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1. Brandes AA, Pasetto LM, Monfardini S: The treatment of cranial germ cell tumours. Cancer Treat Rev; 2000 Aug;26(4):233-42
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The treatment of cranial germ cell tumours.
  • Germ cell tumours of the central nervous system (CNS) include many subtypes whose response to treatment varies, even though the symptoms and radiological appearances are similar.
  • Patients with choriocarcinoma, embryonal carcinoma, or yolk sac tumour have the lowest survival rates; patients with germinoma or mature teratoma have longer survival rates.
  • Although a wider resection is associated with a higher rate of survival for patients with non-germinomatous germ cell (NGGC) tumours, to date an aggressive surgical approach has been advocated only for pineal region tumours, but not for hypothalamic/neurohypophyseal tumours.
  • Cisplatin is considered an indispensable drug, but it may cause renal damage, ototoxicity, peripheral neuropathy and sterility, while etoposide is associated with an excess frequency of second neoplasms.
  • Taking into account all of the published literature, the following therapeutic options are suggested: in pure germinoma tumours (GT) radiotherapy alone will usually ensure adequate control of the disease, and the long-term sequelae may be limited by reducing the dose delivered, as was proposed for germ cell testicular tumours, to 30 Gy to limited fields plus 25-30 Gy to the spinal axis if there is disseminated disease.
  • In NGGC tumours, the prognosis is more unfavourable and there is often dissemination to the spine at diagnosis; however, the tumour's high chemosensitivity suggests neoadjuvant treatment chemotherapy with cisplatin and etoposide for three cycles followed by consolidation radiotherapy with 40 Gy to the limited fields plus 30 Gy to the spinal axis if disseminated.
  • [MeSH-major] Brain Neoplasms / therapy. Neoplasms, Germ Cell and Embryonal / therapy
  • [MeSH-minor] Combined Modality Therapy. Cranial Irradiation. Drug Therapy. Humans. Neurosurgical Procedures. Prognosis. Radiotherapy Dosage. Survival Rate

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  • [Copyright] Copyright 2000 Harcourt Publishers Ltd.
  • (PMID = 10913379.001).
  • [ISSN] 0305-7372
  • [Journal-full-title] Cancer treatment reviews
  • [ISO-abbreviation] Cancer Treat. Rev.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] ENGLAND
  • [Number-of-references] 59
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2. Méndez K, Avellanet Y, Umpierre S: A rare case of cutaneous metastasis of postpartum choriocarcinoma. P R Health Sci J; 2009 Jun;28(2):143-5
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  • [Title] A rare case of cutaneous metastasis of postpartum choriocarcinoma.
  • Several factors place patients at high risk of experiencing treatment failure with single agent chemotherapy.
  • Choriocarcinoma following term pregnancy is very rare and associated with a poor prognosis and a mortality rate of 33-40%.
  • We present a rare case of cutaneous metastasis of choriocarcinoma to the left third digit.
  • [MeSH-major] Choriocarcinoma / secondary. Fingers / pathology. Head and Neck Neoplasms / secondary. Puerperal Disorders / pathology. Scalp / pathology. Skin Neoplasms / secondary. Uterine Neoplasms / pathology
  • [MeSH-minor] Biomarkers, Tumor. Brain Neoplasms / diagnosis. Brain Neoplasms / secondary. Cesarean Section. Chorionic Gonadotropin, beta Subunit, Human / blood. Fatal Outcome. Female. Fetal Death / etiology. Humans. Infant, Newborn. Lung Neoplasms / diagnosis. Lung Neoplasms / secondary. Mediastinal Neoplasms / diagnosis. Mediastinal Neoplasms / secondary. Postoperative Complications / blood. Postoperative Complications / diagnosis. Postoperative Complications / pathology. Pregnancy. Young Adult


