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Multiple lymph node metastases in a boy with primary testicular carcinoid, despite negative preoperative imaging procedures.

Journal article
Authors Jonas Abrahamsson
Lotta Mellander
Ola Nilsson
Allan Rubensson
Published in Journal of pediatric surgery
Volume 40
Issue 11
Pages e19-21
ISSN 1531-5037
Publication year 2005
Published at Institute of Laboratory Medicine, Dept of Pathology
Institute for the Health of Women and Children, Dept of Paediatrics
Pages e19-21
Language en
Links dx.doi.org/10.1016/j.jpedsurg.2005....
Keywords Carcinoid Tumor, pathology, radionuclide imaging, surgery, Child, False Negative Reactions, Humans, Lymph Node Excision, Lymphatic Metastasis, radionuclide imaging, Male, Neoplasm Staging, methods, Reoperation, Testicular Neoplasms, pathology, radionuclide imaging, surgery, Tomography, X-Ray Computed
Subject categories Medical and Health Sciences

Abstract

A testicular tumor in a 12-year-old boy proved to be a carcinoid tumor. An extensive investigation including a computed tomographic scan of the abdominal and pelvic region as well as both 123I-labeled metaiodobenzylguanidine and 111In-coupled octreotide scintigraphy was normal. Because histopathologic examination of the primary surgical specimen revealed tumor growth in the resection border of the spermatic vessels, a second operation with unilateral lymph node dissection was performed. Surprisingly, 3 lymph node metastases were found. No further treatment was given and the boy is alive without disease 9 years after surgery. This case illustrates that modern scintigraphic techniques do not always detect carcinoid tumors. Because carcinoids respond poorly to other treatment modalities, the importance of initial radical surgery including a meticulous examination of regional lymph nodes is emphasized.

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