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1. Fujita K, Tsujimura A, Miyagawa Y, Kiuchi H, Matsuoka Y, Takao T, Takada S, Nonomura N, Okuyama A: Isolation of germ cells from leukemia and lymphoma cells in a human in vitro model: potential clinical application for restoring human fertility after anticancer therapy. Cancer Res; 2006 Dec 1;66(23):11166-71
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  • [Title] Isolation of germ cells from leukemia and lymphoma cells in a human in vitro model: potential clinical application for restoring human fertility after anticancer therapy.
  • More than 70% of patients survive childhood cancer, but chemotherapy and radiation therapy may cause irreversible impairment of spermatogenesis.
  • To treat infertility secondary to anticancer treatment for childhood cancer, we have developed a procedure to isolate germ cells from leukemic mice by fluorescence-activated cell sorting with two surface markers, and transplantation of isolated germ cells successfully restored fertility without inducing leukemia.
  • Testicular specimens were obtained from a patient who underwent surgery for testicular rupture.
  • Treatment with IFNgamma induced the expression of MHC class I on K562 cells but not on germ cells and made it possible to isolate germ cells from K562 cells.
  • In conclusion, we isolated human germ cells from malignant cells with two surface markers after treatment with IFNgamma.
  • [MeSH-minor] Antigens, CD45 / genetics. Antigens, CD45 / metabolism. Cell Line, Tumor. Drug-Related Side Effects and Adverse Reactions. Fertility / drug effects. Fertility / radiation effects. HL-60 Cells. HLA-A Antigens / genetics. HLA-A Antigens / metabolism. HLA-B Antigens / genetics. HLA-B Antigens / metabolism. HLA-C Antigens / genetics. HLA-C Antigens / metabolism. Humans. Immunohistochemistry. Infertility / etiology. Infertility / therapy. Jurkat Cells. K562 Cells. Leukemia / genetics. Leukemia / metabolism. Leukemia / pathology. Lymphoma / genetics. Lymphoma / metabolism. Lymphoma / pathology. Male. Radiotherapy / adverse effects. Reverse Transcriptase Polymerase Chain Reaction. Testis / cytology. Testis / metabolism. U937 Cells

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  • (PMID = 17145860.001).
  • [ISSN] 0008-5472
  • [Journal-full-title] Cancer research
  • [ISO-abbreviation] Cancer Res.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / HLA-A Antigens; 0 / HLA-B Antigens; 0 / HLA-C Antigens; EC 3.1.3.48 / Antigens, CD45
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2. Dohle GR: Male infertility in cancer patients: Review of the literature. Int J Urol; 2010 Apr;17(4):327-31
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  • The number of men surviving cancer at a young age has increased dramatically in the past 20 years as a result of early detection and improved cancer treatment protocols; more than 75% of young cancer patients nowadays are long-term survivors.
  • Quality of life has become an important issue in childhood and adult cancer patients.
  • The commonest cancers in patients of reproductive age are leukaemia, Hodgkin's lymphomas and testicular germ cell tumors.
  • Fertility is often impaired after chemotherapy and radiation therapy.
  • Cryopreservation of semen before cancer treatment starts is currently the only method to preserve future male fertility.
  • In some malignancies, especially in germ cell tumors, sperm quality is already abnormal at the time of diagnosis.
  • In approximately 12% of men, no viable spermatozoa are present for cryopreservation before the start of chemotherapy.
  • Cytotoxic therapy influences spermatogenesis at least temporarily and in some cases permanently.
  • The amount of damage inflicted by chemotherapy on spermatogenesis depends on the combination of drugs used and on the cumulative dose given for cancer treatment.
  • Radiation therapy, especially whole-body irradiation, is also associated with the risk of permanent sterility.
  • Besides the cancer treatment, tumor type and pretreatment fertility are of prognostic value for future fertility in male cancer survivors.
  • After cancer treatment, many men need artificial reproductive techniques to achieve fatherhood; usually in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) is indicated for successful treatment.
  • About 15% of men will use their cryopreserved semen because of persistent azoospermia after cancer treatment.
  • Treatment results with cryopreserved semen are generally good and comparable to general IVF and ICSI results.
  • So far, no studies have reported an increased rate of congenital abnormalities or malignancies in children born from fathers who had cancer treatment is the past, but close follow up is warranted, especially in children born after IVF/ICSI.
  • [MeSH-major] Drug-Related Side Effects and Adverse Reactions. Infertility, Male / etiology. Neoplasms / therapy. Radiotherapy / adverse effects


3. Abd El-Aal HH, Habib EE, Mishrif MM: Rhabdomyosarcoma: the experience of the pediatric unit of Kasr El-Aini Center of Radiation Oncology and Nuclear Medicine (NEMROCK) (from January 1992 to January 2001). J Egypt Natl Canc Inst; 2006 Mar;18(1):51-60

