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1. Koshida K, Kato H, Mizokami A, Morishita H, Seto C, Komatsu K, Kou E, Uchibayashi T, Shiobara S, Namiki M: High-dose chemotherapy with peripheral blood stem cell transplantation for advanced testicular cancer. Int J Urol; 2002 Mar;9(3):146-53
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  • [Title] High-dose chemotherapy with peripheral blood stem cell transplantation for advanced testicular cancer.
  • BACKGROUND: The aim of this study was to investigate the efficacy and safety of high-dose chemotherapy (HDCT) for the treatment of patients with advanced testicular cancer.
  • METHODS: Fourteen patients were treated with high-dose carboplatin, etoposide and cyclophosphamide (with or without THP-adriamycin) followed by peripheral blood stem cell transplantation.
  • The treatment was used for two refractory cases, a second relapse, and for consolidation after the first relapse in one case each.
  • It was also used for nine cases as part of the first-line treatment following primary conventional-dose chemotherapy, and for one case as the first salvage for a late recurrent tumor of teratoma with malignant transformation.
  • RESULTS: The first two patients who received intensive pretreatment with cisplatin-based chemotherapy did not respond to HDCT.
  • The two patients who were treated with HDCT as the first or second salvage therapy achieved successful outcomes.
  • The results for the subsequent nine patients (consisting of two with stage IIIC, five with IIIB2, one with IIB, and one extragonadal seminoma) were two progressive disease, three no change and four partial remission.
  • Finally, a case of teratoma with malignant transformation did not respond well to two cycles of HDCT.
  • CONCLUSIONS: The results demonstrated the limited efficacy of HDCT even in cases with a good to intermediate risk rating according to classification by the International Germ Cell Cancer Collaborative Group.
  • Because treatment for relapse after HDCT is extremely difficult, new HDCT regimens consisting of drugs that are not used in induction chemotherapy need to be established.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Hematopoietic Stem Cell Transplantation. Testicular Neoplasms / therapy
  • [MeSH-minor] Adolescent. Adult. Bleomycin / administration & dosage. Carboplatin / administration & dosage. Cisplatin / administration & dosage. Cyclophosphamide / administration & dosage. Dose-Response Relationship, Drug. Doxorubicin / administration & dosage. Doxorubicin / analogs & derivatives. Etoposide / administration & dosage. Humans. Male. Middle Aged. Teratoma / drug therapy. Teratoma / therapy

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  • (PMID = 12010324.001).
  • [ISSN] 0919-8172
  • [Journal-full-title] International journal of urology : official journal of the Japanese Urological Association
  • [ISO-abbreviation] Int. J. Urol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Australia
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; BG3F62OND5 / Carboplatin; D58G680W0G / pirarubicin; Q20Q21Q62J / Cisplatin; BEP protocol; CEC protocol
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2. Bastian PJ, Skowasch D, Bauriedel G, Behrens P, Muller SC, Albers P: Primary extragonadal germ cell tumor of the prostate in a young man. Int J Urol; 2004 Aug;11(8):671-3
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  • [Title] Primary extragonadal germ cell tumor of the prostate in a young man.
  • We report on a case of malignant prostatic teratoma treated with radical cystoprostatectomy and cisplatin-based chemotherapy because of intraoperative tumor rupture.
  • During chemotherapy the patient suffered acute myocardial infarction and was treated with percutanous coronarangiography and stenting.

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  • (PMID = 15285762.001).
  • [ISSN] 0919-8172
  • [Journal-full-title] International journal of urology : official journal of the Japanese Urological Association
  • [ISO-abbreviation] Int. J. Urol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Australia
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3. Kuroda I, Ueno M, Mitsuhashi T, Nakagawa K, Yanaihara H, Tsukamoto T, Deguchi N: Testicular seminoma after the complete remission of extragonadal yolk sac tumor : a case report. BMC Urol; 2004 Nov 16;4:13
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  • [Title] Testicular seminoma after the complete remission of extragonadal yolk sac tumor : a case report.
  • BACKGROUND: Between 2% and 5% of malignant germ-cell tumors in men arise at extragonadal sites.
  • Of extragonadal germ cell tumors, testicular carcinoma in situ (CIS) are present in 31-42% of cases, and CIS are reported to have low sensitivity to chemotherapy in spite of the various morphology and to have a high likelihood of developing into testicular tumors.
  • A testicular biopsy may thus be highly advisable when evaluating an extragonadal germ cell tumor.
  • CASE PRESENTATION: A 36-year-old man was diagnosed as having an extragonadal non-seminomatous germ cell tumor, that was treated by cisplatin-based chemotherapy, leading to a complete remission.
  • About 4 years later, a right testicular tumor was found, and orchiectomy was carried out.
  • Microscopically, the tumor was composed of seminoma.
  • CONCLUSIONS: We herein report a case of metachronous occurrence of an extragonadal and gonadal germ cell tumor.
  • In the evaluation of an extragonadal germ cell tumor, a histological examination should be included since ultrasonography is not sufficient to detect CIS or minute lesions of the testis.
  • [MeSH-major] Endodermal Sinus Tumor / drug therapy. Neoplasms, Second Primary / etiology. Seminoma / etiology. Testicular Neoplasms / drug therapy. Testicular Neoplasms / etiology
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bleomycin / administration & dosage. Cisplatin / administration & dosage. Etoposide / administration & dosage. Humans. Male. Orchiectomy. Remission Induction

