Indian Journal of Urology
CASE REPORT
Year
: 2000  |  Volume : 17  |  Issue : 1  |  Page : 48--50

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




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


How to cite this URL:
Rathi SS, Mulay AV, Kulkarni JN, Oza UG, Kirpalani AL. Seminoma testis in a renal allograft recipient. Indian J Urol [serial online] 2000 [cited 2021 Sep 22 ];17:48-50
Available from: https://www.indianjurol.com/text.asp?2000/17/1/48/41015


Full Text

 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

1Modlin CS, Flechner SM, Penn I. Testicular seminoma originating in an undescended testis in a renal allograft recipient. Urology 1996: 48: 145-148.
2Villalona-Calero MA. Ducker T. Holasek M, Najarian J. Kennedy BJ. Management of testicular seminoma following organ transplantation. Med Pediatr Oncol 1992: 20: 338-340.