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  • [Title] Rhabdomyosarcoma: the experience of the pediatric unit of Kasr El-Aini Center of Radiation Oncology and Nuclear Medicine (NEMROCK) (from January 1992 to January 2001).
  • Our present study is a retrospective analysis of the treatment results of new rhabdomyosarcoma pediatric patients who had attended the pediatric unit clinic of Kasr El-Aini Center of Radiation Oncology and Nuclear Medicine (NEMROCK) from January 1992 to January 2001).
  • PATIENTS AND METHODS: Fifty-five new cases of pediatric rhabdomyosarcoma attended the pediatric unit outpatient clinic of (NEMROCK) from the period of January 1992 until January 2001.
  • Stage I, II orbital and stage I para-testicular embryonal rhabdomyosarcomas received 32 weeks of vincristine and actinomycin- D (vincristine 1.5 mg/m2 weekly, actinomycin-D 0.015 mg/Kg/day day 1 to day 5).
  • Other pathologies, sites and stages received 52 weeks of chemotherapy.
  • Chemotherapy regimens included VAC (vincristine 1.5 mg/m2 weekly, actinomycin-D 0.015 mg/Kg/day day 1 to day 5 and endoxan 2.2 gm/m2 I.V with mesna every 21 days), VAI (vincristine, actinomycin-D and ifosfamide 1.8 gm/m2 I.V day 1 to day 5 with mesna) or VIE (vincristine, ifosfamide and vepesid 100 mg/m2 I.V day 1 to day 5) [11,12].
  • Stages I and II received conventional fractionation radiotherapy 4140 cGy on week 13, stages III and IV received conventional fractionation radiation therapy 5040 cGy also, on week 13.
  • The radiation volume included the tumor bed with a 2 cm safety margin at least.
  • Relapsing cases received palliative radiation therapy and chemotherapy (cisplatinum I.V 100 mg/m2 divided over 2 days and vepesid 100 mg/m2 I.V day 1 to day 3 to be recycled every 21 days).
  • Overall survival, disease free survival, treatment response, and complications of treatment were assessed and statistically analyzed.
  • RESULTS: Fifty-five new cases of pediatric rhabdomyosarcoma attended the pediatric unit outpatient clinic of (NEMROCK) and were evaluated.
  • Pathologically, embryonal type was the commonest statistically (48/55, i.e.
  • 87.3%) compared to the alveolar type (7/55, i.e. 12.7%).
  • Concerning site of the primary tumor it was found to be highest in the head and neck (20/55, i.e.
  • CONCLUSION: Despite the advances in the therapy of rhabdomyosarcoma.
  • Nearly 30% of the pediatric cases with rhabdomyosarcoma experience progressive or relapsing disease, which has a fatal end.
  • The factors determining the 5-year survival after relapse at the time of initial diagnosis include histological subtype, and disease cluster.
  • These findings will form the basis of a multi-institutional risk adapted relapse protocol for childhood rhabdomyosarcoma patients.
  • [MeSH-major] Rhabdomyosarcoma / mortality. Rhabdomyosarcoma / pathology. Rhabdomyosarcoma / therapy
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Child. Child, Preschool. Combined Modality Therapy. Disease-Free Survival. Female. Humans. Male. Neoplasm Staging. Prognosis. Radiotherapy. Retrospective Studies. Survival Analysis

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  • (PMID = 17237856.001).
  • [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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4. Coloma del Peso A, Arellano Gañán R, Garrido Abad P, Fernández González I, Couñago Lorenzo F, Gómez-Ulla Astray J, Ortega Serrano MP, Bocardo Fajardo G, Rabadán Ruiz M, Pereira Sanz I: [Atypical lymphatic dissemination of a testicular tumor from a cryptorquid testicle]. Arch Esp Urol; 2009 Jun;62(5):389-92
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  • [Title] [Atypical lymphatic dissemination of a testicular tumor from a cryptorquid testicle].
  • [Transliterated title] Diseminación linfática atípica de un tumor testicular sobre un testículo criptorquídico.
  • METHODS: A patient with cryptorchidism and failed orchiopexy in his childhood was diagnosed with a testicular neoplasm.
  • Patient was treated with adjuvant chemotherapy.
  • [MeSH-major] Cryptorchidism / complications. Seminoma / complications. Seminoma / secondary. Testicular Neoplasms / complications. Testicular Neoplasms / pathology

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  • (PMID = 19721174.001).
  • [ISSN] 0004-0614
  • [Journal-full-title] Archivos españoles de urología
  • [ISO-abbreviation] Arch. Esp. Urol.
  • [Language] spa
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Spain
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5. Heller KN, Teruya-Feldstein J, La Quaglia MP, Wexler LH: Primary follicular lymphoma of the testis: excellent outcome following surgical resection without adjuvant chemotherapy. J Pediatr Hematol Oncol; 2004 Feb;26(2):104-7
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  • [Title] Primary follicular lymphoma of the testis: excellent outcome following surgical resection without adjuvant chemotherapy.
  • The authors report a case of follicular lymphoma of the testis in a 3-year-old boy.
  • Follicular lymphoma of childhood is rare, accounting for less than 5% of all non-Hodgkin lymphomas in the pediatric population.
  • The authors conducted a comprehensive review of the literature and found that this patient is the only child reported to have localized follicular lymphoma of the testis successfully treated without systemic chemotherapy.
  • In all previously reported cases, a favorable outcome was seen following surgical resection and chemotherapy.
  • The successful outcome in this case following surgical resection, without postoperative adjuvant chemotherapy, suggests that localized follicular non-Hodgkin lymphoma in children may not be associated with occult systemic disease and that subsequent chemotherapy may not be necessary for cure.
  • [MeSH-major] Lymphoma, Follicular / surgery. Testicular Neoplasms / surgery
  • [MeSH-minor] Biomarkers, Tumor / analysis. Chemotherapy, Adjuvant. Child, Preschool. Humans. Immunophenotyping. Male. Orchiectomy. Treatment Outcome

