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Testicular cancer metastasizes in a predictable pattern, and lymph nodes in the retroperitoneum are typically the first place it lands. [1] [2] By examining the removed lymphatic tissue, a pathologist can determine whether the disease has spread. If no malignant tissue is found, the cancer can be labeled Stage I, limited to the testicle. [3]
Retroperitoneal fibrosis; Retroperitoneal lymph node dissection; It is also possible to have a neoplasm in this area, more commonly a metastasis; or very rarely a primary neoplasm. The most common type is a sarcoma followed by lymphoma, extragonadal germ cell tumor, and gastrointestinal stromal tumor/GIST. [9] Examples of tumors include:
The association of idiopathic retroperitoneal fibrosis with various immune-related conditions and response to immunosuppression led to a search for an autoimmune cause of idiopathic RPF. [ 5 ] [ 6 ] Many of these previously idiopathic cases can now be attributed to IgG4-related disease , an autoimmune disorder proposed in 2003.
G (1–4): the grade of the cancer cells (i.e. they are "low grade" if they appear similar to normal cells, and "high grade" if they appear poorly differentiated) S (0–3): elevation of serum tumor markers; R (0–2): the completeness of the operation (resection-boundaries free of cancer cells or not) Pn (0–1): invasion into adjunct nerves
Patients in response categories 4-9 should be considered as failing to respond to treatment (disease progression). Thus, an incorrect treatment schedule or drug administration does not result in exclusion from the analysis of the response rate. Precise definitions for categories 4-9 will be protocol specific.
Grey Turner's sign refers to bruising of the flanks, the part of the body between the last rib and the top of the hip.The bruising appears as a blue discoloration, [1] and is a sign of retroperitoneal hemorrhage, or bleeding behind the peritoneum, which is a lining of the abdominal cavity.
The more aggressive forms of disease require treatment with chemotherapy, radiotherapy, immunotherapy and—in some cases—a bone marrow transplant. The use of rituximab has been established for the treatment of B-cell–derived hematologic malignancies, including follicular lymphoma (FL) and diffuse large B-cell lymphoma (DLBCL). [7]
Cancer staging can be divided into a clinical stage and a pathologic stage. In the TNM (Tumor, Node, Metastasis) system, clinical stage and pathologic stage are denoted by a small "c" or "p" before the stage (e.g., cT3N1M0 or pT2N0). This staging system is used for most forms of cancer, except brain tumors and hematological malignancies.