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EFFECT OF BILATERAL ADRENALECTOMY ON METASTATIC CHORIOCARCINOMA FROM TERATOMA OF THE TESTIS

The Departments of Surgery (Urology Section), Radiology and Pathology, Baylor University College of Medicine, and the Veterans Administration Hospital Houston, Texas

Testicular cancer becomes apparent most frequently in the middle and late twenties, that is, near the height of sexual potency. This might suggest an androgenic influence. McClelland (1) performed bilateral orchiectomy in a 26-year-old man with embryonal-cell carcinoma of a testis. The clinically evident metastases vanished after a month. This patient, however, had three courses of deep roentgen therapy before being seen by McClelland. Although a large epigastric mass was present at the time of orchiectomy and disappeared thereafter, the history does not indicate whether the orchiectomy was performed in the immediate postradiation period. If it were, regression might have been due to the radiotherapy. Saleeby (2) reported disappearance of a large retroperitoneal mass from a testicular teratoma in a 50-year-old man after bilateral orchiectomy and after the delivery of 3500 r to the mass from several fields. Description of the testicular tumor fits seminoma, and radiotherapy may have accounted for the regression of the tumor. Schwartz and Mallis (3) noted that bilateral orchiectomy did not seem to delay death from the metastases of testicular teratoma. Our patient showed no improvement from bilateral orchiectomy. The abdominal and supraclavicular masses continued to grow and the patient deteriorated rapidly. Hooker and Pfeiffer (4) reported that prolonged treatment of certain strains of mice with estrogen resulted in cancer of Leydig's interstitial cells and that androgen retarded formation of this metastasizing neoplasm.

^* Present address: Kaiser Foundation Hospital, Los Angeles 27, California.

^** Present address: Radiology Department, Temple University Hospital, Philadelphia, Pa.

Received December 16, 1955.