You have accessJournal of UrologyAdrenal/Single Port Surgery/LESS/NOTES1 Apr 2016V11-08 LAPAROSCOPIC ADRENAL METASTATECTOMY IN TESTICULAR SEMINOMA: FIRST CASE IN AMERICA Marino Cabrera Fierro, Claudia Lucia Ochoa, Rodolfo Varela, Jorge Alfredo Forero, German Fabian Godoy, and Maria Cristina Maldonado Marino Cabrera FierroMarino Cabrera Fierro More articles by this author , Claudia Lucia OchoaClaudia Lucia Ochoa More articles by this author , Rodolfo VarelaRodolfo Varela More articles by this author , Jorge Alfredo ForeroJorge Alfredo Forero More articles by this author , German Fabian GodoyGerman Fabian Godoy More articles by this author , and Maria Cristina MaldonadoMaria Cristina Maldonado More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1825AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Testicular germ cell tumours are the most common neoplasias presenting in young men; most of which are seminomas. The most common sites of metastasis in seminoma are the retroperitoneum, lung, liver, bones, bowel and central nervous system. Furthermore, there are unusual sites of metastases reported in the literature such as prostate, skin and adrenal gland. We describe the first case report of a metastatic adrenal seminoma treated with salvage laparoscopic adrenal metastatectomy METHODS To our knowledge there are no case reports in America of Adrenal metastasis in testicular seminoma. We performed a systematic search in PubMed and a critical analysis of the literature RESULTS 26 year-old man with a pT1N0M0S0 right testicular seminoma. He underwent right radical orchidectomy and adjuvant external para-aortic radiation therapy. Three years later he presents mediastinal metastasis treated with PEB (bleomycin, etoposide and CDDP). Relapses with mediastinal, tracheal and lung metastasis; initiating treatment with TIP (paclitaxel, ifosfamide and CDDP), but could only receive 3 cycles due to febrile neutropenia. Salvage mediastinal radiotherapy was done. He persist with lung lessions and a new onset right adrenal mass was found; he received one cycle of gemcitabine and paclitaxel with partial response to treatment. A PET/CT scan was performed in where the adrenal size increase, hence we offered salvage surgical therapy with a laparoscopic adrenal metastatectomy using a transperitoneal approach. There were no intraoperative or postoperative complications. The pathology report confirmed the presence of metastatic seminoma with negative margins. After 12 months of followup no recurrence has been found. CONCLUSIONS Adrenal metastasis are an atypical presentation of seminoma. PET/CT scan focuses therapy in patients presenting with residual masses to assess their viability. The laparoscopic approach for metastatic adrenal lesions is a feasible and safe procedure; Offering an optimal oncologic results and an adequate vascular control and resection margins. This procedure Should be done by experienced surgeons. ? © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e1005 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Marino Cabrera Fierro More articles by this author Claudia Lucia Ochoa More articles by this author Rodolfo Varela More articles by this author Jorge Alfredo Forero More articles by this author German Fabian Godoy More articles by this author Maria Cristina Maldonado More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...