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  • (PMID = 15546481.001).
  • [ISSN] 1471-2490
  • [Journal-full-title] BMC urology
  • [ISO-abbreviation] BMC Urol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
  • [Other-IDs] NLM/ PMC535804
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4. Fakhr IM, Khalil el-SA, El-Baradie TS, Shaalan MA, Shalaby LM, Nassif SL, Farahat IG: The role of surgical management in pediatric germ cell tumors (GCTs), NCI case series. J Egypt Natl Canc Inst; 2008 Mar;20(1):70-9

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  • [Title] The role of surgical management in pediatric germ cell tumors (GCTs), NCI case series.
  • PURPOSE: To review the experience of a tertiary referral center in pediatric germ cell tumors (GCTs) in the last 8 years and to investigate the impact of surgery and site of disease on prognosis.
  • PATIENTS AND METHODS: We retrospectively analyzed the cases of pediatric germ cell tumors at National Cancer Institute over an 8 years period.
  • Anatomic distribution of GCTs according to sex organ involvement was either gonadal in 21 patients (61.8%) or extragonadal in 13 patients (38.2%).
  • Yolk sac tumor and malignant teratoma were the commonest histologic subtypes in our series.
  • Adjuvant chemotherapy was administered in 28 out of 33 patients (84.8%), following surgery, including all patients with extragonadal disease.
  • Pelvic extragonadal site was the worst site regarding resectability.
  • Complete surgical resection showed better disease free survival, while those with irresectable disease had comparable overall survival while none could be rendered disease free with chemotherapy.
  • CONCLUSION: The initial surgical approach to malignant GCTs at all sites should be complete resection when possible; the morbidity of extensive surgical resection should be weighed carefully against the good tumor control with chemotherapy.
  • The site of primary disease plays a role in the prognosis of pediatric germ cell tumors with the extragonadal pelvic tumors being the worst regarding resectability.
  • Good tumor response can be achieved with surgery and chemotherapy even for advanced stage and metastatic disease.
  • [MeSH-major] Neoplasms, Germ Cell and Embryonal / surgery
  • [MeSH-minor] Adolescent. Chemotherapy, Adjuvant. Child. Child, Preschool. Female. Humans. Infant. Lymphatic Metastasis. Male. Neoplasm Staging. Prognosis. Retrospective Studies

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  • (PMID = 19847284.001).
  • [ISSN] 1110-0362
  • [Journal-full-title] Journal of the Egyptian National Cancer Institute
  • [ISO-abbreviation] J Egypt Natl Canc Inst
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Egypt
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5. Kim E, Bae TS, Kwon Y, Kim TH, Chung KW, Kim SW, Ro J, Lee ES: Primary malignant teratoma with a primitive neuroectodermal tumor component in thyroid gland: a case report. J Korean Med Sci; 2007 Jun;22(3):568-71
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  • [Title] Primary malignant teratoma with a primitive neuroectodermal tumor component in thyroid gland: a case report.
  • Teratomas comprise the most common extragonadal germ cell tumors in childhood.
  • However, the adult cases reported are mostly malignant and commonly arise in the thyroid.
  • Pathologic examination revealed it to be malignant teratoma composed of primitive neuroepithelial tissue with primitive neural tubes and loose myxoid to fibrous immature mesenchymal stroma.
  • The patient underwent extensive evaluation of the thyroid gland with computed tomography (CT) scan and positron emission tomography (PET) scan, which revealed no evidence of metastatic disease.
  • She underwent total thyroidectomy with bilateral modified radical neck dissection, intensive chemotherapy and radiotherapy.
  • This is the first case, to our knowledge, of malignant thyroid teratoma with a exuberant primitive neuroectodermal tumor component in Korea.
  • [MeSH-minor] Adult. Female. Head and Neck Neoplasms / pathology. Humans. Neoplasm Metastasis. Positron-Emission Tomography / methods. Thyroid Diseases / diagnosis. Thyroidectomy. Tomography, X-Ray Computed

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  • (PMID = 17596674.001).
  • [ISSN] 1011-8934
  • [Journal-full-title] Journal of Korean medical science
  • [ISO-abbreviation] J. Korean Med. Sci.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Korea (South)
  • [Other-IDs] NLM/ PMC2693658
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6. Rejlekova K, Mego M, Rajec J, Sycova-Mila Z, Obertova J, Mardiak J: A rare case of malignant extragonadal germ cell tumor in the pineal region with an aggressive behaviour. Bratisl Lek Listy; 2009;110(5):296-7
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  • [Title] A rare case of malignant extragonadal germ cell tumor in the pineal region with an aggressive behaviour.
  • Though germ cell cancer is rare, it is the most common cancer in males between 20 and 40 years.
  • The primary site for the development of germ cell tumor is testes, but it can be seen in extragonadal locations as well.
  • Herein, we present a rare case of a 19-year-old patient with non/seminomatous extragonadal germ cell tumor in the pineal region with an aggressive behaviour, refractory to the combined therapy (surgery, radio- and chemotherapy).
  • We suggest that early diagnosis and aggressive multimodal approaches along with surgery, radiotherapy and chemotherapy is necessary to improve the outcome of these patients (Ref. 5).
  • [MeSH-major] Brain Neoplasms. Neoplasms, Germ Cell and Embryonal. Pineal Gland