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  • (PMID = 14767197.001).
  • [ISSN] 1077-4114
  • [Journal-full-title] Journal of pediatric hematology/oncology
  • [ISO-abbreviation] J. Pediatr. Hematol. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
  • [Number-of-references] 13
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6. Güler E, Tezer Kutluk M, Büyükpamukçu N, Caglar M, Varan A, Akyüz C, Büyükpamukçu M: Testicular germ cell tumors in childhood: treatment results of 52 patients. Pediatr Hematol Oncol; 2004 Jan-Feb;21(1):49-56
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  • [Title] Testicular germ cell tumors in childhood: treatment results of 52 patients.
  • We analysed the treatment results of 52 children with testicular germ cell tumors.
  • Histopathological diagnoses were endodermal sinus tumor (63.4%), embryonal carcinoma (28.8%), teratocarcinoma (5.7%), and mixed tumors (2.1%).
  • Five-year overall survival rates were 85.8% and 100% for stage I patients who received chemotherapy or not (p =.27); BEP regimen: 85.7%; classical VAC: 67.9%; vinblastine + bleomycin: 63.6%.
  • Chemotherapy is not required in stage I.
  • BEP regimen is effective in testicular germ cell tumors.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Neoplasms, Germ Cell and Embryonal / drug therapy. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Adolescent. Child. Child, Preschool. Humans. Infant. Male. Survival Analysis. Time Factors. Treatment Outcome

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  • (PMID = 14660306.001).
  • [ISSN] 0888-0018
  • [Journal-full-title] Pediatric hematology and oncology
  • [ISO-abbreviation] Pediatr Hematol Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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7. Göbel U, Calaminus G, Schneider DT, Koch S, Teske C, Harms D: The malignant potential of teratomas in infancy and childhood: the MAKEI experiences in non-testicular teratoma and implications for a new protocol. Klin Padiatr; 2006 Nov-Dec;218(6):309-14
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  • [Title] The malignant potential of teratomas in infancy and childhood: the MAKEI experiences in non-testicular teratoma and implications for a new protocol.
  • Since 1982, mature and immature teratomas have been recruited into the MAHO and MAKEI protocols of the German Society for Pediatric Oncology and Hematology (GPOH) for testicular and non-testicular germ cell tumors in order to study the epidemiology and clinical behaviour of teratomas.
  • Patients were registered in the epidemiologic German Childrens Cancer Registry and the GPOH Childrens Tumor Registry for pathological review.
  • Patients with immaturity grade 2 and 3 according to Gonzales-Crussi were eligible for adjuvant chemotherapy.
  • 1) EFS after complete tumor resection has been estimated to 0.96 +/- 0.01 in both observation periods.
  • 2) Incomplete tumor resection remains the main risk factor for relapse (EFS 0.55 +/- 0.09).
  • 4) In MAKEI 83/86/89 four newborns with teratoma died due to perioperative complications and nine children as a result of tumor progression, whereas in MAKEI 96 no newborn died, only one child died from tumor progression, and another child died during long time observation for another reason (meningitis).
  • 5) In accordance to the experience of the MAKEI 83/86/89 studies, no child of the MAKEI 96 study presented with yolk sac tumor at recurrence if adjuvant chemotherapy was administered during first-line treatment because of immaturity.
  • In contrast, more than half of the children with tumor recurrence after watch and wait strategy had yolk sac tumor in addition to teratoma.
  • [MeSH-minor] Adolescent. Adult. Age Factors. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chemotherapy, Adjuvant. Chi-Square Distribution. Child. Child, Preschool. Data Interpretation, Statistical. Disease Progression. Female. Humans. Infant. Infant, Newborn. Male. Neoplasm Recurrence, Local. Neoplasm Staging. Neoplasms, Germ Cell and Embryonal / pathology. Ovary / pathology. Prospective Studies. Randomized Controlled Trials as Topic. Sacrococcygeal Region. Sex Factors. Treatment Outcome. World Health Organization

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  • (PMID = 17080332.001).
  • [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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8. Ishibashi M, Nakayama K, Oride A, Yeasmin S, Katagiri A, Iida K, Nakayama N, Miyazaki K: [A case of PEP(BEP)-resistant ovarian dysgerminoma successfully treated by VeIP therapy]. Gan To Kagaku Ryoho; 2009 Mar;36(3):513-7
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  • [Title] [A case of PEP(BEP)-resistant ovarian dysgerminoma successfully treated by VeIP therapy].
  • Ovarian germ cell tumors are malignant tumors which commonly develop during childhood, and which are sensitive to chemotherapy.
  • We have had a case of germ cell tumors which showed resistance to first-line PEP(BEP)chemotherapy.
  • As second-line chemotherapy, VeIP therapy was used, because it is possible that this therapy is effective against recurrent testicular germ cell tumors.
  • She experienced acute abdominal pain and visited the hospital, where she was diagnosed with torsion of an ovarian tumor.
  • Then she received chemotherapy PEP(BEP), but after eight months of PEP (BEP), her serum hCG-CTP was again elevated to 14.5 mIU/mL.
  • After the operation, the patient again underwent chemotherapy.
  • After 6 courses of this therapy, she had a follow-up operation.
  • She remains without recurrence of this disease 24 months after VeIP therapy.
  • This case suggests that VeIP therapy might be an effective second-line therapy for patients with PEP(BEP)-resistant ovarian dysgerminoma.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Drug Resistance, Neoplasm / drug effects. Dysgerminoma / drug therapy. Dysgerminoma / pathology. Ovarian Neoplasms / drug therapy. Ovarian Neoplasms / pathology
  • [MeSH-minor] Adolescent. Bleomycin / therapeutic use. Cisplatin / therapeutic use. Female. Humans. Magnetic Resonance Imaging. Positron-Emission Tomography. Remission Induction. Tomography, X-Ray Computed. Treatment Outcome

