SYNCHRONOUS DIAGNOSIS OF TESTICULAR AND THYROID CANCER IN A YOUNG MALE.

N Tsoukalas, M Kiakou, M Tolia, M Galanopoulos, K Tsapakidis, E Arvanitou, N Charalambakis, V Tountziaris, M Nikolaou, Ch Christofyllakis
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Abstract

Testicular cancer is the most common neoplasm in young males. The early diagnosis and the appropriate treatment make it a curable malignancy in over 90% of the patients, but 6% of the patients with testicular cancer develop a second, mostly treatment-related, malignancy in another primary site many years after the first diagnosis. The simultaneous appearance of a testicular tumor with another primary neoplasm is rarely described in the literature. Here is presented an interesting case of a coexisting non-seminomatous germ cell testicular tumor with a papillary thyroid carcinoma, which was detected early during post-treatment restaging of the testicular tumor. The synchronous presence of these two neoplasms might indicate a probable common pathogenetic background. As treatment-related oncogenesis is highly improbable in this case and the common environmental factors are not known yet, the interest is focused on genetic predisposition. Recent discoveries in molecular genetics show that the two neoplasms share common genetic alterations in the RAS and BRAF genes, which affect the significant signaling pathways. Interestingly, BRAF-V600E was positive in both primary malignancies in our individual.

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一名年轻男性睾丸癌和甲状腺癌的同步诊断。
睾丸癌症是年轻男性最常见的肿瘤。早期诊断和适当的治疗使90%以上的患者成为可治愈的恶性肿瘤,但6%的癌症患者在首次诊断多年后在另一个原发部位发展为第二种主要与治疗相关的恶性肿瘤。睾丸肿瘤与另一原发性肿瘤同时出现的情况在文献中很少描述。这是一个有趣的病例,同时存在非精原细胞生殖细胞睾丸肿瘤和甲状腺乳头状癌,这是在睾丸肿瘤治疗后的早期发现的。这两种肿瘤的同时存在可能预示着共同的发病背景。由于在这种情况下,与治疗相关的致癌作用极不可能发生,而且常见的环境因素尚不清楚,因此人们的兴趣集中在遗传易感性上。分子遗传学的最新发现表明,这两种肿瘤在RAS和BRAF基因中有共同的遗传改变,这会影响重要的信号通路。有趣的是,BRAF-V600E在我们个体的两种原发性恶性肿瘤中均呈阳性。
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