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  • (PMID = 19507665.001).
  • [ISSN] 0006-9248
  • [Journal-full-title] Bratislavské lekárske listy
  • [ISO-abbreviation] Bratisl Lek Listy
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Slovakia
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7. Cushing B, Giller R, Cullen JW, Marina NM, Lauer SJ, Olson TA, Rogers PC, Colombani P, Rescorla F, Billmire DF, Vinocur CD, Hawkins EP, Davis MM, Perlman EJ, London WB, Castleberry RP, Pediatric Oncology Group 9049, Children's Cancer Group 8882: Randomized comparison of combination chemotherapy with etoposide, bleomycin, and either high-dose or standard-dose cisplatin in children and adolescents with high-risk malignant germ cell tumors: a pediatric intergroup study--Pediatric Oncology Group 9049 and Children's Cancer Group 8882. J Clin Oncol; 2004 Jul 1;22(13):2691-700
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  • [Title] Randomized comparison of combination chemotherapy with etoposide, bleomycin, and either high-dose or standard-dose cisplatin in children and adolescents with high-risk malignant germ cell tumors: a pediatric intergroup study--Pediatric Oncology Group 9049 and Children's Cancer Group 8882.
  • PURPOSE: To determine in a randomized comparison whether combination chemotherapy with high-dose cisplatin (HDPEB) improves the event-free (EFS) and overall (OS) survival of children and adolescents with high-risk malignant germ cell tumors (MGCT) as compared with standard-dose cisplatin (PEB) and to compare the regimens' toxicity.
  • PATIENTS AND METHODS: Between March 1990 and February 1996, 299 eligible patients with stage III and IV gonadal and extragonadal (all stages) MGCT were enrolled onto this Pediatric Oncology Group and Children's Cancer Group study.
  • Chemotherapy included bleomycin 15 units/m(2) on day 1, etoposide 100 mg/m(2) on days 1 through 5, and either high-dose cisplatin 40 mg/m(2) on days 1 through 5 (HDPEB; n = 149) or standard-dose cisplatin 20 mg/m(2) on days 1 through 5 (PEB; n = 150).
  • Patients were evaluated after four cycles of therapy, and those with residual disease underwent surgery.
  • Those with malignant disease in resected specimen received two additional cycles of their assigned regimen.
  • RESULTS: One hundred thirty-four eligible patients with advanced testicular (n = 60) or ovarian (n = 74) tumors and 165 with stage I to IV extragonadal tumors were enrolled.
  • HDPEB treatment resulted in significantly improved 6-year EFS rate +/- SE (89.6% +/- 3.6% v 80.5% +/- 4.8% for PEB; P =.0284).
  • Tumor-related deaths were more common after PEB (14 deaths v two deaths).
  • Other treatment-related toxicities were more common with HDPEB.
  • CONCLUSION: Combination chemotherapy with HDPEB significantly improves EFS for children with high-risk MGCT.
  • [MeSH-major] Antineoplastic Agents / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cisplatin / administration & dosage. Neoplasms, Germ Cell and Embryonal / drug therapy. Ovarian Neoplasms / drug therapy. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Adolescent. Bleomycin. Child. Child, Preschool. Disease-Free Survival. Dose-Response Relationship, Drug. Etoposide. Female. Humans. Male. Prognosis. Risk Factors

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  • (PMID = 15226336.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA13539; United States / NCI NIH HHS / CA / CA30969; United States / NCI NIH HHS / CA / U10CA29139
  • [Publication-type] Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; BEP protocol
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8. Billmire D, Vinocur C, Rescorla F, Colombani P, Cushing B, Hawkins E, London WB, Giller R, Lauer S: Malignant mediastinal germ cell tumors: an intergroup study. J Pediatr Surg; 2001 Jan;36(1):18-24
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  • [Title] Malignant mediastinal germ cell tumors: an intergroup study.
  • PURPOSE: This review was conducted to determine clinical characteristics and response to therapy in this rare pediatric neoplasm.
  • METHODS: An intergroup Pediatric Oncology Group (POG) 9049/Children's Cancer Study Group (CCG) 8882 randomized trial was conducted to evaluate response rate and survival with chemotherapy using etoposide, bleomycin, and high or standard dose cisplatin for high-risk malignant germ cell tumors at extragonadal sites.
  • RESULTS: Of the 38 children with malignant mediastinal germ cell tumors (MGCT), 36 had sufficient data to be included in this review.
  • Yolk sac tumor was the only malignant element in girls.
  • Boys had yolk sac tumor in 7, germinoma in 3, choriocarcinoma in 2, and mixed malignant elements in 15.
  • Four patients had biopsy and chemotherapy without tumor resection, and only 1 survived.
  • Fourteen patients had resection at diagnosis followed by chemotherapy with 12 survivors.
  • Eighteen patients had biopsy followed by chemotherapy and postchemotherapy tumor resection with 13 survivors.
  • Tumor size in response to chemotherapy for these 18 patients was stable or increased in 6, and decreased in 12 (mean decrease of 57% in greatest dimension).
  • Ten patients died: 5 of tumor (all boys > or =15 yr), 2 of sepsis, and 3 of second malignancy.
  • CONCLUSIONS: Malignant MGCT is a complex tumor of varied histology with frequent coexistence of benign elements.
  • Lesions often have incomplete regression with chemotherapy alone.
  • Tumor resection may be undertaken at diagnosis or after attempted shrinkage with chemotherapy.
  • Aggressive attempt at complete tumor resection should be offered to all patients even if bulky tumor persists after induction chemotherapy with expectation of a significant salvage rate.
  • Boys > or =15 years may be a high-risk subgroup for mortality from tumor progression.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Mediastinal Neoplasms / drug therapy. Neoplasms, Germ Cell and Embryonal / drug therapy
  • [MeSH-minor] Adolescent. Biopsy. Bleomycin / administration & dosage. Child. Child, Preschool. Cisplatin / administration & dosage. Disease-Free Survival. Etoposide / administration & dosage. Female. Humans. Infant, Newborn. Male. Survival Rate. Treatment Outcome

