A 61-year-old patient, a 20-cigarette smoker per day, diagnosed several years before chronic atrial fibrillation, hypertension, AFO, with prosthesis in the right knee and treated with dicoumarinics, antihypertensives.
He came to the Emergency Department of the Center in late November 2006 for pain and swelling in the left inguinal region of 12 days of evolution together with increased volume of the ipsilateral testicle.
She was evaluated by a pediatric urologist who detected in the physical examination and ultrasound (27-11-06) a large solid mass with necrotic areas of 60 X 58 mm located in the left testis; there was also a well-defined heterogeneous adenopathy in the inguinal region 55
Suspicion of testicular tumor was suspected, afetoprotein and B-HCG (normal) were performed and inguinal orchiectomy was scheduled on December 21, 2006.
Pathological Anatomy reported: sections of adenopathy and testicle with a tumor with abundant occre and nodular cells, with mummaging teccas, with irregular nuclei cells enlarged pigment clumps.
The tumor respects the periphery of the test and the albuginea, but mostly adenopathy.
Immunohistochemical study is positive for S-100 and HMB-45 and negative for alpha-inhibine.
1.
Primary melanoma was diagnosed as malignant melanoma, but it was unsuccessful and sent to our Department for evaluation of systemic treatment.
In our consultation the exploration was anodyne.
A CT scan of the chest and abdomen was requested with oral and intravenous contrast: a 6 mm uncalcified nodule in left segment I and a 12 mm nodule in right segment 6 with pleural tail. In the upper lumbar region 3.1 cm, a nodule with soft tissue
Left inguinal adenopathy of 17 mm with uptake.
After obtaining their informed consent, we proceeded to the application of the first cycle of systemic treatment with Dacarbacin (DTIC) but days before the agreed date the patient was admitted to the hospital with bilateral frontal-capneous seizure cm.
1.
He received holocrane radiation therapy in three sessions, with symptomatic improvement.
On the other hand, we have started monochemotherapy with DTIC, with palliative character, receiving to date two cycles that have had no remarkable incidences.
She also received corticotherapy and anticonvulsant therapy.
