Teresa Gawlik-Jakubczak, Stanisław Dobrzański, Jan Iwanicki
- Szpital Marynarki Wojennej w Gdańsku
Introduction. Introduction – testis cancer is the most often recognised neoplasm in young male population. Patients at reproductive age are pressed both by cancer diagnosis and treatment and the risk of infertility.
Objectives. Objectives-to present the case of men with bilateral testicular tumor who would like to be fathered in future.
Materials and methods. Patient 26 years old, went to urologist with painful enlargement of the left testis. Symptoms lasted for 2 months. Standard diagnostic procedures were started. In ultrasound left testis enlarged, presenting pathological echostructure in total. In right, smaller testis two pathological lesions 7 and 4 mm. AFP- 21,39IU/ml, bHCG within normal range. X-ray of chest- no evidence of metastases. Ultrasound of abdomen- no suspected lesions. Patient, childless, would like be a father in future, was informed about diagnosis of bilateral testicular tumors and necessity of treatment, and the risk of infertility. He decided to store his semen before surgerycryopreservation.
- Radical left orchidectomy and resection of 1 tumour- 7mm- from right testis was done, second tumour was not found. The right testis was visible, smaller and flimsy. Additional specimen from healthy tissue of right testis was removed for pathology examination. In this case there was no possibility to deliver sample of healthy tissue from left side for cryopreservation because all tissue was pathologic. During surgery and postoperative period there was no complication.
Results. Pathology examination- carcinoma embryonale T1NxMx of left testis, in tumor from right + active inflammation with fibrosis. No cancer was present, but in healthy tissue no signs of regular sperm maturation was found. Testosterone level in serum after surgery in normal range. In CT of chest and abdomen nosings of distant metastases was fund, only lymph <1 cm retroperitonealy. Patient waits for oncology treatment. Unfortunately we are unable to evaluate the quality of preserved semen.
Conclusions. Always we should consider and inform the patient about possibility of semen storage before treatment even when second testicle is present and we leave them. During discerning diagnostic process we can recognize, that second testis do not produce spermatozoons.