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  • (PMID = 11150432.001).
  • [ISSN] 0022-3468
  • [Journal-full-title] Journal of pediatric surgery
  • [ISO-abbreviation] J. Pediatr. Surg.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Randomized Controlled Trial
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
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9. Horton Z, Schlatter M, Schultz S: Pediatric germ cell tumors. Surg Oncol; 2007 Nov;16(3):205-13
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  • [Title] Pediatric germ cell tumors.
  • Pediatric germ cell tumors are a diverse group of neoplasms with variable clinical behaviors, depending upon the age and site of presentation.
  • Platinum-based chemotherapy has dramatically improved the event-free and overall survival outcomes of pediatric patients with malignant germ cell tumors over the past two decades.
  • Prognosis is dependent on tumor stage and location.
  • Patients with gonadal germ cell tumors have at least a 95% 5-year survival for early stage disease and at least a 85% 5-year survival for advanced stages.
  • In general, extragonadal germ cell tumors carry a poorer prognosis with mediastinal location having the worst outcomes (70% 4-year survival).
  • Current trials are focused on maintaining similar excellent outcomes while reducing morbidity by reducing the dose and duration of chemotherapy.
  • Cytogenetic research studies have found chromosomal aberrations specific to some of these tumors that may serve as prognosticators and even direct therapy.
  • [MeSH-major] Neoplasms, Germ Cell and Embryonal

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  • (PMID = 17719771.001).
  • [ISSN] 0960-7404
  • [Journal-full-title] Surgical oncology
  • [ISO-abbreviation] Surg Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Netherlands
  • [Number-of-references] 78
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10. Kobayashi T, Kawakita M, Terachi T, Habuchi T, Ogawa O, Kamoto T: Significance of elevated preoperative alpha-fetoprotein in postchemotherapy residual tumor resection for the disseminated germ cell tumors. J Surg Oncol; 2006 Dec 1;94(7):619-23
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  • [Title] Significance of elevated preoperative alpha-fetoprotein in postchemotherapy residual tumor resection for the disseminated germ cell tumors.
  • BACKGROUND AND OBJECTIVES: The purpose of the study is to determine the significance of elevated serum alpha-fetoprotein (AFP) in the setting prior to residual tumor resection (RTR) following chemotherapy for metastatic germ cell tumor in terms of the prediction of histology of the specimen and postoperative survival.
  • METHODS: We conducted a retrospective review of 68 patients undergoing RTR for metastatic nonseminomatous germ cell tumor or extragonadal germ cell tumor after at least a first-line chemotherapy.
  • Rates of presence of residual malignant cell in RTR specimen were similar between patients with normal AFP (7/28 or 25%) and with mildly elevated (10-30 ng/ml) AFP (3/11 or 27%).
  • It should be carefully considered individually whether a mild elevation of AFP after chemotherapy represents residual malignancy or benign pathogenesis.
  • [MeSH-major] Biomarkers, Tumor / blood. Chorionic Gonadotropin, beta Subunit, Human / blood. Neoplasms, Germ Cell and Embryonal / surgery. Testicular Neoplasms / surgery. alpha-Fetoproteins / metabolism
  • [MeSH-minor] Adolescent. Adult. Chemotherapy, Adjuvant. Child. Child, Preschool. Combined Modality Therapy. Humans. Male. Middle Aged. Neoplasm Metastasis. Neoplasm, Residual / blood. Neoplasm, Residual / pathology. Neoplasm, Residual / surgery. Prognosis. Retrospective Studies. Survival Analysis. Treatment Outcome

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  • [Copyright] (c) 2006 Wiley-Liss, Inc.
  • (PMID = 17111392.001).
  • [ISSN] 0022-4790
  • [Journal-full-title] Journal of surgical oncology
  • [ISO-abbreviation] J Surg Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Chorionic Gonadotropin, beta Subunit, Human; 0 / alpha-Fetoproteins
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11. Bayar GR, Gulses A, Sencimen M, Aydintug YS, Arpaci F, Gunhan O: Oral metastasis of the mediastinal germ cell tumor (yolk sac). J Craniofac Surg; 2010 Nov;21(6):1828-30
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  • [Title] Oral metastasis of the mediastinal germ cell tumor (yolk sac).
  • A yolk sac tumor is a rare malignant tumor of germ cell origin.
  • It most commonly arises from the testes and ovaries in young adults, but extragonadal sites of origin are reported in 10% to 15% of the cases.
  • Yolk sac tumors are malignant, tend to recur locally, and may present with widespread metastases at the time of diagnosis.
  • In this study, we present the case of a 23-year-old man presenting with mandibular and adjacent gingival metastasis of a mediasatinal yolk sac tumor.
  • Thus, the patient has already undergone chemotherapy; no additional treatment was provided.
  • In this case report, clinical and histopathologic features of the oral metastases of a yolk sac tumor were briefly discussed.
  • [MeSH-major] Endodermal Sinus Tumor / secondary. Gingival Neoplasms / secondary. Mandibular Neoplasms / secondary. Mediastinal Neoplasms / pathology

