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CASE REPORT |
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| Year : 2000 | Volume
: 17
| Issue : 1 | Page : 48-50 |
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Seminoma testis in a renal allograft recipient
Sushil Shivlal Rathi, Atul Vasant Mulay, Jagdish N Kulkarni, Umesh G Oza, Ashok L Kirpalani
Departments of Urology and Nephrology, Bombay Hospital Institute of Medical Sciences, Mumbai, India
Correspondence Address:
Jagdish N Kulkarni
Department of Urology, Bombay Hospital Institute of Medical Sciences, 20, New Marine Lines, Mumbai
India
 Source of Support: None, Conflict of Interest: None  | Check |
Keywords: Seminoma; Testis; Transplantation; Immu-nosuppression.
How to cite this article:
Rathi SS, Mulay AV, Kulkarni JN, Oza UG, Kirpalani AL. Seminoma testis in a renal allograft recipient. Indian J Urol 2000;17:48-50 |
 Case Report | |  |
A 37-year-old male, renal transplant recipient since two years, presented with left testicular swelling since two months. He was receiving azathioprine (2.5 mg/kg/day) and prednisolone (10 mg/day). On examination, right testis was normal. Left testis was enlarged, 8x5x5 cm in size, elliptical, smooth surface and firm. Abdominal examination revealed a scar in right iliac fossa and normal palpable transplanted kidney. CT scan of abdomen & pelvis [Figure 1] showed para-aortic & aortocaval lymph nodes, largest measuring 2.5 cm in size and left testicular mass of 6.3x3.5 cm in size. CT scan of chest was normal. Serum creatinine was 1.4 mg%. Alpha-fetoprotein was 1.15 ng/ ml. (Normal-0 to 8.6 ng/ml.) Beta-HCG was 11.9 mIU/ ml. (Normal-0 to 3mlU/ml.)
Left high orchiectomy was performed. Cut section of the specimen showed a well-circumscribed homogenous tumour. Tunica was intact. Epididymis was normal and cut margins of cord were unremarkable. Microscopy revealed classical seminoma of testis [Figure 2]. Thus patient had stage 2b seminoma testis. The patient received three cycles of chemotherapy consisting of carbaplatin and etoposide. Azathioprin was omitted during the cycles. He required GM-CSF support during the period of neutropenia. His renal function remained stable and at the time of last follow-up s. creatinine was 1.5 mg%.
| Comment | | |
Immunosuppression poses a significant risk of development of malignancy in renal transplant recipients. But only 6 cases of post-transplantation seminoma testis are reported in English literature. [1] We propose close surveillance of renal transplant recipients with regard to development of cancer and individualize its treatment. [2] Radiotherapy, though the treatment of choice for stage 2b seminoma, involves risk of radiation nephritis. Our patient preferred chemotherapy over radiotherapy after being explained about treatment options. He is doing well after three cycles of chemotherapy.
| References | | |
| 1. | Modlin CS, Flechner SM, Penn I. Testicular seminoma originating in an undescended testis in a renal allograft recipient. Urology 1996: 48: 145-148.  |
| 2. | Villalona-Calero MA. Ducker T. Holasek M, Najarian J. Kennedy BJ. Management of testicular seminoma following organ transplantation. Med Pediatr Oncol 1992: 20: 338-340. |
[Figure 1], [Figure 2]
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