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Maligne Hodentumoren: Therapie des Primärtumors

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Uroonkologie

Part of the book series: Springer Reference Medizin ((SRM))

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Zusammenfassung

Der erste Schritt in der Therapie der Hodentumoren ist die inguinale Ablatio testis. Nur bei weit fortgeschrittener Erkrankung erfolgt initial die Chemotherapie und dann sekundär die ablatio testis. Nach fälschlich erfolgter skrotaler Ablatio testis, muß keine Korrekturoperation erfolgen. Die organerhaltende Teilresektion ist indiziert bei benignen Tumoren oder bei Solitärhoden. Nach organerhaltender Op eines Keimzelltumors sollte eine adjuvante Strahlentherapie des Resthodens erfolgen, um die obligatorische Keimzellneoplasie in situ zu eradizieren. Die Implantation einer Silikonhodenprothese sollte präoperativ angeboten werden. Die kontralaterale Hodenbiopsie dient der Früherkennung eines Zweittumors auf der Stufe der Keimzellneoplasie in situ, die sich bei 5–6 % der Fälle findet. Erhöhtes Risiko besteht bei Patienten unter 40 Jahren sowie bei Hodenatrophie. Diesen Patienten sollte die kontralaterale Doppelbiopsie empfohlen werden. Die Bereitstellung einer Fertilitätsreserve in Form einer Kryospermadeponierung sollte möglichst frühzeitig mit dem Patienten besprochen werden.

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Authors and Affiliations

  1. Urologische Abteilung, Asklepios Klinik Altona, Hamburg, Deutschland

    Klaus-Peter Dieckmann

  2. Klinik für Urologie, Uro-Onkologie, spezielle urologische und Roboter-assistierte Chirurgie, Universitätsklinik Köln, Köln, Deutschland

    Axel Heidenreich

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Correspondence to Klaus-Peter Dieckmann .

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  1. Helios Marien Klinikum Duisburg, Duisburg, Nordrhein-Westfalen, Germany

    Herbert Rübben

  2. Urologische Klinik/Poliklinik, Universitätsklinikum Rostock, Rostock, Mecklenburg-Vorpommern, Germany

    Oliver Hakenberg

  3. Klinik und Poliklinik für Urologie , Universitätsklinikum Jena, Jena, Thüringen, Germany

    Marc-Oliver Grimm

  4. Caritaskrankenhaus St. Josef, Regensburg, Germany

    Maximilian Burger

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Dieckmann, KP., Heidenreich, A. (2019). Maligne Hodentumoren: Therapie des Primärtumors. In: Rübben, H., Hakenberg, O., Grimm, MO., Burger, M. (eds) Uroonkologie. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-54652-9_63-1

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