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Maligne Hodentumoren: Therapie des Primärtumors

  • Klaus-Peter DieckmannEmail author
  • Axel Heidenreich
Living reference work entry
Part of the Springer Reference Medizin book series (SRM)

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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Copyright information

© Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature 2019

Authors and Affiliations

  1. 1.Urologische AbteilungAsklepios Klinik AltonaHamburgDeutschland
  2. 2.Klinik für Urologie, Uro-Onkologie, spezielle urologische und Roboter-assistierte ChirurgieUniversitätsklinik KölnKölnDeutschland

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