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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.
  • 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.
  • Finally, a case of teratoma with malignant transformation did not respond well to two cycles of HDCT.
  • 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. Kasai T, Moriyama K, Tsuji M, Uema K, Sakurai N, Fujii Y: Adenocarcinoma arising from a mature cystic teratoma of the testis. Int J Urol; 2003 Sep;10(9):505-9
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  • [Title] Adenocarcinoma arising from a mature cystic teratoma of the testis.
  • Histopathological examination revealed a well-differentiated, mucinous adenocarcinoma originating from the gastrointestinal epithelium in a mature cystic teratoma (dermoid cyst) of the testis and metastatic mucinous adenocarcinoma of the skin.
  • We made a diagnosis of teratoma with malignant transformation (TMT) of the testis.
  • Combination chemotherapy with low-dose cisplatin/5'-deoxy-5-fluorouridine (CDDP/5'-DFUR) was initiated, but the patient died 8 months after orchiectomy.
  • [MeSH-major] Adenocarcinoma, Mucinous / diagnosis. Adenocarcinoma, Mucinous / secondary. Dermoid Cyst / diagnosis. Skin Neoplasms / secondary. Teratoma / diagnosis. Testicular Neoplasms / diagnosis

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  • (PMID = 12941133.001).
  • [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. Spiess PE, Pisters LL, Liu P, Pettaway CA, Kamat AM, Gomez JA, Tannir NM: Malignant transformation of testicular teratoma: a chemoresistant phenotype. Urol Oncol; 2008 Nov-Dec;26(6):595-9
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  • [Title] Malignant transformation of testicular teratoma: a chemoresistant phenotype.
  • PURPOSE: To review our experience in the management of malignant transformation of teratoma (MTT).
  • RESULTS: Two patients presented with clinical stage I disease in which malignant transformation occurred within the primary testis tumor (rhabdomyosarcoma in 1 and adenocarcinoma in 1).
  • No viable tumor was identified in the specimen, and both patients were alive without disease at 16 months follow-up.
  • Of the remaining 7 patients, the clinical stages were IIA (N = 1), IIB (N = 3), and III (N = 3), and all were treated with chemotherapy followed by RPLND.
  • Following preoperative chemotherapy, a significant radiologic response (defined as more than a 25% reduction in maximum tumor circumferential diameter) was demonstrated in 1 patient, and normalization of serum tumor markers was demonstrated in 6.
  • CONCLUSIONS: In our experience, MTT is significantly resistant to current chemotherapeutic regimens, as demonstrated by its poor radiologic response to treatment.
  • Alternative therapeutic strategies targeted to MTT are thus needed.
  • [MeSH-major] Teratoma / drug therapy. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Adolescent. Adult. Drug Resistance, Neoplasm. Humans. Lymph Node Excision. Male. Neoplasm Staging. Retroperitoneal Space

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  • [Cites] J Clin Oncol. 2005 Apr 20;23(12):2781-8 [15837993.001]
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  • [CommentIn] Urol Oncol. 2009 Mar-Apr;27(2):218; author reply 218-9 [19285238.001]
  • (PMID = 18367105.001).
  • [ISSN] 1078-1439
  • [Journal-full-title] Urologic oncology
  • [ISO-abbreviation] Urol. Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / P30 CA016672
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Other-IDs] NLM/ NIHMS610854; NLM/ PMC4121060
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4. El Mesbahi O, Terrier-Lacombe MJ, Rebischung C, Theodore C, Vanel D, Fizazi K: Chemotherapy in patients with teratoma with malignant transformation. Eur Urol; 2007 May;51(5):1306-11; discussion 1311-2
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  • [Title] Chemotherapy in patients with teratoma with malignant transformation.
  • OBJECTIVE: Germ-cell tumours (GCTs) with a non-GCT malignant component are a unique and rare phenomenon called teratoma with malignant transformation (TMT).
  • The only published series of patients with TMT treated with chemotherapy comprised 10 patients.
  • Other histological types included adenocarcinoma (n=3) and bronchoalveolar carcinoma (n=1).
  • Immunohistochemistry was performed to help in identifying the malignant non-GCT component.
  • RESULTS: Primary treatment consisted of surgery alone in 4 patients.
  • The remaining 10 patients received first-line cisplatin-based chemotherapy with resection of residual masses (n=5): 4 patients had a complete response and 5 had a partial response.
  • Overall, 9 patients developed a relapse with a median time of 84 mo (range: 6-168).
  • At relapse, 8 patients received a chemotherapy regimen directed to the non-GCT component.
  • CONCLUSION: To our knowledge, this is by far the largest reported European series of chemotherapy in TMT.
  • Although TMT has a poor prognosis compared to GCT, its management may be improved by adapted chemotherapy associated with surgical resection of residual masses.
  • [MeSH-major] Neoplasms, Germ Cell and Embryonal / drug therapy. Teratoma / drug therapy
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / pathology. Adult. Humans. Male. Mediastinal Neoplasms / drug therapy. Mediastinal Neoplasms / pathology. Middle Aged. Retroperitoneal Neoplasms / drug therapy. Retroperitoneal Neoplasms / pathology. Sarcoma / drug therapy. Sarcoma / pathology. Testicular Neoplasms / drug therapy. Testicular Neoplasms / pathology

