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1. Castillo-Avila W, Piulats JM, Garcia Del Muro X, Vidal A, Condom E, Casanovas O, Mora J, Germà JR, Capellà G, Villanueva A, Viñals F: Sunitinib inhibits tumor growth and synergizes with cisplatin in orthotopic models of cisplatin-sensitive and cisplatin-resistant human testicular germ cell tumors. Clin Cancer Res; 2009 May 15;15(10):3384-95
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  • [Title] Sunitinib inhibits tumor growth and synergizes with cisplatin in orthotopic models of cisplatin-sensitive and cisplatin-resistant human testicular germ cell tumors.
  • PURPOSE: Germ cell tumors (GCT) of the testis are highly curable, but those patients who are refractory to cisplatin (CDDP)-based combination chemotherapy have a poor prognosis.
  • Therefore, identifying new alternatives for treatment remains a priority.
  • Several studies support an important role for angiogenesis in GCTs, suggesting that antiangiogenic treatment might be a good alternative.
  • In the present study, we evaluated the effect of sunitinib, CDDP, or the combination of both drugs using an orthotopic model of human testicular GCT.
  • EXPERIMENTAL DESIGN: Mice were implanted with four different testicular tumors: a yolk sac, two choriocarcinomas, and a CDDP-resistant choriocarcinoma variant induced in mice by continuous exposure to CDDP.
  • Mice were treated with vehicle, CDDP, sunitinib, or the combination of both drugs and their effects on tumors were analyzed.
  • RESULTS: We observed a significant inhibition in tumor growth accompanied by longer survival after sunitinib treatment.
  • Combination therapy with CDDP significantly enhanced these effects.
  • Sunitinib induced apoptosis, reduced tumor cell proliferation and tumor vasculature, and inhibited vascular endothelial growth factor receptor 1, 2, and 3 and platelet-derived growth factor receptor alpha phosphorylation without affecting phosphorylation of other tyrosine kinase receptors.
  • More importantly, tumor growth inhibition induced by sunitinib was also observed in the induced CDDP-resistant choriocarcinoma model.
  • CONCLUSIONS: Taken together, these results suggest that sunitinib might be a new alternative for treatment of CDDP-refractory patients.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Indoles / therapeutic use. Neoplasms, Germ Cell and Embryonal / drug therapy. Pyrroles / therapeutic use. Testicular Neoplasms / drug therapy. Xenograft Model Antitumor Assays
  • [MeSH-minor] Angiogenesis Inhibitors / administration & dosage. Angiogenesis Inhibitors / pharmacology. Angiogenesis Inhibitors / therapeutic use. Animals. Apoptosis / drug effects. Blotting, Western. Cell Line, Tumor. Cell Proliferation / drug effects. Cell Survival / drug effects. Cisplatin / administration & dosage. Cisplatin / pharmacology. Drug Resistance, Neoplasm. Drug Synergism. Humans. Male. Mice. Mice, Nude. Neovascularization, Pathologic / genetics. Neovascularization, Pathologic / metabolism. Neovascularization, Pathologic / prevention & control. Receptors, Platelet-Derived Growth Factor / genetics. Receptors, Platelet-Derived Growth Factor / metabolism. Receptors, Vascular Endothelial Growth Factor / genetics. Receptors, Vascular Endothelial Growth Factor / metabolism. Reverse Transcriptase Polymerase Chain Reaction. Survival Analysis. Tumor Burden / drug effects

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  • (PMID = 19417025.001).