3. Kamakura Y, Hasegawa M, Minamoto T, Yamashita J, Fujisawa H: C-kit gene mutation: common and widely distributed in intracranial germinomas. J Neurosurg; 2006 Mar;104(3 Suppl):173-80
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • OBJECT: Of the intracranial germ cell tumors (IGCTs), 10% of germinomas and most nongerminomatous tumors remain refractory to multimodality therapy.
  • The authors investigated the mutation of c-kit and the expression of its product KIT in IGCTs to identify tumors susceptible to imatinib mesylate, a synthetic agent targeting KIT.
  • METHODS: The authors investigated 26 IGCTs, including 13 germinomas, five mixed germ cell tumors (MGCTs), four immature teratomas (ITs), and two each of yolk sac tumors and choriocarcinomas.
  • Strong KIT expression was found in the cell membrane of germinomas (100%) and germinomatous cells of MGCTs (80%), as well as in the cytoplasm of epithelial and smooth-muscle cells of ITs.
  • The membranous expression of CD34 was found in the nongerminomatous tumor cells and the chondrocytes of MGCTs (60%), ITs (100%), and a choriocarcinoma (50%), but not in germinomas and germinomatous cells.
  • The novel mutations E73K, T96M (both in exon 2), and A636V (in exon 13) were detected in a single tumor.
  • The presence or type of c-kit mutation was not correlated with patient prognosis.
  • CONCLUSIONS: Immunohistochemical analysis of KIT expression is useful for the diagnosis of germinoma.
  • This study may help in clarifying the pathogenesis of IGCTs and in identifying tumors susceptible to drugs targeting KIT.
  • [MeSH-major] Brain Neoplasms / genetics. Germinoma / genetics. Proto-Oncogene Proteins c-kit / genetics

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  • (PMID = 16572634.001).
  • [ISSN] 0022-3085
  • [Journal-full-title] Journal of neurosurgery
  • [ISO-abbreviation] J. Neurosurg.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] EC 2.7.10.1 / Proto-Oncogene Proteins c-kit
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4. Mamelak AN, Withers GJ, Wang X: Choriocarcinoma brain metastasis in a patient with viable intrauterine pregnancy. Case report. J Neurosurg; 2002 Aug;97(2):477-81
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  • [Title] Choriocarcinoma brain metastasis in a patient with viable intrauterine pregnancy. Case report.
  • The authors report the case of a woman who presented during her 30th week of pregnancy with a large brain metastasis from a previously undetected metastatic choriocarcinoma.
  • Medical management included a regimen of high-dose corticosteroid medications for 36 hours, followed by cesarean delivery of the fetus and craniotomy to remove the metastatic tumor, chemotherapy and radiation therapy were begun within 1 week postsurgery.
  • This is only the second report of a metastatic choriocarcinoma associated with a simultaneous viable intrauterine pregnancy, and the only case in which surgical removal of a brain metastasis was required.
  • [MeSH-major] Brain Neoplasms / secondary. Brain Neoplasms / surgery. Choriocarcinoma / secondary. Choriocarcinoma / surgery. Pregnancy Complications, Neoplastic / pathology. Pregnancy Complications, Neoplastic / surgery. Pregnancy Outcome. Uterine Neoplasms / pathology


5. Doyle DM, Einhorn LH: Delayed effects of whole brain radiotherapy in germ cell tumor patients with central nervous system metastases. Int J Radiat Oncol Biol Phys; 2008 Apr 1;70(5):1361-4
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  • [Title] Delayed effects of whole brain radiotherapy in germ cell tumor patients with central nervous system metastases.
  • PURPOSE: Central nervous system (CNS) metastases are uncommon in patients with germ cell tumors, with an incidence of 2-3%.
  • CNS metastases have been managed with whole brain radiotherapy (WBRT) and concomitant cisplatin-based combination chemotherapy.
  • Our previous study did not observe serious CNS toxicity (Int J Radiat Oncol Biol Phys 1991;22:17-22).
  • The initial diagnosis was between 1981 and 2003.
  • All patients had poor-risk disease according to the International Germ Cell Consensus Collaborative Group criteria.
  • Of the 5 patients, 3 had CNS metastases at diagnosis and 2 developed relapses with CNS metastases.
  • CONCLUSION: Whole brain radiotherapy is not innocuous in young patients with germ cell tumors and can cause late CNS toxicity.
  • [MeSH-major] Brain / radiation effects. Brain Neoplasms / radiotherapy. Cranial Irradiation / adverse effects. Neoplasms, Germ Cell and Embryonal / radiotherapy. Radiation Injuries / complications. Testicular Neoplasms
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / adverse effects. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Choriocarcinoma / blood. Choriocarcinoma / drug therapy. Choriocarcinoma / radiotherapy. Choriocarcinoma / secondary. Chorionic Gonadotropin / blood. Cisplatin / administration & dosage. Combined Modality Therapy / adverse effects. Combined Modality Therapy / methods. Fatal Outcome. Humans. Leukoencephalopathy, Progressive Multifocal / etiology. Lung Neoplasms / secondary. Male. Neoplasm Proteins / blood. Radiotherapy Dosage. Salvage Therapy / methods. Stem Cell Transplantation. Time Factors