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  • (PMID = 17081678.001).
  • [ISSN] 0302-2838
  • [Journal-full-title] European urology
  • [ISO-abbreviation] Eur. Urol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Switzerland
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5. Chang YL, Wu CT, Lee YC: Mediastinal and retroperitoneal teratoma with focal gastrointestinal adenocarcinoma. J Thorac Oncol; 2006 Sep;1(7):729-31
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  • [Title] Mediastinal and retroperitoneal teratoma with focal gastrointestinal adenocarcinoma.
  • We report an unusual case of gastrointestinal adenocarcinoma arising in a giant posterior mediastinal mature cystic teratoma extending into the retroperitoneum, which was treated by complete excision with a good outcome for more than 2 years.
  • Teratomas with malignant transformation are rare non-germ cell malignant tumors arising from a preexisting mature teratoma.
  • Histological examination revealed that the cyst wall was composed of mature ectodermal, mesodermal, and endodermal elements.
  • Strong cytokeratin 20 cytoplasmic immunostaining of the tumor cells supported the diagnosis of gastrointestinal adenocarcinoma.
  • In this report, we describe the potential aggressiveness of a giant mature cystic teratoma with adenocarcinoma and suggest that complete surgical resection without adjuvant chemotherapy be considered as a therapy in the treatment of teratoma with focal malignant transformation.
  • [MeSH-major] Adenocarcinoma / pathology. Gastrointestinal Neoplasms / pathology. Mediastinal Neoplasms / pathology. Neoplasms, Multiple Primary / pathology. Retroperitoneal Neoplasms / pathology. Teratoma / pathology

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  • (PMID = 17409945.001).
  • [ISSN] 1556-1380
  • [Journal-full-title] Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
  • [ISO-abbreviation] J Thorac Oncol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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6. Donadio AC, Motzer RJ, Bajorin DF, Kantoff PW, Sheinfeld J, Houldsworth J, Chaganti RS, Bosl GJ: Chemotherapy for teratoma with malignant transformation. J Clin Oncol; 2003 Dec 1;21(23):4285-91
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  • [Title] Chemotherapy for teratoma with malignant transformation.
  • PURPOSE: Teratoma with malignant transformation (MT) is a well-described entity that refers to the MT of a somatic teratomatous component in a germ cell tumor (GCT) to a histology that is identical to a somatic malignancy (eg, rhabdomyosarcoma [RMS]).
  • Surgical resection has been the mainstay of therapy for localized transformed disease because these tumors are thought to be resistant to standard treatment.
  • We report that chemotherapy has a role in selected patients with MT, determined by cell type.
  • PATIENTS AND METHODS: Chemotherapy was administered to 12 patients with MT of GCT limited to a single cell type (two patients with primitive neuroectodermal tumors, five with undifferentiated RMS, one with anaplastic small-cell tumor, two with adenocarcinoma, and two with leukemia); 10 patients had measurable disease.
  • Each patient received chemotherapy regimens based on the specific malignant cell observed in the transformed histology.
  • Three patients did not respond to treatment, and all of those patients died as a result of their disease.
  • CONCLUSION: Chemotherapy for MT limited to a single cell type may result in major responses and long-term survival in selected patients.
  • Local therapy after chemotherapy is an important component of treatment to achieve maximum response.
  • [MeSH-major] Cell Transformation, Neoplastic / drug effects. Mediastinal Neoplasms / drug therapy. Teratoma / drug therapy. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / pathology. Adult. Carcinoma / drug therapy. Carcinoma / pathology. Carcinoma, Small Cell / drug therapy. Carcinoma, Small Cell / pathology. Chemotherapy, Adjuvant. Cytogenetics. Humans. Leukemia, Mast-Cell / drug therapy. Leukemia, Mast-Cell / pathology. Male. Middle Aged. Neoplasm Staging. Neuroectodermal Tumors, Primitive / drug therapy. Neuroectodermal Tumors, Primitive / pathology. Rhabdomyosarcoma / drug therapy. Rhabdomyosarcoma / pathology. Treatment Outcome

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  • (PMID = 14645417.001).
  • [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
  • [Publication-type] Journal Article
  • [Publication-country] United States
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7. Miyake M, Fujimoto K, Matsushita C, Chihara Y, Tanaka M, Hirayama A, Hirao Y, Uemura H: [Tumor thrombus arising from the superior vena cava and extending into the right atrium in a patient with advanced testicular germ cell tumor]. Hinyokika Kiyo; 2009 Jun;55(6):371-5
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  • [Title] [Tumor thrombus arising from the superior vena cava and extending into the right atrium in a patient with advanced testicular germ cell tumor].
  • Ultrasonography detected right testicular tumor and computerized tomography scanning revealed a left supraclavicular lymph node mass and bulky retroperitoneal lymph node mass.
  • He initially underwent right high orchiectomy, combination chemotherapy and retroperitoneal lymph node dissection for advanced testicular non-seminomatous germ cell tumor.
  • After complete remission of the lung metastasis with chemotherapy, the serum alpha-fetoprotein began to increase because of superior vena caval thrombus extending into the right atrium.
  • Emergency surgical excision was performed successfully using extracorporeal circulation to prevent pulmonary embolism and the resected specimen pathologically revealed adenocarcinoma interpreted as teratoma malignant transformation.
  • Adjuvant chemotherapy consisting of paclitaxel, ifosfamide and nedaplatin were administered for subsequent slight elevation of serum F-human chorionic gonadotropin beta, resulting in successful normalization again.
  • We report herein an extremely uncommon case of advanced testicular germ cell tumor with development of superior vena caval thrombus extending into the right atrium.
  • [MeSH-minor] Chorionic Gonadotropin, beta Subunit, Human / blood. Humans. Lung Neoplasms / secondary. Male. Young Adult

