Forum pracy nad projektem wskrzeszenia The Forge

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Care of patients recovering from cerebral thrombosis


Higher density of 20cm round shadow, suggesting mediastinal lung metastases, serum alpha-fetoprotein> 400 ng / ml admission diagnosis: testicular cancer, advanced lung metastasis of yolk sac. I994 line on March 30 left high orchiectomy spermatic cord (the parents refused, so do not do retroperitoneal lymph node dissection). Postoperative chemotherapy with CISCA, after two children with the disease after treatment was significantly improved, increased appetite, cough disappeared (cough can not be supine before surgery) three months after surgery the results of test serum alpha-fetoprotein 0 ng / ml, chest B-film and abdomen were normal,[link widoczny dla zalogowanych], the unexpected results obtained Discussion: Pediatric testicular yolk sac carcinoma is the most common pediatric testicular cancer as a clinical practice in three phases: I of a tumor confined to testis, no extravagant transfer signs; l less of a diaphragmatic lymph node metastasis; I of a distant lung metastases. The group I were on both sides, I of the children are to find a painless scrotal mass and symptoms of the late chief complaint of a transfer, the other based on the hardness of mass, light transmission tests and serum alpha-fetoprotein and characterization. AFP from the yolk sac tumor, is still reserved for the fetal synthesis of AFP's ability, and multiplied, almost no false negative results, this group of patients before surgery values ​​were> 400 ng / ml Therefore, the dynamic observation of AFP for early diagnosis, tumor characterization. Clinical stage, clinical observation has an important role. B ultrasound, chest X-ray abdomen and lungs can understand some help metastasis. Testicular yolk sac carcinoma of the major pediatric hematogenous metastasis. Rare lymph node metastasis, and peritoneal lymph node dissection can be easily injured by L-L sympathetic area possible. Brosman had reported 386 cases of yolk sac carcinoma, 98 cases of retroperitoneal lymph node dissection were found only 4 cases of lymph node baptized. Kaplan statistics do 47 cases of retroperitoneal lymph node dissection, of which 9 patients had different complications. Such as: pulmonary atelectasis, wound infection, visceral prolapse, intussusception, a branch was ligated, the renal gland, intestinal obstruction, milk Japan [English Okamoto I] reported: 17 cases of pediatric testicular yolk sac carcinoma, minimum 9 months to 2 years and 8 months, all of the high testicular surgery to do, including 7 cases of retroperitoneal lymph node dissection at the same time, only l case investigation to lymph node metastasis, 1 case is also introduced 2 years and 8 months in children, bilateral lung metastases foci several areas, high testosterone line plus chemotherapy after resection were followed up for 5 years is still key. Based on the above comparative experience, two cases in this group have adopted high spermatic orchiectomy, I have been of the children were followed up for three months a year, AFP, abdominal B ultrasound, chest X-ray were normal, no further treatment, continued follow-up for two years. The other cases of stage Ⅲ for some reason not done in children with retroperitoneal lymph node dissection, when we did not insist, therefore a simple line of high orchiectomy and postoperative chemotherapy using CISCA: cisplatin at 20mg / m by 5 days on day 1, cyclophosphamide 600mg / m once. The first 4,5 days each with doxorubicin 25mg / m time, these three drugs every 5 days for treatment, after three weeks with two treatments, repeated every three months after a course of treatment. Children has been performed in this case finished fourth course of treatment, AFP, B ultrasound, chest X-ray were normal. We are ready to continue application of chemotherapy for two years, asked the AFP in this period as the main monitoring indicators of the above results show that the treatment of two cases: children with testicular cancer, although the yolk sac is reached I, if only the high testis removed, regular use chemotherapy, Recent efficacy is significant, long-term efficacy remains to be observed how