血清AFP値上昇を指標として腹膜後腔リンパ節郭清術を施行した小児睾丸腫瘍の1例

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We present a case of a 32-month-old boy with teratoma accompanied by yolk sac carcinoma and embryonal carcinoma of the right testicle. To treat the gradual rise in serum AFP value 3 months postoperatively, he received combined chemotherapy including VCR, CPM and ADM followed by bilateral retroperitoneal lymph node dissection. The preaortic lymph node disclosed, pathologically, yolk sac carcinoma and embryonal carcinoma, which demonstrated neither degeneration nor necrosis despite remarkable decrease in serum AFP value after the chemotherapy. The patient had normal AFP value and no evidence of recurrent disease 36 months after the lymph node dissection. We emphasize the discrepancy between the response of the tumor marker after the chemotherapy and the histologic alteration. Furthermore, the management of infantile testicular cancer is discussed.