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  • (PMID = 19588874.001).
  • [ISSN] 0018-1994
  • [Journal-full-title] Hinyokika kiyo. Acta urologica Japonica
  • [ISO-abbreviation] Hinyokika Kiyo
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article; Review
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Chorionic Gonadotropin, beta Subunit, Human
  • [Number-of-references] 22
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8. Athanasiou A, Vanel D, El Mesbahi O, Theodore C, Fizazi K: Non-germ cell tumours arising in germ cell tumours (teratoma with malignant transformation) in men: CT and MR findings. Eur J Radiol; 2009 Feb;69(2):230-5
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  • [Title] Non-germ cell tumours arising in germ cell tumours (teratoma with malignant transformation) in men: CT and MR findings.
  • PURPOSE: To describe the imaging findings of germ cell tumours (GCT) containing non-germ cell malignant components (also designated teratoma with malignant transformation or TMT).
  • All patients had computed tomography (CT) and/or magnetic resonance (MR) studies before and after initial surgery and chemotherapy, as well as during follow-up.
  • Imaging findings were correlated with the response to treatment and with overall survival.
  • Other histological types of malignant transformation included adenocarcinoma (n=3) and bronchoalveolar carcinoma (n=1).
  • Overall, 9 patients relapsed at a median time of 84 months (range 60-168).
  • RESULTS: Non-GCT malignant transformation was identified in the retroperitoneum (5), testis (3), mediastinum (3), peritoneum (2) and lungs (1).
  • The CT and MR imaging findings before treatment and after relapse were evaluated with emphasis on imaging features that could possibly imply the presence of malignant transformation (heterogeneously enhancing soft-tissue masses, ossified masses with calcified lymph nodes, diffuse epiploic thickening associated with ascites and peritoneal nodules, pulmonary alveolar infiltration with septal thickening).
  • Imaging can be useful as CT and MR findings may suggest this entity and lead to an early biopsy and appropriate treatment.
  • [MeSH-major] Cell Transformation, Neoplastic / pathology. Magnetic Resonance Imaging. Teratoma / diagnosis. Tomography, X-Ray Computed

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  • (PMID = 19056194.001).
  • [ISSN] 1872-7727
  • [Journal-full-title] European journal of radiology
  • [ISO-abbreviation] Eur J Radiol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Ireland
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9. Yamagami W, Banno K, Kawaguchi M, Yanokura M, Kuwabara Y, Hirao N, Susumu N, Tsukazaki K, Aoki D: Use of the collagen gel droplet embedded drug sensitivity test to determine drug sensitivity against ovarian mature cystic teratoma with malignant transformation to adenocarcinoma: a case report. Chemotherapy; 2007;53(2):137-41
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  • [Title] Use of the collagen gel droplet embedded drug sensitivity test to determine drug sensitivity against ovarian mature cystic teratoma with malignant transformation to adenocarcinoma: a case report.
  • BACKGROUND: The collagen gel droplet embedded drug sensitivity test (CD-DST) is a new anticancer drug sensitivity test that only requires a small number of cells.
  • We report the use of this test in the choice of adjuvant chemotherapy for treatment of a rare case of ovarian cancer involving malignant transformation of ovarian mature cystic teratoma.
  • CASE REPORT: The patient was a 70-year-old female with an ovarian tumor, pleural effusion, carcinomatous ascites and a chest wall tumor.
  • The histopathological diagnosis was adenocarcinoma, mature cystic teratoma with malignant transformation, stage IV.
  • Paclitaxel/carboplatin therapy was selected as adjuvant chemotherapy based on CD-DST results.
  • Upon completion of 6 courses, no increases in carcinomatous ascites or recurrent lesions were evident, and the chest wall tumor had disappeared completely.
  • CONCLUSION: The CD-DST may be particularly useful for selecting preoperative chemotherapeutic drugs for patients with ovarian cancer in which the histological type of the primary tumor is unknown.
  • [MeSH-major] Adenocarcinoma / drug therapy. Antineoplastic Combined Chemotherapy Protocols. Collagen Type I. Drug Screening Assays, Antitumor. Ovarian Neoplasms / drug therapy. Teratoma / drug therapy
  • [MeSH-minor] Aged. Antineoplastic Agents / administration & dosage. Carboplatin / administration & dosage. Female. Gels. Humans. Neoplasm Staging. Paclitaxel / administration & dosage. Pleural Effusion, Malignant

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  • [Copyright] Copyright 2007 S. Karger AG, Basel.
  • (PMID = 17308380.001).
  • [ISSN] 1421-9794
  • [Journal-full-title] Chemotherapy
  • [ISO-abbreviation] Chemotherapy
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Collagen Type I; 0 / Gels; BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel
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10. Carver BS, Shayegan B, Serio A, Motzer RJ, Bosl GJ, Sheinfeld J: Long-term clinical outcome after postchemotherapy retroperitoneal lymph node dissection in men with residual teratoma. J Clin Oncol; 2007 Mar 20;25(9):1033-7
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  • [Title] Long-term clinical outcome after postchemotherapy retroperitoneal lymph node dissection in men with residual teratoma.
  • PURPOSE: The histologic finding of teratoma occurs in approximately 40% of all postchemotherapy retroperitoneal lymph node dissections (PC-RPLND).
  • We evaluated patients at our institution undergoing initial PC-RPLND for teratoma to determine their clinical outcome.
  • PATIENTS AND METHODS: We identified 210 patients from 1989 to 2003 with nonseminomatous germ cell tumors (NSGCT) who underwent initial PC-RPLND and were found to have only teratoma in the retroperitoneum.
  • RESULTS: Of the 210 patients in our series, 192 (92%) received only induction chemotherapy, and 18 (9%) required additional chemotherapy regimens.
  • PC-RPLND pathology revealed mature teratoma in 178 patients (85%), immature teratoma in 15 patients (7%), and teratoma with malignant transformation in 17 patients (8%).
  • With a median follow-up time for survivors of 37 months, disease recurred in 30 patients.
  • Of the 30 patients with disease recurrence, 10 (33%) had recurrence with teratoma, five (17%) had recurrence with teratoma with malignant transformation, and 15 (50%) had recurrence with viable germ cell tumor.
  • Patients found to have teratoma at PC-RPLND have a 10-year probability of freedom from recurrence of 80%.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Lymph Node Excision. Retroperitoneal Neoplasms / secondary. Teratoma / secondary. Teratoma / surgery. Testicular Neoplasms / surgery
  • [MeSH-minor] Combined Modality Therapy. Disease-Free Survival. Follow-Up Studies. Humans. Kaplan-Meier Estimate. Lymph Nodes / pathology. Lymph Nodes / surgery. Male. Neoplasm Staging. Neoplasm, Residual. New York City / epidemiology. Predictive Value of Tests. Prognosis. Proportional Hazards Models. Registries. Retroperitoneal Space. Risk Assessment. Time Factors. Treatment Outcome

