Abstract：
OBJECTIVES:To summarize monoinstitutional experience with gastrointestinal (GI) presentations of germ cell malignancy and to review recent medical literature on this issue. METHODS:Retrospective review of 5 cases with advanced germ cell malignancy (testicular 2 and retroperitoneal 3) and involvement of the upper GI tract and a comparison with published observation. RESULTS:In 4 patients the duodenum and in 1 patient the distal part of the esophagus were involved in germ cell malignancy. In 3 patients grade 3 or grade 4 anemia represented the principle initial symptom. Ulceration of the upper GI tract was in 1 case complicated by an aortoduodenal fistula with rupture of the aorta. This patient and 2 other cases needed emergency surgery due to GI hemorrhage before and/or during the initial phase of chemotherapy. Our observations compare well with the literature, showing the need of multimodality therapy of these complications. CONCLUSION:In young males with a malignant tumor in the upper GI tract, the diagnosis of germ cell malignancy should be considered. Treatment of this condition requires a multimodality approach, not rarely including emergency surgery. Though these patients often belong to a poor-prognosis group, our results and the literature review show that long-term survival is possible using modern treatment principles. In particular, the risk of GI hemorrhage, during the initial phase of therapy, should not be overseen.
journal_name
Eur Uroljournal_title
European urologyauthors
Nord C,Fosså SD,Giercksky KEdoi
10.1159/000020368keywords:
subject
Has Abstractpub_date
2000-12-01 00:00:00pages
721-4issue
6eissn
0302-2838issn
1873-7560pii
20368journal_volume
38pub_type
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