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  • (PMID = 19295284.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; Q20Q21Q62J / Cisplatin
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9. Terenziani M, Piva L, Spreafico F, Salvioni R, Massimino M, Luksch R, Cefalo G, Casanova M, Ferrari A, Polastri D, Mazza E, Bellani FF, Nicolai N: Clinical stage I nonseminomatous germ cell tumors of the testis in childhood and adolescence: an analysis of 31 cases. J Pediatr Hematol Oncol; 2002 Aug-Sep;24(6):454-8
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  • [Title] Clinical stage I nonseminomatous germ cell tumors of the testis in childhood and adolescence: an analysis of 31 cases.
  • A 20-year single-institution experience of clinical stage I nonseminomatous germ cell tumors of the testis (NSGCTT) in childhood and adolescents was reviewed in relation to clinical characteristics, treatment modalities, and survival.
  • After orchiectomy, the children were assigned to surveillance and the adolescents to active treatment: 16 underwent retroperitoneal lymph node dissection (RPLND) and 1 had adjuvant cisplatin-based chemotherapy because of a high-risk histology.
  • All three children were treated with cisplatin-based chemotherapy with or without surgery.
  • All were treated with cisplatin-based chemotherapy with or without surgery.
  • In particular, almost all the childhood cases had the same yolk sac tumor histology, the children tended to have localized disease, and an increased alpha-fetoprotein level had a very high predictive value, suggesting that follow-up should include AFP measurements.
  • A conservative approach is the best option in children, while adolescent NSGCTT behaves like the adult disease and management must include similar treatment strategies.
  • [MeSH-major] Endodermal Sinus Tumor / pathology. Germinoma / pathology. Teratoma / pathology. Testicular Neoplasms / pathology
  • [MeSH-minor] Adolescent. Antineoplastic Agents / therapeutic use. Child. Child, Preschool. Cisplatin / therapeutic use. Combined Modality Therapy. Follow-Up Studies. Humans. Infant. Lymph Node Excision. Lymphatic Metastasis. Male. Neoplasm Staging. Orchiectomy. Retrospective Studies. Risk Factors. Survival Rate. alpha-Fetoproteins / metabolism

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  • (PMID = 12218592.001).
  • [ISSN] 1077-4114
  • [Journal-full-title] Journal of pediatric hematology/oncology
  • [ISO-abbreviation] J. Pediatr. Hematol. Oncol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / alpha-Fetoproteins; Q20Q21Q62J / Cisplatin
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10. Romerius P, Ståhl O, Moëll C, Relander T, Cavallin-Ståhl E, Wiebe T, Giwercman YL, Giwercman A: Hypogonadism risk in men treated for childhood cancer. J Clin Endocrinol Metab; 2009 Nov;94(11):4180-6
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  • [Title] Hypogonadism risk in men treated for childhood cancer.
  • CONTEXT: Pediatric cancer treatment may imply an increased risk of hypogonadism, leading to metabolic disorders and osteoporosis.
  • OBJECTIVE: The aim of this study was to assess diagnosis- and treatment-dependent risk of hypogonadism in male childhood cancer survivors (CCS).
  • MAIN OUTCOME MEASURES: Odds ratios (OR) for biochemical hypogonadism, defined as total testosterone less than 10 nmol/liter and/or LH above 10 IU/liter, were calculated and related to type of cancer, treatment received, as well as testicular volume.
  • The increased presence of hypogonadism was noted in the following treatment groups: brain surgery, chemotherapy (with and without radiotherapy), and testicular irradiation.
  • Low total testicular volume (<or=24 ml) was associated with a high risk of hypogonadism (OR, 31; 95% CI, 11, 92).
  • CONCLUSION: Adult male survivors of childhood cancer are at risk of hypogonadism, which should be acknowledged in the long-term follow-up of these men.
  • [MeSH-major] Hypogonadism / epidemiology. Neoplasms / therapy. Survivors / statistics & numerical data
  • [MeSH-minor] Adult. Brain Neoplasms / therapy. Fertility. Follow-Up Studies. Hospitals, University. Humans. Kidney Neoplasms / therapy. Leukemia / therapy. Luteinizing Hormone / blood. Lymphoma / therapy. Male. Odds Ratio. Reference Values. Risk Factors. Sex Hormone-Binding Globulin / metabolism. Testicular Neoplasms / therapy. Testosterone / blood. Wilms Tumor / therapy. Young Adult