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  • [CommentIn] J Clin Oncol. 2007 Mar 20;25(9):1024-5 [17261852.001]
  • (PMID = 17261854.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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11. Schneider BP, Kesler KA, Brooks JA, Yiannoutsos C, Einhorn LH: Outcome of patients with residual germ cell or non-germ cell malignancy after resection of primary mediastinal nonseminomatous germ cell cancer. J Clin Oncol; 2004 Apr 1;22(7):1195-200
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  • PURPOSE: To identify prognostic variables and outcomes in patients with primary mediastinal nonseminomatous germ cell tumor (PMNSGCT) with postchemotherapy resection of persistent cancer.
  • RESULTS: At diagnosis, 43 patients had elevated serum tumor markers (STMs), and 20 had extramediastinal disease.
  • After resection, 26 patients had germ cell tumors (GCT), 12 had malignant transformation of teratoma with elements of non-GCT, and nine had both GCT and non-GCT.
  • Seven of 21 patients with elevated STMs at time of resection have continuously NED.
  • Sixteen patients received adjuvant chemotherapy, and seven have continuously NED.
  • Overall, 16 of 47 patients have continuously NED, an additional four patients have NED with further therapy (currently NED), two patients are alive with disease, 23 patients died of disease, and two patients died postoperatively.
  • [MeSH-minor] Adolescent. Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chorionic Gonadotropin, beta Subunit, Human / blood. Humans. Middle Aged. Neoplasm, Residual. Prognosis. Retrospective Studies. Survival Rate. Treatment Outcome. alpha-Fetoproteins / metabolism

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  • (PMID = 15051766.001).
  • [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
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Chorionic Gonadotropin, beta Subunit, Human; 0 / alpha-Fetoproteins
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12. Vuky J, Bains M, Bacik J, Higgins G, Bajorin DF, Mazumdar M, Bosl GJ, Motzer RJ: Role of postchemotherapy adjunctive surgery in the management of patients with nonseminoma arising from the mediastinum. J Clin Oncol; 2001 Feb 01;19(3):682-8
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  • The results of postchemotherapy surgical resection, frequency of viable tumor found during postchemotherapy surgery, and prognostic factors for survival were assessed.
  • Histologic analysis of resected residua postchemotherapy revealed viable tumor in 66%, teratoma in 22%, and necrosis in 12% of the specimens.
  • Viable tumor included embryonal carcinoma, choriocarcinoma, yolk sac carcinoma, seminoma, and teratoma with malignant transformation to nongerm cell histology (eg, sarcoma).
  • Clinical characteristics associated with a shorter survival after surgery included the presence of viable tumor in a resected specimen (P =.003) and more than one site resected during surgery (P =.06).
  • There were no statistically significant differences in survival for patients who underwent surgical resection with normal markers compared with patients with elevated serum tumor markers (P =.33).
  • A trend toward shorter survival was found in patients with increasing tumor markers before surgery compared with patients with normal and declining serum tumor markers (P =.09).
  • CONCLUSION: Surgical resection of residual mass after chemotherapy plays an integral role in the management of patients with primary mediastinal nonseminoma.
  • Teratoma and viable tumor were found in the majority of resected residua after chemotherapy.
  • Because patients who undergo conventional salvage chemotherapy programs rarely achieve long-term disease-free status, selected patients with elevated markers after chemotherapy are considered candidates for surgical resection.
  • [MeSH-minor] Adolescent. Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biomarkers, Tumor / blood. Chorionic Gonadotropin, beta Subunit, Human / blood. Humans. Lung Neoplasms / secondary. Male. Middle Aged. Neoadjuvant Therapy. Prognosis. Prospective Studies. Randomized Controlled Trials as Topic. Survival Rate. alpha-Fetoproteins / metabolism

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  • (PMID = 11157018.001).
  • [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 / CA-09207-23
  • [Publication-type] Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Chorionic Gonadotropin, beta Subunit, Human; 0 / alpha-Fetoproteins
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13. Oldenburg J, Wahlqvist R, Fosså SD: Late relapse of germ cell tumors. World J Urol; 2009 Aug;27(4):493-500
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • OBJECTIVE: To assess the main characteristics of late relapsing malignant germ cell tumors (MGCTs).
  • These tumors are rare and occur by definition 2 years or later after successful treatment.
  • METHODS: We present relevant literature on relapsing MGCT in order to highlight the following issues: incidence, impact of initial treatment on the subsequent risk of late relapse, treatment, and survival.
  • The retroperitoneal space is the predominant site of relapse in both histological types.
  • The initial treatment is important for the risk and localization of late relapses.
  • Patients with single site teratoma are usually cured by surgery alone, whereas viable MGCT or teratoma with malignant transformation may require multimodal treatment with chemo- and/or radiotherapy as well as surgery.
  • Surgery is the most important part in the treatment of late relapses.
  • Salvage chemotherapy should, if feasible, be based on a representative biopsy.
  • Five-year cancer-specific survival is above 50% in the recent large series and reaches 100% in case of single site teratoma.
  • CONCLUSIONS: Treatment of late relapsing MGCT patients is challenging and should be performed in experienced centers only.
  • Referral of late relapsing patients to high-volume institutions ensures the best chances of cure and enables multimodal treatment, and contributes to increased knowledge of tumor biology as well experience with the clinical course of these patients.
  • [MeSH-minor] Combined Modality Therapy. Humans. Male. Teratoma / drug therapy. Teratoma / secondary. Teratoma / surgery. Testicular Neoplasms / drug therapy. Testicular Neoplasms / pathology. Testicular Neoplasms / surgery