  • [ISSN] 1078-0432
  • [Journal-full-title] Clinical cancer research : an official journal of the American Association for Cancer Research
  • [ISO-abbreviation] Clin. Cancer Res.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Angiogenesis Inhibitors; 0 / Indoles; 0 / Pyrroles; 0 / sunitinib; EC 2.7.10.1 / Receptors, Platelet-Derived Growth Factor; EC 2.7.10.1 / Receptors, Vascular Endothelial Growth Factor; Q20Q21Q62J / Cisplatin
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2. Kitahara K, Hori J, Tokumitsu M, Saga Y, Hashimoto H, Kaneko S, Yachiku S: [Retroperitoneal germ cell tumor with testicular calcification indicating tiny testicular origin: consideration of the origin of retroperitoneal germ cell tumors: report of two cases]. Hinyokika Kiyo; 2003 May;49(5):291-5
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  • [Title] [Retroperitoneal germ cell tumor with testicular calcification indicating tiny testicular origin: consideration of the origin of retroperitoneal germ cell tumors: report of two cases].
  • Two cases of germ cell neoplasm retrospectively considered to have been of testicular origin are reported. Case 1.
  • A 19-year-old male with brain, liver and retroperitoneal tumors was diagnosed with yolk sac tumor by retroperitoneal tumor biopsy.
  • After multidisciplinary treatment, a region of calcification was detected in the left testis on scrotal sonography and left high inguinal orchiectomy was performed. Case 2.
  • A 57-year-old male with neck, lung and retroperitoneal tumors was diagnosed with yolk sac tumor by supraclavicular biopsy.
  • From initial examination, scrotal sonography revealed a small calcified lesion in the right testis.
  • After chemotherapy, high inguinal orchiectomy and retroperitoneal lymphadenectomy were simultaneously performed.
  • Pathologic evaluation of these testicular specimens revealed calcification and a fibrous scar in correspondence with the clinical diagnosis.
  • These changes were considered as scars of the primary testicular tumor due to burned-out tumor or the result of reaction to chemotherapy.
  • Since a primary tumor of testicular origin may exist in the extragonadal germ cell tumor, it is important to examine the intrascrotal contents in detail in the case of so-called extragonadal germ cell tumors with palpably normal testes.
  • In such cases, there are two possible conditions, an occult testicular tumor and a burned-out testicular tumor.
  • It appears that there are very few true extragonadal germ cell tumors, and that the possibility of primary testicular origin metastasizing from viable occult testicular tumor or burned-out testicular tumor with spontaneous regression is high in retroperitoneal germ cell tumors.
  • [MeSH-major] Calcinosis / pathology. Germinoma / pathology. Retroperitoneal Neoplasms / pathology. Testicular Diseases / pathology. Testicular Neoplasms / pathology
  • [MeSH-minor] Adult. Brain Neoplasms / pathology. Diagnosis, Differential. Endodermal Sinus Tumor. Humans. Liver Neoplasms / pathology. Male. Middle Aged. Retrospective Studies

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  • (PMID = 12822460.001).
  • [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
  • [Number-of-references] 15
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3. Chen YS, Kuo JY, Chin TW, Wei CF, Chen KK, Lin AT, Chang LS: Prepubertal testicular germ cell tumors: 25-year experience in Taipei Veterans General Hospital. J Chin Med Assoc; 2008 Jul;71(7):357-61
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  • [Title] Prepubertal testicular germ cell tumors: 25-year experience in Taipei Veterans General Hospital.
  • BACKGROUND: Due to the rarity of testicular tumors in the prepubertal population, adequate information about their biological course is difficult to document well in a single institution.
  • The purpose of this study was to focus on prepubertal males in an attempt to evaluate clinical features and optimal management among various testicular germ cell tumors with long-term follow-up.
  • METHODS: We retrospectively reviewed the records of children younger than 12 years of age with primary testicular germ cell tumors between February 1981 and December 2005 at Taipei Veterans General Hospital.
  • Mean follow-up time was 139 months (range, 2-283 months).
  • The mean age of the patients at diagnosis ranged from 6 months to 84 months (mean, 20.5 months).
  • All patients underwent radical orchiectomy as an initial treatment.
  • Twenty-nine (85.3%) patients had yolk sac tumors, and 5 (14.7%) had mature teratomas.
