnea and cough. Hemoptysis is rare. Dysphagia and hoarseness may occur occasionally. Due to invasion, superior vena cava syndrome may occur. Seminoma can metastasize to the stomach, lungs, liver, spleen, and tonsils.

Conventional chest X-rays can reveal a giant mass in the anterior longitudinal septum, which can be lobed to one side and cause compression and transfer of the trachea and bronchus. CT scans can also reveal solid masses in the longitudinal septum, with a thin surrounding capsule, and the chest wall is easily affected. Pleural and pericardial infiltration may occur.

Routine blood and urine tests are not very valuable. However, the values ​​of alpha-fetoprotein (AFP), human chorionic gonadotropin (B-HCG), carcinoembryonic antigen (CEA), and lactate dehydrogenase (LDH) can be elevated, regardless of whether the tumor markers are positive. Histological diagnosis is still the main method, and the determination of tumor markers is very valuable for understanding the patient's remission and recurrence, especially the cryptic recurrence.

There is no unified standard for the clinical staging of extragonadal seminoma like septal seminoma, but many scholars basically believe that

Cefaro's staging of spermatogonia is acceptable and is as follows:

Primary Seminomas Staging (Cefaro)

Stage I localized disease

Stage II: Massive mass with compression but no invasion

Stage III cancer with local invasion

Stage IV metastasis

The above staging is valuable for primary septal spermatoma, especially in terms of treatment and prognosis.

Regarding adverse prognostic factors, in addition to the above-mentioned stages, patients over 35 years old, those with unresectable masses, superior vena cava obstruction, enlarged lymph nodes, hilar lesions, and elevated AFP values ​​have a poor prognosis.

Because septal seminoma is rare, its treatment is not standardized and the lesions may be localized, invasive, noninvasive, or metastatic. Therefore, most treatments are the same as those for testicular spermatogonial carcinoma.

Radiation therapy

Longitudinal seminoma is very sensitive to radiation therapy as is testicular seminoma. Many studies have shown that localized longitudinal

It is effective for septal spermatogonial tumors whether they invade or not. It is effective even if radiotherapy is used as a single treatment or followed by surgical resection. The generally recommended dose is 30-50Gy. It is not necessary to use too high a dose for this disease. Radiotherapy should include the entire septum and supraclavicular lymph nodes. If only local areas are irradiated, 2/3 of patients will have local recurrence. In addition, radiotherapy is also effective for those with metastatic symptoms and those without invasion. The five-year survival rate of surgery and radiotherapy is above 50% (50%-75%), and even 100% in some individual reports.

Operation

It is suitable for complete surgical resection, but due to the invasion of seminoma, complete resection is often not possible, and the reported resection rate is only 37.5%. For those who cannot be completely resected, postoperative treatment can also achieve better results.