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  • (PMID = 19789207.001).
  • [ISSN] 1945-7197
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Sex Hormone-Binding Globulin; 3XMK78S47O / Testosterone; 9002-67-9 / Luteinizing Hormone
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11. De Backer A, Madern GC, Wolffenbuttel KP, Oosterhuis JW, Hakvoort-Cammel FG, Hazebroek FW: Testicular germ cell tumors in children: management and outcome in a series of 20 patients. J Pediatr Urol; 2006 Jun;2(3):197-201

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  • [Title] Testicular germ cell tumors in children: management and outcome in a series of 20 patients.
  • Testicular germ cell tumors occurring during childhood are extremely rare.
  • This study reports the clinical presentation, pathological diagnosis, treatment methods and outcome in a series of 20 boys, aged between 3.5 months and 16 years (median: 1.5 years; 19 were prepubertal), who were treated between 1963 and 2003.
  • Histologically, mature teratoma was present in seven, immature teratoma in four and yolk sac tumor in nine.
  • Of the 11 teratomas, 10 were treated by orchiectomy and one by testis-sparing tumor excision only.
  • The nine patients with yolk sac tumor were managed by orchiectomy, in two plus retroperitoneal lymphadenectomy, and in eight plus chemotherapy.
  • One patient is in remission for 10 months, seven are alive with no evidence of disease for 5.5-23 years, and one patient died from a T-cell acute lymphoblastic leukemia, 2 years after the end of treatment of the testicular tumor.
  • A gradual switch towards less invasive treatment has been observed over the years.
  • This study confirms the excellent cure rates obtained in children with testicular germ cell tumor, provided diagnosis is prompt and treatment accurate.

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  • (PMID = 18947609.001).
  • [ISSN] 1873-4898
  • [Journal-full-title] Journal of pediatric urology
  • [ISO-abbreviation] J Pediatr Urol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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12. Mikuz G: [WHO classification of testicular tumors]. Verh Dtsch Ges Pathol; 2002;86:67-75
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  • [Title] [WHO classification of testicular tumors].
  • Twenty years after the first edition (1977), the WHO has presented the updated version of the "Histological typing of testis tumours".
  • 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.
  • This lesion is missed in germ cell tumors of childhood and in spermatocytic seminomas, both seem to have a histogenetic history rather different from the other germ cell in adults.
  • 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.
  • 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.
  • [MeSH-major] Testicular Neoplasms / classification

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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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13. Schneider DT, Calaminus G, Wessalowski R, Pathmanathan R, Harms D, Göbel U: Therapy of advanced ovarian juvenile granulosa cell tumors. Klin Padiatr; 2002 Jul-Aug;214(4):173-8
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  • [Title] Therapy of advanced ovarian juvenile granulosa cell tumors.
  • Among these, juvenile granulosa cell tumors (JGCT) constitute the largest subgroup of ovarian sex cord-stromal tumors during childhood and adolescence.
  • In local disease (FIGO stage I), the beneficial role of tumor-ovarectomy is well established.
  • In contrast, life expectancy in patients with advanced JGCT (FIGO stage >/= II) is short even after complete tumor resection.
  • The current literature provides only limited and inconclusive data regarding the value of adjuvant chemotherapy in such patients with advanced disease.
  • PATIENTS AND METHODS: Therefore, we analyzed the patients with FIGO stage >/= II JGCT who were prospectively documented as follow-up patients of the German MAKEI trials for non-testicular germ cell tumors and received the recommended cisplatin-based chemotherapy in an adjuvant setting.
  • Two patients received laparoscopic tumor resection, which was incomplete in both.
  • All patients received 4 or 6 cycles of adjuvant cisplatin-based three-agent chemotherapy in analogy to the current therapeutic concept applied in malignant germ cell tumors.
  • One patient with a large tumor and multiple peritoneal metastases additionally received 40 Gy abdominal irradiation.
  • RESULTS: All patients achieved complete clinical remission after initial surgery and adjuvant chemotherapy.
  • One patient developed a metachronous tumor of the contralateral ovary after 126 months follow-up and is still alive but currently in therapy of another recurrence.
  • Another patient suffered a tumor recurrence after 12 months but achieved a second complete remission with cisplatin chemotherapy after a follow-up of currently 4 months.
  • One patient achieved complete clinical remission but suffered a diffuse peritoneal tumor recurrence with massive ascites and finally died as a result of tumor progression.
  • In summary, at the time of this report 6 of 7 patients are alive after a median of 47 (15 - 138) months.
  • CONCLUSION: This analysis clearly demonstrates that advanced JGCT can be successfully treated with surgery followed by adjuvant cisplatin-based chemotherapy.
  • Therefore, this study reveals encouraging therapeutic perspectives in these otherwise fatal tumors that merit further investigation in a prospective cooperative trial.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Granulosa Cell Tumor / drug therapy. Ovarian Neoplasms / drug therapy
  • [MeSH-minor] Adolescent. Chemotherapy, Adjuvant. Child. Cisplatin / administration & dosage. Cisplatin / adverse effects. Combined Modality Therapy. Female. Follow-Up Studies. Germany. Humans. Neoplasm Staging. Prospective Studies. Survival Rate

