Adult primary XXXX --report on 5 cases in clinical stage I disease.

@entity1 @entity5 @entity1600 @entity189 @entity3 @entity44 @entity34
OBJECTIVES: Testis pure @entity44 accounts for 2.7% to 3% of all germ cell @entity5 in adult where it behaves as a malignant @entity5 . Pure @entity44 presents in clinical stage I disease in 44% of the @entity1 whose risk of having pathological @entity34 is 16.7% to 19.2%. Herein we report on 5 cases of adult pure @entity44 presenting itself in clinical stage I disease. MATERIALS AND METHODS: From September 1976 to February 2000, 75 @entity1 underwent orchidectomy for clinical stage I nonseminomatous germ cell @entity5 . Testis pure @entity44 was detected in 5 @entity1 (7%). @entity5 markers were evaluated in all cases. @entity1 underwent imaging examination to detect the clinical stage of the disease. Treatment options after orchidectomy included @entity1600 ( @entity1600 ) in 4 @entity1 and surveillance in 1. RESULTS: The average age of the @entity1 was 31 years (range 24-45). The @entity5 was on the left sided in 3 cases (60%) and right in 2 (40%). Tumor average size was 3.2 cm (rang 1-6). Histopathology detected the following subtypes: mature @entity44 in 3 cases (60%), @entity44 in 1 (20%) and @entity44 with malignant transformation in (20%). All @entity1 were at clinical stage I disease. Germ cell cancer microscopic @entity3 including @entity189 was detected in I dissected lymph node of 1/4 @entity1 (25%). Average follow up was 166 months (range 93-249). All @entity1 were alive and disease free and no relapses were detected during the follow up period. CONCLUSIONS: Primary pure @entity44 does not respond to chemotherapy nor does it to radiation therapy. The disease treatment options after orchidectomy for @entity1 with clinical stage I disease include @entity1600 or surveillance with their relative risks and benefits. @entity1600 is the chosen treatment because it is both staging and treating. A close a long term follow up is required since pure @entity3 may clinically develop after more than 10 years.