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  • (PMID = 19373473.001).
  • [ISSN] 1433-8726
  • [Journal-full-title] World journal of urology
  • [ISO-abbreviation] World J Urol
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] Germany
  • [Number-of-references] 58
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14. Brames M, Ehrlich Y, Einhorn L: Malignant transformation of teratoma to primitive neuroectodermal tumor (PNET): Outcome analysis with PNET based chemotherapy. J Clin Oncol; 2009 May 20;27(15_suppl):e16121

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Malignant transformation of teratoma to primitive neuroectodermal tumor (PNET): Outcome analysis with PNET based chemotherapy.
  • Residual teratoma can be surgically resected.
  • However, testicular teratoma can differentiate along endodermal, ectodermal, or mesodermal elements (malignant transformation of teratoma), with capacity to metastasize and not be amenable to surgical resection.
  • We report results of malignant transformation of teratoma to metastatic PNET treated with PNET based chemotherapy.
  • RESULTS: 9 of 10 patients had at least 1 prior platinum based combination chemotherapy regimen for their germ cell tumor.
  • Tumor markers (human chorionic gonadotropin and alphafetoprotein) were normal at start of chemotherapy for biopsy proven PNET.
  • Two of 10 are currently disease-free for 16 and 33 months from initiation of PNET specific chemotherapy and 3 other patients are alive with disease at 73, 34, and 30 months.
  • CONCLUSIONS: PNET specific chemotherapy has a high objective response rate for malignant transformation of teratoma to PNET, with some patients capable of long-term survival with chemotherapy followed by surgical resection.

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  • (PMID = 27963389.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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15. Foster R, Ehrlich Y, Ulbright TM, Cheng L, Bihrle R, Beck SD, Andreoiu M, Brames MJ, Einhorn LH: Malignant transformation of teratoma to primitive neuroectodermal tumor (PNET): Outcome analysis with retroperitoneal lymph node dissection and PNET specific chemotherapy. J Clin Oncol; 2009 May 20;27(15_suppl):5081

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Malignant transformation of teratoma to primitive neuroectodermal tumor (PNET): Outcome analysis with retroperitoneal lymph node dissection and PNET specific chemotherapy.
  • : 5081 Background: Malignant transformation of teratoma to PNET is a rare entity.
  • Surgical resection has been the mainstay of therapy because these tumors are not curable with cisplatin based chemotherapy.
  • We report long-term survival and potential cure with retroperitoneal lymph node dissection (RPLND) and PNET specific chemotherapy.
  • 74 had RPLND as part of initial treatment or at relapse.
  • PNET specific chemotherapy consisted of cyclophosphamide, doxorubicin, vincristine alternating with ifosfamide and etoposide.
  • 9 elected surveillance or adjuvant chemotherapy.
  • 10 of these were treated with PNET specific chemotherapy for unresectable disease.
  • 2 additional pts were treated with PNET specific chemotherapy as adjuvant to RPLND.
  • CONCLUSIONS: Malignant transformation of teratoma to PNET carries an adverse prognosis.
  • RPLND is an integral part of the therapeutic strategy.
  • PNET specific chemotherapy, adjuvant to RPLND or for treatment of unresectable disease followed by surgery, may result in long-term survival and potential cure.

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  • (PMID = 27964284.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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16. Necchi A, Colecchia M, Nicolai N, Mego M, De Giorgi U, Mikuz G, Sava T, Di Nicola M, Pastorino U, Salvioni R: Somatic malignant differentiation in adult male germ-cell tumors (GCTs): Preliminary evidences from the INTera database (International Project for Teratoma with Malignant Transformation). J Clin Oncol; 2009 May 20;27(15_suppl):e16013

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Somatic malignant differentiation in adult male germ-cell tumors (GCTs): Preliminary evidences from the INTera database (International Project for Teratoma with Malignant Transformation).
  • : e16013 Background: Malignant transformation (MT) is a rare phenomenon characterized by a neoplastic somatic differentiation within a GCT.
  • 25 pts had MT in primary tumor: 14 of them had no metastases (11 underwent primary retroperitoneal lymph-node dissection - RPLND), and 11 underwent chemotherapy (CT) ± surgery due to metastatic disease.
  • 6 of 11 pts undergoing chemotherapy remain disease-free following a median f-up of 155 months (8-297+).

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  • (PMID = 27962924.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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17. Porcaro AB, Antoniolli SZ, Martignoni G, Brunelli M, Curti P: Adult primary teratoma of the testis--report on 5 cases in clinical stage I disease. Int Urol Nephrol; 2001;33(4):657-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Adult primary teratoma of the testis--report on 5 cases in clinical stage I disease.
  • OBJECTIVES: Testis pure teratoma accounts for 2.7% to 3% of all germ cell tumors in adult where it behaves as a malignant neoplasm.
  • Pure teratoma of the testis presents in clinical stage I disease in 44% of the patients whose risk of having pathological stage II disease is 16.7% to 19.2%.
  • Herein we report on 5 cases of adult pure teratoma of the testis presenting itself in clinical stage I disease.
  • Testis pure teratoma was detected in 5 patients (7%).
  • Testis tumor markers were evaluated in all cases.
  • Treatment options after orchidectomy included retroperitoneal lymph node dissection (RPLND) in 4 patients and surveillance in 1.
  • The tumor was on the left sided in 3 cases (60%) and right in 2 (40%).
  • Tumor average size was 3.2 cm (rang 1-6).
  • Histopathology detected the following subtypes: mature teratoma in 3 cases (60%), immature teratoma in 1 (20%) and teratoma with malignant transformation in (20%).
  • CONCLUSIONS: Primary pure teratoma of the testis does not respond to chemotherapy nor does it to radiation therapy.
  • The disease treatment options after orchidectomy for patients with clinical stage I disease include RPLND or surveillance with their relative risks and benefits.
  • RPLND is the chosen treatment because it is both staging and treating.
  • A close a long term follow up is required since pure teratoma metastatic disease may clinically develop after more than 10 years.
  • [MeSH-major] Orchiectomy. Teratoma / surgery. Testicular Neoplasms / surgery