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  • (PMID = 12165898.001).
  • [ISSN] 0300-8630
  • [Journal-full-title] Klinische Pädiatrie
  • [ISO-abbreviation] Klin Padiatr
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin
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14. Schmiegelow M, Lassen S, Poulsen HS, Schmiegelow K, Hertz H, Andersson AM, Skakkebaek NE, Müller J: Gonadal status in male survivors following childhood brain tumors. J Clin Endocrinol Metab; 2001 Jun;86(6):2446-52
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  • [Title] Gonadal status in male survivors following childhood brain tumors.
  • The effect of radiotherapy (RT) and chemotherapy (CT) on gonadal function was assessed in males treated for a childhood brain tumor not directly involving the hypothalamus/pituitary (HP) axis in a population-based study with a long follow-up time.
  • All males <15 yr at the time of diagnosis (median: 9.0 yr, range: 0.8 to 14.9 yr) and diagnosed from January 1970 through February 1997 in the eastern part of Denmark and [gte]18 yr at the time of follow-up (median: 25.8 yr, range:18.5 to 39.3 yr) were included.
  • The median age at time of RT was 9.0 yr (range: 0.8 to 14.9 yr) and the median length of follow-up was 18 yr (range: 2.0 to 28.0 yr).
  • The biological effective dose of RT was determined to the HP region and to the spine and expressed in gray because the biological effective dose gives a means of expressing the biological effect on normal tissue of different dosage schedules in a uniform way.
  • We found a significantly inverse correlation between basal FSH and inhibin B and FSH and total testicular volume (r(s) = -0.83; P < 0.0001), (r(s) = -0.67; P < 0.0001), respectively, and a significant correlation between inhibin B and total testicular volume (r(s) = 0.63; P < 0.0001).
  • Stepwise backward multiple linear regression analysis showed the best-fit model to predict inhibin B levels included total testicular volume (P = 0.002) and CT (P = 0.09).
  • In conclusion these data suggest that cranial irradiation for a childhood brain tumor may affect the HP axis, and adjuvant CT can reduce inhibin B indicating primary gonadal damage.
  • Thus, such patients may have normal or even low levels of FSH despite damage to the seminiferous epithelium, and because the fertility status by a semen analysis for psychological reasons can be difficult to obtain in this group of patients, we suggest inhibin B as the most useful direct serum marker of spermatogenesis in the follow-up of individuals who have received both cranial irradiation and gonadotoxic chemotherapy.
  • [MeSH-major] Brain Neoplasms / drug therapy. Brain Neoplasms / radiotherapy. Genitalia, Male / drug effects. Genitalia, Male / radiation effects. Prostatic Secretory Proteins
  • [MeSH-minor] Adult. Combined Modality Therapy / adverse effects. Follicle Stimulating Hormone / blood. Humans. Inhibins / blood. Luteinizing Hormone / blood. Male. Organ Size. Testis / pathology. Testosterone / blood

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  • [ErratumIn] J Clin Endocrinol Metab 2001 Aug;86(8):3967
  • (PMID = 11397837.001).
  • [ISSN] 0021-972X
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Prostatic Secretory Proteins; 0 / beta-microseminoprotein; 3XMK78S47O / Testosterone; 57285-09-3 / Inhibins; 9002-67-9 / Luteinizing Hormone; 9002-68-0 / Follicle Stimulating Hormone
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15. Göbel U, Calaminus G, Schneider DT, Schmidt P, Haas RJ, MAKEI and MAHO Study Groups of the German Society of Pediatric Oncology and Hematology, and the SIOP CNS GCT Study Group: Management of germ cell tumors in children: approaches to cure. Onkologie; 2002 Feb;25(1):14-22
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • The introduction of cisplatinum chemotherapy and current advances in the surgical treatment have resulted in a dramatic improvement of the prognosis of children with malignant germ cell tumors (GCT).
  • Cisplatinum chemotherapy generally results in sufficient systemic tumor control, but local relapses may still occur in patients who did not receive adequate local treatment.
  • Therefore, the therapeutic consideration must take into account age, primary site of the tumor, and its histology.
  • In gonadal tumors, there is a high chance of primary complete resection since these tumors tend to be encapsulated, and particularly testicular GCT are often detected at a low tumor stage.
  • In these tumors, a neoadjuvant or preoperative chemotherapy after clinical diagnosis by imaging and evaluation of tumor markers significantly facilitates complete resection on delayed surgery.
  • In addition, the impact of chemotherapy on local tumor control may be enhanced by locoregional hyperthermia.
  • In intracranial GCT, radiotherapy significantly contributes to local tumor control, and doses are stratified according to histology.
  • These general considerations have been integrated into national and international cooperative treatment protocols.
  • In most current protocols, treatment is stratified according to an initial risk assessment that includes the parameters age, site, histology, stage, completeness of resection and the tumor markers alpha(1)-fetoprotein (AFP) and human choriogonadotropin (beta-HCG).
  • Moreover, the previously high-risk groups may now expect a favorable prognosis with this risk-adapted treatment, whereas an increasing number of low-risk patients are treated expectantly or with significantly reduced chemotherapy.
  • As current biologic studies reveal distinct genetic patterns in childhood GCT, it can be expected that further combined clinical and genetic studies will be valuable for risk assessment of childhood GCT.
  • [MeSH-major] Neoplasms, Germ Cell and Embryonal / therapy
  • [MeSH-minor] Adolescent. Child. Child, Preschool. Chorionic Gonadotropin, beta Subunit, Human / blood. Cisplatin / administration & dosage. Cisplatin / adverse effects. Combined Modality Therapy. Female. Humans. Infant. Infant, Newborn. Male. Neoadjuvant Therapy. Neoplasm Staging. Prognosis. alpha-Fetoproteins / metabolism

