Extramedullary involvement of the testes in childhood leukemia
Extramedullary involvement of the testes in childhood leukemia
复制标题
儿童白血病睾丸髓外受累
作者：
T. J. Stoffel;M. Nesbit;S. Levitt
163例急性白血病男性患儿中有13例发生睾丸髓外受累。发生率为8.0%。这13名儿童经历了19次单独的扩大。所有发作均接受放射治疗。单侧增大9例，双侧增大10例。13例骨髓完全缓解。在13例患者中，8例睾丸是自最初BM缓解以来的第一个复发部位。在初次诊断为白血病时WBC小于20，000/mm 3的男性中，4.3%发生了睾丸并发症，而WBC等于或大于20，000/mm 3的男性中有17.0%发生了睾丸并发症。睾丸受累的中位时间间隔为13个月，死亡为9个月。其他部位的复发通常发生在睾丸受累之后。尸检结果似乎与剂量无关。当总剂量在1200拉德的范围内时，放射治疗在临床上是成功的，并且是这种并发症的治疗选择。
Thirteen out of 163 male children with acute leukemia developed extramedullary involvement of the testes. This represented an incidence of 8.0%. These 13 children experienced 19 separate episodes of enlargement. All episodes were treated with radiotherapy. The enlargement was unilateral in 9 episodes and bilateral in 10. The bone marrow (BM) was in complete remission in 13 episodes. In 8 of 13 patients the testis was the first site of relapse since the initial BM remission. Of the males with a WBC less than 20,000/mm3 on initial diagnosis of leukemia, 4.3% developed this testicular complication, as compared to 17.0% of those with a WBC equal to or greater than 20,000/mm3. The median time interval to testicular involvement was 13 months; to death, 9 months. Relapse at other sites usually followed testicular involvement. Autopsy findings did not appear to be dose‐related. Radiotherapy was clinically successful when a total dose in the range of 1200 rads was used, and is the treatment of choice for this complication.