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Diagnose und Therapie seltener Hodentumoren am Beispiel des malignen Mesothelioms der Tunica vaginalis testis und Sertoli-Zell-Tumoren

Diagnosis and treatment of rare testicular tumors using the example of malignant mesothelioma of the tunica vaginalis testis and Sertoli cell tumors

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Zusammenfassung

Hintergrund

Hodentumoren, die nicht dem Keimepithel entstammen, sind selten und stellen eine diagnostische und therapeutische Herausforderung dar.

Ziel der Arbeit

Das diagotische und therapeutische Vorgehen werden anhand von Sertoli-Zell-Tumoren (SZT) und malignen Mesotheliomen der Tunica vaginalis testis (MMTVT) dargestellt.

Methode

Es erfolgte eine Literaturrecherche in PubMed sowie den Abstract-Datenbanken von ASCO und ESMO. Die Auswahl der Artikel und Buchbeiträge erfolgte basierend auf der Relevanz für den Behandlungsalltag.

Ergebnisse

Die geringe Inzidenz nicht dem Keimepithel entstammender Hodentumoren macht ein standardisiertes Vorgehen schwierig. Diagnostik und Behandlung richten sich nach der zugrunde liegenden Diagnose. Während die meisten SZT benigne sind, steht bei den malignen Verlaufsformen eine umfassende Operation einschließlich einer Metastasenchirurgie im Vordergrund, sofern eine vollständige Resektion möglich ist. Bei MMTVT werden in Anlehnung an die malignen Mesotheliome der Pleura multimodale Behandlungskonzepte verfolgt.

Schlussfolgerung

Die systematische Erfassung seltener Hodentumoren sowie eine umfassende molekularpathologische Analyse sind dringlich erforderlich, um das Verständnis für die Tumorbiologie zu verbessern und neue therapeutische Ansätze zu entwickeln.

Abstract

Background

Rare tumors of the testis not originating from germinal epithelium are a diagnostic and therapeutic challenge.

Objectives

To present current approaches in rare tumors of the testis using the examples of Sertoli cell tumor (SCT) and malignant mesothelioma of the tunica vaginal testis (MMTVT).

Methods

A literature search in PubMed and the abstract databases of ASCO and ESMO was performed. Articles and book chapters were selected based on relevance to everyday treatment.

Results

The low incidence of testicular tumors not originating from the germinal epithelium makes a standardized approach difficult. Diagnosis and treatment depend on the underlying diagnosis. While most SCT are benign, malignant subtypes require extensive resection including metastatic surgery if complete resection is possible. In MMTVT, multimodality treatment concepts are followed, according to the malignant mesotheliomas of the pleura.

Conclusion

Systematic registration of rare testicular tumors and comprehensive molecular pathological analysis are urgently needed to improve the understanding of tumor biology and to develop new therapeutic strategies.

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Correspondence to G. von Amsberg.

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G. von Amsberg, M. Sehovic, M. Hartmann und C. Bokemeyer geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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von Amsberg, G., Sehovic, M., Hartmann, M. et al. Diagnose und Therapie seltener Hodentumoren am Beispiel des malignen Mesothelioms der Tunica vaginalis testis und Sertoli-Zell-Tumoren. Urologe 60, 872–879 (2021). https://doi.org/10.1007/s00120-021-01575-9

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