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  • [Copyright] Copyright 2002 S. Karger GmbH, Freiburg
  • (PMID = 11893878.001).
  • [ISSN] 0378-584X
  • [Journal-full-title] Onkologie
  • [ISO-abbreviation] Onkologie
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Chorionic Gonadotropin, beta Subunit, Human; 0 / alpha-Fetoproteins; Q20Q21Q62J / Cisplatin
  • [Number-of-references] 66
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16. Castellino SM, McLean TW: Pediatric genitourinary tumors. Curr Opin Oncol; 2007 May;19(3):248-53
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Pediatric genitourinary tumors.
  • PURPOSE OF REVIEW: We will review the 2005 and 2006 literature on pediatric genitourinary tumors.
  • RECENT FINDINGS: Survival continues to improve for primary renal, bladder/prostate and testicular tumors in childhood.
  • The addition of more intensive chemotherapy for anaplastic histology disease, recognition of loss of heterozygosity for chromosomes 1p and 16q as an adverse prognostic factor in favorable histology Wilms' tumor, and the utilization of molecular markers to better characterize all renal tumors will better enable individualized therapy.
  • Recognition and treatment of anaplastic histology and bilateral Wilms' tumor remains a challenge.
  • SUMMARY: Advances in molecular oncology, diagnostic imaging, surgical approaches and long-term follow-up of childhood cancer survivors drive risk-stratified therapy in pediatric genitourinary tumors.
  • [MeSH-major] Urogenital Neoplasms / diagnosis. Urogenital Neoplasms / therapy
  • [MeSH-minor] Child. Female. Humans. Kidney Neoplasms / diagnosis. Kidney Neoplasms / therapy. Loss of Heterozygosity. Male. Neoplasm Staging. Prognosis. Rhabdomyosarcoma / genetics. Rhabdomyosarcoma / metabolism. Wilms Tumor / diagnosis. Wilms Tumor / genetics. Wilms Tumor / therapy

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  • (PMID = 17414644.001).
  • [ISSN] 1040-8746
  • [Journal-full-title] Current opinion in oncology
  • [ISO-abbreviation] Curr Opin Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 66
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17. Talon I, Moog R, Kauffmann I, Grandadam S, Becmeur F: Sertoli cell tumor of the testis in children: reevaluation of a rarely encountered tumor. J Pediatr Hematol Oncol; 2005 Sep;27(9):491-4
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  • [Title] Sertoli cell tumor of the testis in children: reevaluation of a rarely encountered tumor.
  • Testis tumors are uncommon in childhood, and they differ from adult tumors in terms of histology and frequency.
  • They are more frequently benign, but because of the absence of specific signs of malignancy, treatment consists of radical orchiectomy, sometimes followed by radiotherapy or chemotherapy based on histologic analysis.
  • In the authors' hospital, of 13 testis tumors diagnosed since 1996, only 2 were Sertoli cell tumors.
  • It would be helpful to have an algorithm for the management of testis tumors, outlining how to make the diagnosis of malignancy and which treatment and follow-up to pursue.
  • [MeSH-major] Algorithms. Sertoli Cell Tumor / pathology. Testicular Neoplasms / pathology
  • [MeSH-minor] Age Factors. Child, Preschool. Humans. Infant. Male. Neoplasm Staging. Orchiectomy

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  • (PMID = 16189443.001).
  • [ISSN] 1077-4114
  • [Journal-full-title] Journal of pediatric hematology/oncology
  • [ISO-abbreviation] J. Pediatr. Hematol. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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18. Morsi H, Yong KL, Jewell AP: Preferential survival of acute lymphoblastic leukemia cells at 33 degrees C is associated with up-regulation of bcl-2. Leuk Lymphoma; 2006 Jun;47(6):1117-22
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • An important feature of childhood acute lymphoblastic leukemia (ALL) is the risk of testicular relapse in affected males, which may occur months or years after induction of remission.
  • However, little is known about the factors that regulate leukemic cell survival and resistance to chemotherapy in the testis.
  • This may be important in determining survival of ALL cells at lower temperatures in the testis.
  • [MeSH-minor] Adolescent. Apoptosis. Cell Line, Tumor. Female. Humans. Jurkat Cells. K562 Cells. Male. Middle Aged. Models, Biological. Temperature. Testicular Diseases / etiology

