PMC3862327_01
Magnetic resonance imaging of a tumor developing from the left testis in a patient with androgen insensitivity syndrome. (A) Before chemotherapy, a T2-weighted image showed that the internal intensity was slightly high. (B) Marked shrinkage of the tumor occurred after 3 cycles of neoadjuvant chemotherapy (NAC).
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A tumor the size of 23 cm in diameter was detected in the abdomen by palpation and was determined to be solid upon examination by computed tomography (CT) and magnetic resonance imaging (MRI) images (Fig. 1A). Following NAC, the tumor shrank to the size of 3.5 cm in diameter (Fig. 1B), and serum levels of CA-125, LD, and beta-hCG decreased to within the normal levels.
(A) A biopsy specimen obtained before chemotherapy showed evenly spaced and relatively large uniform tumor cells with distinct cell borders (magnification x 200). (B and C) Infiltration of lymphocytes was noticed, but tumor cells were not seen after NAC (B, magnification x 40; C, magnification x 200).
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Abdominal biopsy of a tumor on the left ovary showed that the tumor was a seminoma (Fig. 2A).
Laparotomy after NAC. (A) The tumor shrank following NAC. (B) The right testis is indicated by an asterisk. (C) The uterine streak is indicated by arrows.
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Abdominal surgery was performed to remove the tumors derived from the left and right gonads (Fig. 3), and pathological examination revealed that no residual tumor remained in the obtained specimen (Fig. 2B).