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  • (PMID = 12452623.001).
  • [ISSN] 0301-1623
  • [Journal-full-title] International urology and nephrology
  • [ISO-abbreviation] Int Urol Nephrol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Netherlands
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18. Mikuz G: [WHO classification of testicular tumors]. Verh Dtsch Ges Pathol; 2002;86:67-75
MedlinePlus Health Information. consumer health - Testicular Cancer.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • The most important is obviously the precursor lesion of germ cell tumors, which has been called "intratubular malignant germ cells".
  • Such atypical cells appear in the tubules adjacent to the germ cell tumors, in some few cases (6%) also in the contra lateral healthy gonad and rarely in infertile men (1%).
  • The precursor lesion can progress to franc germ cell tumor starting probably with seminoma, which still maintain the capability of differentiation (pluripotente cells) in all other types of non-seminomatous germ cell tumors.
  • In the group of mature teratomas the "dermoid cyst" appears as a benign subtype mostly observed in children.
  • Unfortunately, however, the old term "teratoma with malignant transformation" was changed to "teratoma with malignant areas" in the 1998 classification.
  • This is a harmless name for an extremely dangerous tumor in which one tissue overgrows the other and gives rise to somatic type sarcomas or carcinomas.
  • Such tumors do not respond like germ cell tumors to the usual chemotherapy.
  • Treatment should be tailored according to that used in standard management of the respective sarcoma or carcinoma.
  • In the comments it is mentioned that the testis carcinoid could be a part of teratoma, but the diagnosis is listed in the group of "miscellaneous" tumors together with tumors of ovarian epithelial type.
  • This is a very questionable decision because the normal testis does not contain neuroendocrine cells from which carcinoids would have to be able to develop.
  • "Large cell calcifying Sertoli cell tumour" has been recently described and can be sporadic or inherited.
  • This morphologically peculiar tumor can be part of the Swiss syndrome also called Carney's complex.
  • The patients have cardiac myxomas, spotty skin pigmentation, hormone active nodular hyperplasia of the adrenals and soft tissue myxomas.
  • For the therapy of germ cell tumor an assessment of risk factors found by the pathologists is extremely important.
  • The most important independent predictors of relapse are tumor invasion of blood or lymph-vessels, absence of yolk sac elements and the presence of an embryonal carcinoma component.
  • In the absence of such predictors a surveillance policy allows some patients to forgo chemotherapy.

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  • (PMID = 12647353.001).
  • [ISSN] 0070-4113
  • [Journal-full-title] Verhandlungen der Deutschen Gesellschaft für Pathologie
  • [ISO-abbreviation] Verh Dtsch Ges Pathol
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Germany
  • [Number-of-references] 48
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19. Okada S, Ohaki Y, Inoue K, Nakajo H, Kawamata H, Kumazaki T: A case of dermoid cyst of the ovary with malignant transformation complicated with small intestinal fistula formation. Radiat Med; 2005 Sep;23(6):443-6
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  • [Title] A case of dermoid cyst of the ovary with malignant transformation complicated with small intestinal fistula formation.
  • Microscopic examination revealed a squamous cell carcinoma in the dermoid cyst wall.
  • The carcinoma had directly invaded the small intestine and a fistula between the cyst and the intestine was noted.
  • Thickened omentum showed granulomatous inflammation in the fatty tissue, but no metastases were detected.
  • The histopathological diagnosis was dermoid cyst with malignant transformation and invasion of the small intestine.
  • Chemotherapy was performed, but the patient died of progression of peritoneal metastases 10 months after the operation.
  • [MeSH-major] Carcinoma, Squamous Cell / radiography. Cell Transformation, Neoplastic. Dermoid Cyst / radiography. Intestinal Fistula / radiography. Ovarian Neoplasms / radiography

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  • (PMID = 16389989.001).
  • [ISSN] 0288-2043
  • [Journal-full-title] Radiation medicine
  • [ISO-abbreviation] Radiat Med
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
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20. Jin FM, Zhu GZ, Feng YJ: [Clinical features and prognostic factors of malignant ovarian teratoma]. Zhongguo Yi Xue Ke Xue Yuan Xue Bao; 2003 Aug;25(4):427-30
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Clinical features and prognostic factors of malignant ovarian teratoma].
  • OBJECTIVE: To assess the clinical features and prognostic factors of malignant ovarian teratoma.
  • METHODS: Eighty-four patients with malignant ovarian teratoma between 1954 and 2001 were studied retrospectively.
  • Patient characteristics, surgical therapy, pathologic diagnosis, histological grade, and follow-up data were extracted and survival curves were depicted.
  • Thirty-seven women were diagnosed with malignant transformation of ovarian teratoma while 47 were of ovarian immature teratoma.
  • Five-year survival rate of malignant ovarian teratoma with stage I, II, III, and IV were (87.20 +/- 4.52)%, (50.00 +/- 35.36)%, (30.55 +/- 9.43)%, and 0.00%, respectively (P = 0.00).
  • Five-year survival rate of ovarian immature teratoma with histological grade I, II, and III were (90.48 +/- 6.41)%, (68.75 +/- 11.59)%, and (57.14 +/- 16.38)%, respectively (P = 0.08).
  • Among 31 women died of malignant ovarian teratoma, 27 (87.1%) died within 2 years after operation.
  • CONCLUSION: This retrospective study suggests that malignant transformation of ovarian teratoma is clinically different from ovarian immature teratoma.
  • Complete staging surgery or Debulking surgery followed by 4-6 courses adjuvant chemotherapy with cisplatin, vincristine, and bleomycin are the principle treatment.
  • [MeSH-major] Ovarian Neoplasms / diagnosis. Teratoma / diagnosis
  • [MeSH-minor] Adolescent. Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bleomycin / administration & dosage. Carcinoma, Squamous Cell / diagnosis. Carcinoma, Squamous Cell / surgery. Chemotherapy, Adjuvant. Child. Cisplatin / administration & dosage. Female. Follow-Up Studies. Humans. Hysterectomy. Male. Middle Aged. Neoplasm Staging. Ovariectomy. Prognosis. Retrospective Studies. Survival Rate. Vincristine / administration & dosage