  • Of the 29 patients with yolk sac tumor, 26 (89.7%) were diagnosed as stage I, 1 (3.4%) as stage III, and 2 (7.0%) as stage IV.
  • Five (19.2%) of the 26 stage I yolk sac tumors progressed to metastasis after radical orchiectomy, and all of these 5 patients later received chemotherapy.
  • One patient initially with stage III yolk sac tumor and 2 patients with stage IV yolk sac tumor were also treated with chemotherapy.
  • Eventually, 1 patient with stage IV yolk sac tumor died due to tumor progression; the remaining 28 patients with yolk sac tumor all survived without tumor relapse after appropriate treatment.
  • In the 5 patients with teratomas, there was no tumor relapse after radical orchiectomy with a mean follow-up time of 139.1 months.
  • The 5-year survival rates for yolk sac tumor and teratomas were 96.5% and 100%, respectively.
  • CONCLUSION: The most common prepubertal malignant testicular tumor is yolk sac tumor, and the most common benign testicular tumor is teratoma.
  • Children with testicular germ cell tumors have excellent long-term survival rates after appropriate treatment.
  • [MeSH-major] Neoplasms, Germ Cell and Embryonal / therapy. Testicular Neoplasms / therapy

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  • (PMID = 18653399.001).
  • [ISSN] 1726-4901
  • [Journal-full-title] Journal of the Chinese Medical Association : JCMA
  • [ISO-abbreviation] J Chin Med Assoc
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] China (Republic : 1949- )
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4. Ye YL, Qin ZK, Zhou FJ, Han H, Liu ZW, Yu SL, Li YH, Chen ZF: [Clinical analysis of stage I pediatric testicular yolk sac tumors: a report of ten cases]. Ai Zheng; 2008 Nov;27(11):1226-8
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  • [Title] [Clinical analysis of stage I pediatric testicular yolk sac tumors: a report of ten cases].
  • BACKGROUND & OBJECTIVE: At present, pediatric testicular yolk sac tumor is hard to be diagnosed at early stage, and the treatment strategy for this disease after radical inguinal orchiectomy is uncertain.
  • This study was to summarize our experience in diagnosing and treating clinical stage I pediatric testicular yolk sac tumors.
  • METHODS: Clinical data of ten patients with clinical stage I pediatric testicular yolk sac tumors treated from July 2001 to June 2007 were analyzed.
  • RESULTS: Testicular masses with low or uneven echoes were detected by B ultrasound in 11 testes of ten patients.
  • Radical inguinal orchiectomy (RIO) was performed for all patients whereas chemotherapy was not administered preoperatively.
  • Pathology examination was used to confirm the diagnosis of yolk sac tumor.
  • One patient with vascular invasion and another one with bilateral testicular yolk sac tumor received cisplatin-based adjuvant chemotherapy.
  • The patient with bilateral testicular tumor had retroperitoneal and lung metastases at 23 months after adjuvant chemotherapy, and achieved complete remission again after salvage chemotherapy.
  • CONCLUSIONS: With the combination of B ultrasound and serum AFP level, we can assess and diagnose stage I pediatric testicular yolk sac tumor.
  • Chemotherapy is recommended to treat patients with high-risk of relapse.
  • [MeSH-major] Endodermal Sinus Tumor. Testicular Neoplasms
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bleomycin / therapeutic use. Chemotherapy, Adjuvant. Child, Preschool. Cisplatin / therapeutic use. Etoposide / therapeutic use. Follow-Up Studies. Humans. Infant. Lung Neoplasms / drug therapy. Lung Neoplasms / secondary. Male. Neoplasm Staging. Orchiectomy / methods. Remission Induction. Retroperitoneal Neoplasms / drug therapy. Retroperitoneal Neoplasms / secondary. alpha-Fetoproteins / metabolism

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  • (PMID = 19000459.001).