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  • [CommentIn] Int J Radiat Oncol Biol Phys. 2008 Apr 1;70(5):1300-2 [18374219.001]
  • (PMID = 18374223.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Chorionic Gonadotropin; 0 / Neoplasm Proteins; Q20Q21Q62J / Cisplatin
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6. Bilgin T, Ozan H, Ozuysal S, Ozkan L: Successful salvage therapy of resistant gestational trophoblastic disease with etoposide, methotrexate, actinomycin-D, etoposide, cisplatin (EMA/EP). Arch Gynecol Obstet; 2004 Jan;269(2):159-60
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  • A 26-year-old woman who had been treated for nonmetastatic gestational trophoblastic tumor with three courses of methotrexate with folinic acid rescue and had been lost to follow up for 4 years was referred with the fractional curettage diagnosis of choriocarcinoma that had been performed for abnormal vaginal bleeding.
  • The uterus was 12 weeks pregnant-size and a 6 x 6-cm tumor mass was seen within the anterior uterine wall at ultrasonography.
  • Whole brain radiation of 30 Gy in 3 weeks for brain metastasis, discovered in magnetic resonance imaging was given after the first course.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brain Neoplasms / diagnosis. Trophoblastic Neoplasms / diagnosis. Uterine Neoplasms / diagnosis
  • [MeSH-minor] Adult. Cisplatin / administration & dosage. Combined Modality Therapy. Dactinomycin / administration & dosage. Diagnosis, Differential. Drug Resistance, Neoplasm. Etoposide / administration & dosage. Female. Humans. Hysterectomy. Methotrexate / administration & dosage. Pregnancy. Salvage Therapy


7. McNally OM, Tran M, Fortune D, Quinn MA: Successful treatment of mother and baby with metastatic choriocarcinoma. Int J Gynecol Cancer; 2002 Jul-Aug;12(4):394-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Successful treatment of mother and baby with metastatic choriocarcinoma.
  • The second case of successful management of a mother and neonate with metastatic choriocarcinoma is described.
  • In a woman with a history of gestational trophoblastic disease, a high index of suspicion and thereby early diagnosis lead to prompt treatment in both mother and neonate.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Choriocarcinoma / drug therapy. Choriocarcinoma / surgery. Uterine Neoplasms / drug therapy. Uterine Neoplasms / surgery
  • [MeSH-minor] Adult. Brain Neoplasms / drug therapy. Brain Neoplasms / secondary. Chorionic Gonadotropin / blood. Etoposide / administration & dosage. Female. Humans. Infant, Newborn. Infectious Disease Transmission, Vertical. Kidney Neoplasms / drug therapy. Kidney Neoplasms / secondary. Liver Neoplasms / drug therapy. Liver Neoplasms / secondary. Male. Paclitaxel / administration & dosage. Pregnancy. Pregnancy Complications, Neoplastic / pathology

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  • (PMID = 12144689.001).
  • [ISSN] 1048-891X
  • [Journal-full-title] International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
  • [ISO-abbreviation] Int. J. Gynecol. Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Chorionic Gonadotropin; 6PLQ3CP4P3 / Etoposide; P88XT4IS4D / Paclitaxel
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8. Ishizuka O, Satoh T, Mizuno H, Mizusawa H, Seki S, Nishizawa O: [A difficult case of advanced testicular choriocarcinoma effectively treated by chemotherapy and resection of lung metastasis]. Gan To Kagaku Ryoho; 2004 Feb;31(2):263-5
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  • [Title] [A difficult case of advanced testicular choriocarcinoma effectively treated by chemotherapy and resection of lung metastasis].
  • We found testicular choriocarcinoma with multiple lung, liver, and brain metastases.
  • The patient received 5 courses of VIP therapy (cisplatin, etoposide, ifosfamide) and 1 course of high-dose chemotherapy (carboplatin, etoposide, cyclophospamide) with peripheral blood stem cell transplantation.
  • Pathological diagnosis showed a remnant of choriocarcinoma.
  • Three years and three months after surgery, no recurrence of the choriocarcinoma has been found.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Choriocarcinoma / drug therapy. Choriocarcinoma / surgery. Lung Neoplasms / secondary. Testicular Neoplasms / drug therapy. Testicular Neoplasms / surgery
  • [MeSH-minor] Adult. Brain Neoplasms / secondary. Carboplatin / administration & dosage. Cisplatin / administration & dosage. Cyclophosphamide / administration & dosage. Drug Administration Schedule. Etoposide / administration & dosage. Humans. Ifosfamide / administration & dosage. Liver Neoplasms / secondary. Male. Peripheral Blood Stem Cell Transplantation. Pneumonectomy