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  • (PMID = 12974088.001).
  • [ISSN] 1000-503X
  • [Journal-full-title] Zhongguo yi xue ke xue yuan xue bao. Acta Academiae Medicinae Sinicae
  • [ISO-abbreviation] Zhongguo Yi Xue Ke Xue Yuan Xue Bao
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 5J49Q6B70F / Vincristine; Q20Q21Q62J / Cisplatin
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21. Donadio AC, Bosl GJ: The future of therapy for nonseminomatous germ cell tumors. Chest Surg Clin N Am; 2002 Nov;12(4):769-89
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The future of therapy for nonseminomatous germ cell tumors.
  • This article has reviewed recent advances in understanding the molecular mechanisms of germ cell transformation, germ cell tumor differentiation, and germ cell tumor chemotherapy sensitivity and resistance.
  • Future developments should include the following: The use of high-throughput techniques to assess tumor biology and evaluate new markers will allow more sophisticated assessment of prognosis.
  • Future therapy will use oligonucleotide chips, perhaps specific to germ cell tumors or gene products associated with drug resistance, to assign treatment (radiation, RPLND, chemotherapy).
  • The pathways associated with metastases and resistance will either replace or amplify the current risk algorithms and the clinician's ability to select therapy.
  • The same high-throughput techniques will identify critical molecules and pathways, providing new specific treatment targets.
  • In this context, the treatment of malignant transformation and the prediction of teratoma at metastatic sites will take on a greater importance.
  • Over the past 2 decades, the treatment of germ cell tumors has become well-defined.
  • Further improvement requires that investigators find new markers corresponding to tumor phenotype.
  • This achievement will prevent unnecessary treatment in patients destined to have a favorable outcome, and will target biologically unfavorable or resistant disease for new therapy developed specifically to target the molecular or genetic defects that disrupt normal cell cycle control.
  • [MeSH-major] Germinoma / diagnosis. Germinoma / therapy. Teratoma / diagnosis. Teratoma / therapy. Testicular Neoplasms / diagnosis. Testicular Neoplasms / therapy
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Cell Transformation, Neoplastic. Combined Modality Therapy. Drug Resistance, Neoplasm. Forecasting. Humans. Male. Molecular Biology. Neoplasm Metastasis. Neoplasm Staging. Prognosis. Treatment Outcome

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  • (PMID = 12471877.001).
  • [ISSN] 1052-3359
  • [Journal-full-title] Chest surgery clinics of North America
  • [ISO-abbreviation] Chest Surg. Clin. N. Am.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 90
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22. Biskup W, Calaminus G, Schneider DT, Leuschner I, Göbel U: Teratoma with malignant transformation: experiences of the cooperative GPOH protocols MAKEI 83/86/89/96. Klin Padiatr; 2006 Nov-Dec;218(6):303-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Teratoma with malignant transformation: experiences of the cooperative GPOH protocols MAKEI 83/86/89/96.
  • BACKGROUND: The designation of a teratoma with malignant transformation (TMT) refers to the occurrence of somatic non-germ cell malignancies within a teratoma.
  • PATIENTS AND METHODS: Between 1982 and 2003, 641 patients with extracranial nontesticular pure teratoma (256 coccygeal, 246 ovarian, 139 other sites) were reported to the MAKEI protocols 83/86/89/96 by various, mainly German centres.
  • Patients with teratoma and somatic malignancy were identified by database queries.
  • Patients with malignant germ cell tumor components were excluded from this analysis.
  • Resection was performed in seven patients (including both coccygeal tumors) and adjuvant chemotherapy was administered in one of them.
  • Two patients relapsed after resection, but both were cured with chemotherapy.
  • Two patients suffered from advanced tumors and both were treated with primary chemotherapy.
  • One patient was cured from the malignant component (astrocytoma), but the teratomatous components persisted.
  • The other patient died as a result of progression of her malignant medulloepithelioma.
  • CONCLUSIONS: Malignant transformation of pure teratomas constitutes a very rare entity in children and adolescents that is most commonly observed in postpubertal girls with ovarian teratoma.
  • Compared to adult patients, similar malignant entities can be observed in association with teratoma.
  • In localised tumors, complete resection appears to be adequate, whereas chemotherapy should be considered in patients with R1- or R2-resection.
  • Cisplatinum-based chemotherapy was effective as two of four relapsed patients survived tumor free.
  • However, the ideal regimen has not yet been established and the known sensitivity of the histologic components to cytostatic drugs has to be considered in the choice of treatment.
  • [MeSH-major] Ovarian Neoplasms. Teratoma
  • [MeSH-minor] Adolescent. Adult. Age Factors. Antineoplastic Combined Chemotherapy Protocols. Chemotherapy, Adjuvant. Child. Child, Preschool. Cytogenetic Analysis. Female. Humans. Infant. Infant, Newborn. Middle Aged. Neoplasm Staging. Neoplasms, Germ Cell and Embryonal / pathology. Ovary / pathology. Sacrococcygeal Region / pathology. Treatment Outcome