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  • (PMID = 21119432.001).
  • [ISSN] 1536-3732
  • [Journal-full-title] The Journal of craniofacial surgery
  • [ISO-abbreviation] J Craniofac Surg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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12. Göbel U, Schneider DT, Calaminus G, Haas RJ, Schmidt P, Harms D: Germ-cell tumors in childhood and adolescence. GPOH MAKEI and the MAHO study groups. Ann Oncol; 2000 Mar;11(3):263-71

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Germ-cell tumors in childhood and adolescence. GPOH MAKEI and the MAHO study groups.
  • In mature and immature teratoma the treatment is surgical.
  • In case of a microscopically complete tumor resection there is no role for adjuvant chemo- or radiotherapy irrespective of the histological grade of immaturity.
  • Malignant germ-cell tumors (GCT) account for 2.9% of all malignant tumors of children younger than 15 years of age.
  • More than half of the tumors occur at extragonadal sites such as the ovaries (26%), the coccygeal region (24%), the testes (18%) and the brain (18%) represent then primary sites.
  • In patients with extensive tumor growth, metastatic disease or secreting intracranial tumors a delayed tumor resection after preoperative chemotherapy is preferable.
  • In these patients malignant non-seminomatous GCT may be diagnosed clinically due to the increased serum or cerebrospinal fluid levels of the tumor markers AFP and/or beta-HCG.
  • Current risk adapted treatment protocols containing cisplatinum allow long-term remissions in about 80% including patients with bulky or metastatic tumors.
  • In the cisplatinum era the prognostic factors like histology, primary site of the tumor and initial tumor stage have partly lost their former impressive significance in infants and children.
  • On the other hand the completeness of the primary tumor resection according to oncological standards has been established as the most powerful prognostic parameter superior to tumor marker levels or primary site of the tumor.

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  • (PMID = 10811491.001).
  • [ISSN] 0923-7534
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Biomarkers; 0 / Biomarkers, Tumor
  • [Number-of-references] 44
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13. Lo Curto M, Lumia F, Alaggio R, Cecchetto G, Almasio P, Indolfi P, Siracusa F, Bagnulo S, De Bernardi B, De Laurentis T, Di Cataldo A, Tamaro P: Malignant germ cell tumors in childhood: results of the first Italian cooperative study "TCG 91". Med Pediatr Oncol; 2003 Nov;41(5):417-25
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Malignant germ cell tumors in childhood: results of the first Italian cooperative study "TCG 91".
  • BACKGROUND AND AIMS: About 20% of patients with germ cell tumor (GCT) are still resistant to therapy.
  • The site of the primary tumor was gonadal in 59, extragonadal in 36.
  • The treatment was surgery alone in 31; surgery plus radiotherapy in 1; chemotherapy +/- surgery in 63.
  • Post-chemotherapy resection in 19 (10 complete, 9 partial).
  • The chemotherapy regimen was carboplatin 400 mg/m2/day on days 1, 2; etoposide 150 mg/m2/day on days 1, 2; ifosfamide 1,500 mg/m2/day on days 21, 22; dactinomycin 1.5 mg/m2/day on day 21; vincristine 1.5 mg/m2/day on day 21.
  • Three patients died because of toxicity and two non-responders (to primary chemotherapy), died of progression; among the remaining 90 patients 20 relapsed, 9 are in second remission, 2 are alive with disease, and 9 died of disease progression (one from progression and intracranial hemorrhage).
  • All the pts who had complete resection of the primary tumor at diagnosis or at delayed surgery, remained in remission.
  • CONCLUSIONS: Multivariate analysis showed that the primary site of tumor was the only independent prognostic factor for survival and EFS.
  • [MeSH-major] Germinoma / pathology. Germinoma / therapy. Ovarian Neoplasms / pathology. Ovarian Neoplasms / therapy. Testicular Neoplasms / pathology. Testicular Neoplasms / therapy
  • [MeSH-minor] Adolescent. Age Distribution. Child. Child, Preschool. Cohort Studies. Combined Modality Therapy. Confidence Intervals. Female. Humans. Incidence. Italy / epidemiology. Male. Multivariate Analysis. Neoplasm Staging. Probability. Prognosis. Retrospective Studies. Risk Assessment. Sex Distribution. Survival Analysis. Treatment Outcome

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  • [Copyright] Copyright 2003 Wiley-Liss, Inc.
  • (PMID = 14515380.001).
  • [ISSN] 0098-1532
  • [Journal-full-title] Medical and pediatric oncology
  • [ISO-abbreviation] Med. Pediatr. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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14. Robertson JH, Dixit A, Smith A, Slevin M: An unusual tumor presentation. Int Surg; 2007 Jul-Aug;92(4):218-20

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] An unusual tumor presentation.
  • Germ cell cancer is the most common malignancy in men 15-35 years of age; 5% of malignant germ cell tumors are of extragonadal origin.
  • The key to diagnosis and management is tumor histology.
  • It also reinforces that germ cell tumor markers should be done in all young patients diagnosed with malignancy.
  • We describe the case of a 21-year-old man who was diagnosed as having inoperable cancer of the ascending colon, which turned out to be extragonadal germ cell tumor after studies.
  • This patient has responded very well to bleomycin, etoposide, and cisplatin chemotherapy.
  • [MeSH-major] Colonic Neoplasms / surgery. Neoplasms, Germ Cell and Embryonal / surgery
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Colonoscopy. Combined Modality Therapy. Diagnosis, Differential. Fluorodeoxyglucose F18. Humans. Male. Radiopharmaceuticals. Tomography, Emission-Computed. Tomography, X-Ray Computed