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  • (PMID = 14997765.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; 8N3DW7272P / Cyclophosphamide; BG3F62OND5 / Carboplatin; Q20Q21Q62J / Cisplatin; UM20QQM95Y / Ifosfamide; CEC protocol; ICE protocol 1; VP-P protocol
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9. Blohm ME, Göbel U: Unexplained anaemia and failure to thrive as initial symptoms of infantile choriocarcinoma: a review. Eur J Pediatr; 2004 Jan;163(1):1-6
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  • [Title] Unexplained anaemia and failure to thrive as initial symptoms of infantile choriocarcinoma: a review.
  • Infantile choriocarcinoma is a highly malignant germ cell tumour sub-entity thought to originate from the placenta.
  • The aim of this review is to alert clinicians to clinical symptoms and course of neonatal/infantile choriocarcinoma in order to improve the prognosis of affected children by early diagnosis and appropriate treatment.
  • The clinical details of all 30 cases according to a Medline literature search including two cases documented in the MAKEI germ cell tumour study are analysed.
  • Children suffering from infantile choriocarcinoma become symptomatic at a median age of 1 month (range 0 days-5 months).
  • The tumour affected more than one organ in most cases; organs involved were liver (23/30 cases, 77%), lung (20/30, 67%), brain (8/30, 27%), or skin (3/30, 10%).
  • Without appropriate anti-neoplastic treatment, infantile death occurs on average within 3 weeks from first presentation with a high rate of post-mortem diagnoses (9/28, 32% of live born infants).
  • In recent years, five reported patients (5/30, 18%) achieved a sustained remission after multi-agent cisplatinum-based chemotherapy and delayed (4/5) or primary tumour resection (1/5).
  • Maternal choriocarcinoma was reported in 17 of the 30 cases.
  • CONCLUSION: The differential diagnosis of infantile anaemia, failure to thrive and liver enlargement should include infantile choriocarcinoma and prompt measurement of beta-human chorionic gonadotropin.
  • [MeSH-major] Anemia / etiology. Choriocarcinoma / diagnosis. Failure to Thrive / etiology. Hepatomegaly / etiology. Uterine Neoplasms / diagnosis
  • [MeSH-minor] Chorionic Gonadotropin, beta Subunit, Human / blood. Combined Modality Therapy. Diagnosis, Differential. Female. Humans. Infant. Infant, Newborn. Male. Placenta Diseases. Pregnancy. Treatment Outcome

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  • (PMID = 14628141.001).
  • [ISSN] 0340-6199
  • [Journal-full-title] European journal of pediatrics
  • [ISO-abbreviation] Eur. J. Pediatr.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Chorionic Gonadotropin, beta Subunit, Human
  • [Number-of-references] 36
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10. Behtash N, Behnamfar F, Hamedi B, Ramezanzadeh F: Term delivery following successful treatment of choriocarcinoma with brain metastases, a case report and review of literature. Arch Gynecol Obstet; 2009 Apr;279(4):579-81
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Term delivery following successful treatment of choriocarcinoma with brain metastases, a case report and review of literature.
  • BACKGROUND: Cerebral metastases from choriocarcinoma are a poor prognostic indicator of outcome in both the World Health Organization and FIGO classification systems.
  • CASE: A 27-year-old woman (G(4)P(2)Ab(1)) presented with hemiplegia due to brain metastases of choriocarcinoma 1 year after spontaneous abortion.
  • She underwent craniotomy and was treated with nine courses of multiple agent etoposide, methotrexate, actinomycin- etoposide, and cisplatinum (EMA-EP) regimen combined with whole brain irradiation.
  • CONCLUSION: Multiagent EMA-EP chemotherapy and whole brain irradiation with craniotomy in selected patients preserves fertility and may improve a patient overall prognosis.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Brain Neoplasms / drug therapy. Choriocarcinoma / drug therapy. Uterine Neoplasms / drug therapy






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