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  • (PMID = 17080331.001).
  • [ISSN] 0300-8630
  • [Journal-full-title] Klinische Pädiatrie
  • [ISO-abbreviation] Klin Padiatr
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
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23. Kim SM, Choi HS, Byun JS, Kim YH, Kim KS, Rim SY, Kim HR, Nam JH, Choi YD: Mucinous adenocarcinoma and strumal carcinoid tumor arising in one mature cystic teratoma of the ovary with synchronous cervical cancer. J Obstet Gynaecol Res; 2003 Feb;29(1):28-32
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  • [Title] Mucinous adenocarcinoma and strumal carcinoid tumor arising in one mature cystic teratoma of the ovary with synchronous cervical cancer.
  • Malignant transformation of mature cystic teratoma is an uncommon complication.
  • While any of the constituent tissues of a teratoma has the potential to undergo malignant transformation, squamous cell carcinoma is the most commonly associated cancer.
  • We present an unusual case of a postmenopausal woman with synchronous mucinous adenocarcinoma and strumal carcinoid tumor from one of two ovarian mature cystic teratomas (one in each ovary) with synchronous cervical cancer.
  • We suggest that malignant transformation of mature cystic teratoma and synchronous cervical cancer be treated by hysterectomy, chemotherapy, and radiotherapy.
  • [MeSH-major] Adenocarcinoma, Mucinous / diagnosis. Carcinoid Tumor / diagnosis. Neoplasms, Multiple Primary / diagnosis. Ovarian Neoplasms / diagnosis. Struma Ovarii / diagnosis. Uterine Cervical Neoplasms / diagnosis
  • [MeSH-minor] Diagnosis, Differential. Female. Humans. Middle Aged. Teratoma / complications. Teratoma / diagnosis. Teratoma / pathology


24. Beck SD, Patel MI, Sheinfeld J: Tumor marker levels in post-chemotherapy cystic masses: clinical implications for patients with germ cell tumors. J Urol; 2004 Jan;171(1):168-71
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Tumor marker levels in post-chemotherapy cystic masses: clinical implications for patients with germ cell tumors.
  • PURPOSE: Increased tumor markers after induction chemotherapy for patients with germ cell tumor usually represent systemic disease and consequently second line chemotherapy is instituted, while retroperitoneal lymph node dissection (RPLND) is reserved for patients with marker normalization.
  • We report the concentration of alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG) in the fluid of post-chemotherapy cystic masses to evaluate this as a potential source for serum marker elevation.
  • MATERIALS AND METHODS: From March 2002 to December 2002, 11 consecutive patients with post-chemotherapy cystic masses underwent RPLND.
  • Only 5 post-chemotherapy RPLNDs were performed in patients with increased serum tumor markers, including the 3 patients in our study.
  • Patients with increasing tumor markers and/or multifocal disease with noncystic residual masses after induction chemotherapy underwent salvage chemotherapy despite teratomatous elements in the primary tumor.
  • RESULTS: All 11 patients had teratoma in the orchiectomy specimen and retroperitoneum, including one with malignant transformation.
  • Two patients with an increased serum AFP before surgery (47.9 and 31.6) had cyst levels of 73.5 and 790.4 respectively.
  • One patient with increased pre-RPLND serum HCG (11.6) had a cyst level of 233.
  • CONCLUSION: Fluid from cystic teratoma contains variably elevated levels of HCG and AFP in all patients and appears to be independent of serum marker level or pathology.
  • It is possible that a "slow leak" of fluid from cystic teratoma may explain elevated serum markers in selected patients with teratoma and thus may potentially avoid second line chemotherapy.
  • [MeSH-major] Biomarkers, Tumor / analysis. Chorionic Gonadotropin / analysis. Cysts / chemistry. Cysts / diagnosis. Germinoma / drug therapy. Testicular Neoplasms / drug therapy. alpha-Fetoproteins / analysis
  • [MeSH-minor] Cyst Fluid / chemistry. Humans. Lymph Node Excision. Male. Retroperitoneal Space. Testicular Diseases / diagnosis. Testicular Diseases / surgery

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  • (PMID = 14665869.001).
  • [ISSN] 0022-5347
  • [Journal-full-title] The Journal of urology
  • [ISO-abbreviation] J. Urol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Chorionic Gonadotropin; 0 / alpha-Fetoproteins
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25. Chen YH, Chang CH, Chen KC, Diau GY, Loh IW, Chu CC: Malignant transformation of a well-organized sacrococcygeal fetiform teratoma in a newborn male. J Formos Med Assoc; 2007 May;106(5):400-2
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Malignant transformation of a well-organized sacrococcygeal fetiform teratoma in a newborn male.
  • We report herein a case of a male newborn with a sacrococcygeal fetiform teratoma (FT).
  • The baby presented with a large coccygeal teratoma.
  • The preoperative diagnosis of FT was made by plain radiography, ultrasonography and magnetic resonance imaging.
  • Postoperative follow-up was uneventful until the teratoma recurred 11 months later as a malignancy.
  • After undergoing a second operative procedure accompanied by chemotherapy, he has been doing well for 18 months.

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  • (PMID = 17561476.001).
  • [ISSN] 0929-6646
  • [Journal-full-title] Journal of the Formosan Medical Association = Taiwan yi zhi
  • [ISO-abbreviation] J. Formos. Med. Assoc.
  • [Language] ENG
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Singapore
  • [Chemical-registry-number] 0 / alpha-Fetoproteins; 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
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