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  • (PMID = 18050831.001).
  • [ISSN] 0020-8868
  • [Journal-full-title] International surgery
  • [ISO-abbreviation] Int Surg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
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15. Mogaddam AS, Memar B, Aledavood A, Eslampoor A: Isolated orbital endodermal sinus tumor. Ophthal Plast Reconstr Surg; 2007 Nov-Dec;23(6):477-9

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Isolated orbital endodermal sinus tumor.
  • PURPOSE: To describe the clinical, serologic, histopathologic, and immunohistochemical findings of an isolated endodermal sinus tumor of the orbit in a 1-year-old boy.
  • After the diagnosis was established by serologic analysis and histopathology, the patient underwent chemotherapy.
  • CONCLUSIONS: Endodermal sinus tumor is a malignant germ-cell tumor that usually involves the gonadal tissue.
  • Primary extragonadal sites occur rarely, and include the orbit.
  • Treatment options include surgical removal and chemotherapy.
  • [MeSH-major] Endodermal Sinus Tumor / pathology. Orbital Neoplasms / pathology
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biomarkers, Tumor / analysis. Combined Modality Therapy. Humans. Infant. Male. Retrospective Studies. Tomography, X-Ray Computed. alpha-Fetoproteins / analysis

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  • (PMID = 18030121.001).
  • [ISSN] 0740-9303
  • [Journal-full-title] Ophthalmic plastic and reconstructive surgery
  • [ISO-abbreviation] Ophthal Plast Reconstr Surg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / AFP protein, human; 0 / Biomarkers, Tumor; 0 / alpha-Fetoproteins
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16. Kiratli H, Erkan Balci K, Güler G: Primary orbital endodermal sinus tumor (yolk sac tumor). J AAPOS; 2008 Dec;12(6):623-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Primary orbital endodermal sinus tumor (yolk sac tumor).
  • Endodermal sinus tumor, or yolk sac tumor, is the most common malignant neoplasm of germ cell origin and usually occurs in infant testes or ovaries.
  • On rare occasions, the tumor may arise from extragonadal sites, including sacrococcygeal region, uterus, vagina, prostate, retroperitoneum, liver, mediastinum, pineal gland, and third ventricle.
  • The orbit is an unusual location for the primary development of this neoplasm.
  • We report the case of a girl with primary orbital endodermal sinus tumor who was managed with exenteration and chemotherapy with the result of a disease-free survival of 9 years.

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  • (PMID = 18835732.001).
  • [ISSN] 1528-3933
  • [Journal-full-title] Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus
  • [ISO-abbreviation] J AAPOS
  • [Language] ENG
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibiotics, Antineoplastic; 0 / Antineoplastic Agents, Phytogenic; 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
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17. Malagón HD, Valdez AM, Moran CA, Suster S: Germ cell tumors with sarcomatous components: a clinicopathologic and immunohistochemical study of 46 cases. Am J Surg Pathol; 2007 Sep;31(9):1356-62
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  • [Title] Germ cell tumors with sarcomatous components: a clinicopathologic and immunohistochemical study of 46 cases.
  • The clinicopathologic features of 46 patients with germ cell tumors with sarcomatous components (GCTSC) involving either the primary site or their metastases were studied.
  • The germ cell component consisted of pure mature or immature teratoma (23 cases), teratoma mixed with other seminomatous or nonseminomatous components (17), pure seminoma (2), intratubular germ cell neoplasia (1), and yolk sac tumor (1).
  • The SC included embryonal rhabdomyosarcoma (29), angiosarcoma (6), leiomyosarcoma (4), undifferentiated sarcoma (3), myxoid liposarcoma (1), malignant peripheral nerve sheath tumor (1), malignant "triton" tumor (1), and epithelioid hemangioendothelioma (1).
  • All patients were treated by cisplatinum-based chemotherapy plus other agents followed by surgery.
  • Thirty-two of 40 patients either died of tumor (25/40; 62.5%) or were alive with advanced, progressive disease (7/40; 17.5%), and only 8/40 (20%) were alive and free of disease between 5 to 40 months (mean=18 mo).
  • On the basis of our findings, the presence of SC appears to represent a poor prognostic sign for GCTs of gonadal and extragonadal origin.
  • [MeSH-major] Immunohistochemistry. Mediastinal Neoplasms / diagnosis. Neoplasms, Germ Cell and Embryonal / diagnosis. Ovarian Neoplasms / diagnosis. Retroperitoneal Neoplasms / diagnosis. Sarcoma / diagnosis. Testicular Neoplasms / diagnosis
  • [MeSH-minor] Adolescent. Adult. Aged. Antineoplastic Combined Chemotherapy Protocols. Disease-Free Survival. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Metastasis. Neoplasm Staging. Orchiectomy. Ovariectomy. Time Factors. Treatment Outcome