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  • (PMID = 16840204.001).
  • [ISSN] 1042-8194
  • [Journal-full-title] Leukemia & lymphoma
  • [ISO-abbreviation] Leuk. Lymphoma
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Proto-Oncogene Proteins c-bcl-2
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19. 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).
  • Survival according to: (a) site: testis: 100%; ovary: 88%; sacrococcyx: 69.6%; other sites: 33.3% (P < 0.001);.
  • 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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20. Suita S, Shono K, Tajiri T, Takamatsu T, Mizote H, Nagasaki A, Inomata Y, Hara T, Okamura J, Miyazaki S, Kawakami K, Eguchi H, Tsuneyoshi M, Committee for Pediatric Solid Malignant Tumors in the Kyushu Area: Malignant germ cell tumors: clinical characteristics, treatment, and outcome. A report from the study group for Pediatric Solid Malignant Tumors in the Kyushu Area, Japan. J Pediatr Surg; 2002 Dec;37(12):1703-6
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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: clinical characteristics, treatment, and outcome. A report from the study group for Pediatric Solid Malignant Tumors in the Kyushu Area, Japan.
  • PURPOSE: This study aims to assess the prognostic factors and optimal treatments for malignant germ cell tumors (MGCT) in childhood.
  • The prognostic factors and treatments were assessed based on the 5-year survival rate. RESULTS:.
  • (1) Stage: 100% for stage I (n = 54), 75.0% for stage II (n = 4), 67.3% for stage III (n = 14), and 54.8% for stage IV (n = 33); Unknown: n = 12. (2) Primary site: 93.4% for the testis (n = 52), 86.7% for the ovary (n = 31), 56.9% for the sacrococcygeal (n = 21), and 60.6% for others (n = 12); unknown: n = 1. (3) Surgical intervention for primary tumor: 100% for stage I with a complete resection (n = 53), 78.4% for stage III, IV with a complete resection (n = 26), and 33.3% for stage III, IV with an incomplete resection (n = 21). (4) Type of chemotherapy for the stage III and IV: 83.9% for the PVB (cisplatin, vinblastin, bleomycin; n = 13), 66.7% for the VAC (vincristine, actinomycin D, cyclophosphamide; n = 6), and 47.1% for other regimens (n = 25).
  • Radical complete resection alone is a sufficient treatment for localized MGCT.
  • The PVB regimen is optimal chemotherapy for advanced MGCT; however, high-risk cases still may require more aggressive treatment.
  • [MeSH-major] Germinoma / diagnosis. Germinoma / therapy
  • [MeSH-minor] Adolescent. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Child. Child, Preschool. Female. Humans. Incidence. Infant. Infant, Newborn. Liver Neoplasms / secondary. Lung Neoplasms / secondary. Male. Neoplasm Staging. Ovarian Neoplasms / diagnosis. Ovarian Neoplasms / epidemiology. Ovarian Neoplasms / surgery. Prognosis. Retrospective Studies. Survival Rate. Testicular Neoplasms / diagnosis. Testicular Neoplasms / epidemiology. Testicular Neoplasms / surgery. Treatment Outcome

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  • [Copyright] Copyright 2002, Elsevier Science (USA). All rights reserved.
  • [CommentIn] J Urol. 2003 Sep;170(3):1040 [12926414.001]
  • (PMID = 12483635.001).
  • [ISSN] 1531-5037
  • [Journal-full-title] Journal of pediatric surgery
  • [ISO-abbreviation] J. Pediatr. Surg.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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21. Pakzad K, MacLennan GT, Elder JS, Flom LS, Trujillo YP, Sutherland SE, Meyerson HJ: Follicular large cell lymphoma localized to the testis in children. J Urol; 2002 Jul;168(1):225-8
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  • [Title] Follicular large cell lymphoma localized to the testis in children.
  • PURPOSE: Primary follicular lymphoma of the testis in childhood is rare with only 6 cases previously reported.
  • MATERIALS AND METHODS: We extensively analyzed primary follicular lymphoma of the testis in 3 boys.
  • Two patients presented with painless unilateral testicular enlargement and 1 presented with unilateral hydrocele.
  • The excised testes were partially or completely replaced by tumor.
  • In all cases the features were those of follicular, large cell-type malignant lymphoma.
  • Tumor cells in all cases were CD20 and CDw75 positive, focally CD23 positive and bcl-2 negative, while in 2 they were CD10 positive and bcl-6 positive.
  • All patients underwent combination chemotherapy and were in complete remission 7 to 59 months after therapy.
  • CONCLUSIONS: We present 3 cases of pediatric primary follicular lymphoma of the testis.
  • Pathological findings and clinical features were similar to those in the 6 previously reported cases and suggest that primary pediatric testicular follicular lymphoma may represent unique subset of follicular lymphoma with a particularly good prognosis.
  • [MeSH-major] Lymphoma, Follicular / pathology. Testicular Neoplasms / pathology
  • [MeSH-minor] Chemotherapy, Adjuvant. Child. Child, Preschool. Combined Modality Therapy. Humans. Immunophenotyping. Male. Orchiectomy. Testis / pathology


22. Tang JY, Pan C, Xu M: [Protocol for diagnosis and treatment of childhood malignant germ cell tumor]. Zhonghua Er Ke Za Zhi; 2008 May;46(5):388-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Protocol for diagnosis and treatment of childhood malignant germ cell tumor].
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Neoplasms, Germ Cell and Embryonal / diagnosis. Neoplasms, Germ Cell and Embryonal / drug therapy
  • [MeSH-minor] Child. Child, Preschool. Female. Humans. Infant. Male. Ovarian Neoplasms / diagnosis. Ovarian Neoplasms / drug therapy. Testicular Neoplasms / diagnosis. Testicular Neoplasms / drug therapy

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  • (PMID = 19099762.001).
  • [ISSN] 0578-1310
  • [Journal-full-title] Zhonghua er ke za zhi = Chinese journal of pediatrics
  • [ISO-abbreviation] Zhonghua Er Ke Za Zhi
  • [Language] chi
  • [Publication-type] Journal Article
  • [Publication-country] China
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