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

• 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.

Nyckelord

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

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