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  • (PMID = 17721191.001).
  • [ISSN] 0147-5185
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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18. Tsang RW, Brierley JD, Asa SL, Sturgeon JF: Malignant teratoma of the thyroid: aggressive chemoradiation therapy is required after surgery. Thyroid; 2003 Apr;13(4):401-4
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  • [Title] Malignant teratoma of the thyroid: aggressive chemoradiation therapy is required after surgery.
  • Malignant teratoma of the thyroid gland is exceedingly rare in adults.
  • Many of the cases previously reported in the medical literature have fatal outcomes because of spread of tumor refractory to treatment.
  • We report a case of primary malignant teratoma of the thyroid in a 37-year-old woman.
  • She was treated successfully with a combination of surgery, postoperative cis-platinum-based chemotherapy and radiation therapy to the neck, with long-term follow-up (10 years).
  • This case and the modern experience of combined modality therapy in extragonadal germ cell tumors of the thyroid and other sites illustrate that these tumors should be managed aggressively in order to achieve best results.
  • [MeSH-minor] Adult. Combined Modality Therapy. Female. Humans. Radionuclide Imaging. Ultrasonography

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  • (PMID = 12804109.001).
  • [ISSN] 1050-7256
  • [Journal-full-title] Thyroid : official journal of the American Thyroid Association
  • [ISO-abbreviation] Thyroid
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 12
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19. Huang HY, Ko SF, Chuang JH, Jeng YM, Sung MT, Chen WJ: Primary yolk sac tumor of the urachus. Arch Pathol Lab Med; 2002 Sep;126(9):1106-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Primary yolk sac tumor of the urachus.
  • Pure yolk sac tumor is the most common malignant gonadal tumor of infants and toddlers.
  • However, the majority of extragonadal germ cell tumors in the midline are either seminomas (germinomas) or teratomas, and pure yolk sac tumors account for only a small fraction of these lesions.
  • To date, only 1 primary urachal pure yolk sac tumor has been reported in the literature.
  • We describe another case, occurring in a 7-month-old male infant who presented with a rapidly enlarging intra-abdominal tumor with marked engorgement of the superficial venous plexus around the umbilicus.
  • With periodic follow-up for 3 years following surgical extirpation of the tumor and adjuvant chemotherapy, this patient is still alive without evidence of disease.
  • Notably, the glandular elements predominating in the frozen sections resulted in the initial misdiagnosis of the tumor as a urachal adenocarcinoma, although the entirely resected specimen revealed typical histologic patterns and Schiller-Duval bodies.
  • Immunohistochemistry showed that the tumor cells were diffusely reactive to alpha-fetoprotein, alpha(1)-antitrypsin, and cytokeratin.
  • Tumor cells were negative for p53 protein, but revealed overexpression for MDM2 protein.
  • Flow cytometry demonstrated a diploid DNA content with S-phase being as high as 55.36%.
  • This case emphasizes that pure yolk sac tumor can occur primarily in the remnant of the urachus in young children.
  • [MeSH-major] Endodermal Sinus Tumor / pathology. Nuclear Proteins. Urachus / pathology. Urinary Bladder Neoplasms / pathology
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biomarkers, Tumor / analysis. Bleomycin / therapeutic use. Chemotherapy, Adjuvant. Cisplatin / therapeutic use. DNA, Neoplasm / analysis. Etoposide / therapeutic use. Flow Cytometry. Humans. Immunohistochemistry. Infant. Keratins / analysis. Male. Proto-Oncogene Proteins / analysis. Proto-Oncogene Proteins c-mdm2. Tomography, X-Ray Computed. Treatment Outcome. alpha 1-Antitrypsin / analysis. alpha-Fetoproteins / analysis

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  • (PMID = 12204063.001).
  • [ISSN] 0003-9985
  • [Journal-full-title] Archives of pathology & laboratory medicine
  • [ISO-abbreviation] Arch. Pathol. Lab. Med.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / DNA, Neoplasm; 0 / Nuclear Proteins; 0 / Proto-Oncogene Proteins; 0 / alpha 1-Antitrypsin; 0 / alpha-Fetoproteins; 11056-06-7 / Bleomycin; 68238-35-7 / Keratins; 6PLQ3CP4P3 / Etoposide; EC 6.3.2.19 / MDM2 protein, human; EC 6.3.2.19 / Proto-Oncogene Proteins c-mdm2; Q20Q21Q62J / Cisplatin; BEP protocol
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20. Chen CH, Chen TC, Huang WC, Chen TY, Liu HC: An unusual successfully treated case of pulmonary yolk sac tumor. Ann Thorac Surg; 2008 Feb;85(2):656-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] An unusual successfully treated case of pulmonary yolk sac tumor.
  • Extragonadal germ cell tumors are relatively rare, particularly malignant yolk sac tumors arising in the lung parenchyma.
  • We report a case of a huge malignant yolk sac tumor in the right middle lobe.
  • The patient was successfully treated with neoadjuvant chemotherapy followed by complete resection of the tumor.
  • [MeSH-major] Endodermal Sinus Tumor / surgery. Lung Neoplasms / surgery. Neoadjuvant Therapy. Pneumonectomy / methods
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Biopsy, Needle. Female. Follow-Up Studies. Humans. Immunohistochemistry. Neoplasm Staging. Risk Assessment. Thoracotomy / methods. Treatment Outcome

