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BJU International 2000 85 (3), 374
CASE REPORTS
Intracaval mass after chemotherapy for metastatic nonseminomatous germ cell tumour
H.
Sells, A.
Stewart and G. N.
Sibley
Bristol Royal Infirmary, Bristol, UK
Case report
Comment  References Authors A 37–year–old man underwent excision of a residual paracaval mass in 1997 after chemotherapy for metastatic nonseminomatous germ cell tumour (NSGCT). Histology showed differentiated teratoma with cysts lined by intestinal–type epithelium. Initial MRI 3 months later showed no residual disease but a follow–up at 18 months showed a recurrent cystic mass measuring 2.4 cm in the paracaval region. At 22 months this had grown to 2.8 cm and appeared to be partially obstructing the inferior vena cava (Fig. 1). At operation, there was negligible remaining nodal tissue and it was apparent that the mass lay within the lumen of the vena cava. The infrarenal cava and common iliac veins were controlled and a venotomy performed. A mobile 4 × 4 × 2.5 cm mass attached to the caval wall by a 2 mm pedicle was removed (Fig.2) and the patient made an uneventful recovery. Histology again showed differentiated teratoma.
Comment
Case report  References Authors After chemotherapy for metastatic NSGCT, resection of residual well–differentiated teratoma can give a 5–year survival rate of 88%[1]. Residual masses related to the vena cava have previously been described [1–3], although no other reports detail mature teratoma floating within the lumen. MRI can differentiate between intraluminal thrombus and external compression of the vena cava in metastatic NSGCT [3] but, in hindsight, a venogram in the present patient may have given more relevant information. Clearly, detachment of the intraluminal mass before or during surgery could have had disastrous consequences.
References
Case report Comment Authors
Authors
Case report Comment References
H. Sells, FRCS, Specialist Registrar.
A. Stewart, Senior House Officer.
G.N. Sibley, DM, MCh, FRCS, Consultant Urologist.
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| To cite this article |
| Sells, H., Stewart, A. & Sibley, G. N. Intracaval mass after chemotherapy for metastatic nonseminomatous germ cell tumour.
BJU International 2000 85 (3), 374
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| Medline Author Search |
Sells, H
Stewart, A
Sibley, G
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| Correspondence: Mr H. Sells, Department of Urology, Bristol Royal Infirmary, Bristol BS2 8HW, UK. |
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