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  • (PMID = 18222293.001).
  • [ISSN] 1552-6259
  • [Journal-full-title] The Annals of thoracic surgery
  • [ISO-abbreviation] Ann. Thorac. Surg.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Netherlands
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21. Elli M, Pinarli FG, Kandemir B, Dagdemir A, Ceyhan M, Acar S: Sacrococygeal teratoma with sarcomatous differentiation in a child. Pediatr Hematol Oncol; 2008 Jun;25(4):345-50
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  • Most of the extragonadal teratomas are located in the sacrococygeal region.
  • Teratoma with malignant sarcomatous differentiation is a rare form of germ cell tumor.
  • The patient was treated with complete surgical excision and adjuvant chemotherapy according to sarcoma protocols.
  • [MeSH-major] Sacrococcygeal Region. Sarcoma / pathology. Soft Tissue Neoplasms / pathology. Teratoma / pathology
  • [MeSH-minor] Actins / analysis. Child, Preschool. Combined Modality Therapy. Dactinomycin / therapeutic use. Female. Humans. Magnetic Resonance Imaging. Vimentin / analysis. Vincristine / therapeutic use

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  • (PMID = 18484480.001).
  • [ISSN] 1521-0669
  • [Journal-full-title] Pediatric hematology and oncology
  • [ISO-abbreviation] Pediatr Hematol Oncol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Actins; 0 / Vimentin; 1CC1JFE158 / Dactinomycin; 5J49Q6B70F / Vincristine
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22. Pelosi G, Petrella F, Sandri MT, Spaggiari L, Galetta D, Viale G: A primary pure yolk sac tumor of the lung exhibiting CDX-2 immunoreactivity and increased serum levels of alkaline phosphatase intestinal isoenzyme. Int J Surg Pathol; 2006 Jul;14(3):247-51
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A primary pure yolk sac tumor of the lung exhibiting CDX-2 immunoreactivity and increased serum levels of alkaline phosphatase intestinal isoenzyme.
  • Malignant extragonadal germ cell tumors primary to the lung are quite uncommon lesions, but pure yolk sac tumor is even more exceptional.
  • This is believed to be the first reported case of yolk sac tumor of the lung in which an intense and diffuse immunoreactivity for CDX2, a marker of intestinal differentiation reportedly expressed also in gonadal yolk sac tumor, was associated with increased serum levels of the alkaline phosphatase intestinal isoform.
  • Nine months after radical surgery and adjuvant chemotherapy, the patient is alive and well without evidence of recurrent or metastatic disease and with serum levels of the alkaline phosphatase intestinal isoform within normal limits.
  • The pathologist should be aware of yolk sac tumor arising in the lung and that alkaline phosphatase intestinal isoform could become an additional serum marker for such a tumor.
  • [MeSH-major] Alkaline Phosphatase / blood. Endodermal Sinus Tumor / metabolism. Homeodomain Proteins / metabolism. Intestines / enzymology. Lung Neoplasms / metabolism. Trans-Activators / metabolism
  • [MeSH-minor] Biomarkers, Tumor / metabolism. Combined Modality Therapy. Humans. Isoenzymes / blood. Male. Middle Aged. Treatment Outcome

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  • (PMID = 16959714.001).
  • [ISSN] 1066-8969
  • [Journal-full-title] International journal of surgical pathology
  • [ISO-abbreviation] Int. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Homeodomain Proteins; 0 / Isoenzymes; 0 / Trans-Activators; 156560-97-3 / Cdx-2-3 protein; EC 3.1.3.1 / Alkaline Phosphatase
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23. Shen K, Lang J, Huang H: [Treatment of childhood genital malignancies]. Zhonghua Fu Chan Ke Za Zhi; 2001 Jun;36(6):360-3
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  • [Title] [Treatment of childhood genital malignancies].
  • OBJECTIVE: To present the clinical profile and the result of treatment in childhood genital malignancies.
  • METHODS: Twenty seven childhood patients (< 12 years) with genital malignancies diagnosed and treated in Peking Union Medical College hospital were analyzed retrospectively focusing on the clinical characteristics and outcome of the treatment.
  • Of the 27 patients, 23 had ovarian malignancies including 21 (77.8%) germ cell tumor.
  • Four of the patients had extragonadal tumors with 2 endodermal sinus tumor of the vagina, and 2 embryonic rhabdomysarcoma.
  • In vaginal malignancies, vaginal bleeding and polypoid tumor of the vagina were important clinical manifestations.
  • Childhood genital malignancies were very sensitive to the chemotherapy.
  • Postoperative vincristine, actinomycine, cyclophosphamide (VAC) or cisplatine, vincristine, blyomycine (PVB) chemotherapy was individualized according to the tumor site, International Federation of Gynecology and obstetrics stage and histopathology.
  • Survival rate in our series was 71.4% during the follow-up time (mean 47.4 months).
  • CONCLUSIONS: Malignant germ cell tumor of the ovary is the most common tumor in the childhood genital malignancies.
  • Principle of primary surgery is preservation of fertility and chemotherapy is also considered as a very important treatment modality.
  • [MeSH-major] Genital Neoplasms, Female / therapy
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bleomycin / administration & dosage. Child. Child, Preschool. Cisplatin / administration & dosage. Combined Modality Therapy. Cyclophosphamide / administration & dosage. Dactinomycin / administration & dosage. Drug Administration Schedule. Female. Humans. Retrospective Studies. Vinblastine / administration & dosage. Vincristine / administration & dosage

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  • (PMID = 11783136.001).
  • [ISSN] 0529-567X
  • [Journal-full-title] Zhonghua fu chan ke za zhi
  • [ISO-abbreviation] Zhonghua Fu Chan Ke Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 1CC1JFE158 / Dactinomycin; 5J49Q6B70F / Vincristine; 5V9KLZ54CY / Vinblastine; 8N3DW7272P / Cyclophosphamide; Q20Q21Q62J / Cisplatin; PVB protocol; VAC protocol
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