  • [Journal-full-title] Ai zheng = Aizheng = Chinese journal of cancer
  • [ISO-abbreviation] Ai Zheng
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 0 / alpha-Fetoproteins; 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; BEP protocol
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5. Lee JK, Kim SH, Kim JH, Kim IY, Kim TS, Jung S, Kang SS, Lee JH, Lee MC: Metastatic spinal cord compression of testicular yolk sac tumor. Childs Nerv Syst; 2002 Apr;18(3-4):171-4
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  • [Title] Metastatic spinal cord compression of testicular yolk sac tumor.
  • INTRODUCTION: Pediatric testicular tumors are rare.
  • Spinal metastasis of testicular yolk sac tumor (YST) is extremely rare, with only one reported case.
  • CASE REPORT: We report a rare case of metastatic spinal cord compression of testicular YST in a 14-month-old boy who presented with progressive paraparesis and neurological bladder dysfunction.
  • Two months prior to admission, he underwent a left radical orchiectomy for YST of the testis.
  • Emergency surgical resection was performed for tissue diagnosis and spinal decompression.
  • Histopathological features of the epidural mass indicated metastasis of the testicular YST.
  • CONCLUSION: Although spinal involvement with metastatic YST is rare, it must be considered in children with testicular YST exhibiting evidence of pain or weakness, and surgical decompression followed by adjuvant chemotherapy should not be delayed.
  • [MeSH-major] Endodermal Sinus Tumor / complications. Endodermal Sinus Tumor / secondary. Spinal Cord Compression / etiology. Spinal Neoplasms / complications. Spinal Neoplasms / secondary. Testicular Neoplasms / pathology

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  • (PMID = 11981629.001).
  • [ISSN] 0256-7040
  • [Journal-full-title] Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
  • [ISO-abbreviation] Childs Nerv Syst
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Germany
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6. Atsü N, Eskiçorapçi S, Uner A, Ekici S, Güngen Y, Erkan I, Uygur MC, Ozen H: A novel surveillance protocol for stage I nonseminomatous germ cell testicular tumours. BJU Int; 2003 Jul;92(1):32-5
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  • [Title] A novel surveillance protocol for stage I nonseminomatous germ cell testicular tumours.
  • All pathology specimens were studied retrospectively by the same pathologist for embryonal carcinoma, yolk sac tumour and lymphovascular invasion components.
  • A loose surveillance protocol was designed in which computed tomography (CT) was used only for the first year.
  • Platinum-based chemotherapy was given to patients with relapse, and surgery used after chemotherapy in seven.
  • The overall survival was no different from those reported for retroperitoneal lymph node dissection and primary chemotherapy.
  • [MeSH-major] Germinoma / pathology. Testicular Neoplasms / pathology
  • [MeSH-minor] Adolescent. Adult. Clinical Protocols. Follow-Up Studies. Humans. Male. Middle Aged. Multivariate Analysis. Neoplasm Recurrence, Local / pathology. Neoplasm Staging / methods. Retrospective Studies. Risk Factors

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  • (PMID = 12823379.001).
  • [ISSN] 1464-4096
  • [Journal-full-title] BJU international
  • [ISO-abbreviation] BJU Int.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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7. Berney DM, Shamash J, Gaffney J, Jordan S, Oliver RT: DNA topoisomerase I and II expression in drug resistant germ cell tumours. Br J Cancer; 2002 Sep 9;87(6):624-9
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  • [Title] DNA topoisomerase I and II expression in drug resistant germ cell tumours.
  • A small number of testicular germ cell tumours are refractory to current chemotherapy regimens.
  • DNA topoisomerase I is the target for several new drugs and a potential candidate treatment for chemorefractory germ cell tumours.
  • DNA topoisomerase II alpha is the target for etoposide, which is currently used regularly in germ cell tumour treatment.
  • The expression of DNA topoisomerase I and II alpha were therefore assessed immunohistochemically in a range of testicular tumours, especially those with persistent malignant elements on retroperitoneal lymph node dissection.
  • Pre-chemotherapy orchidectomy specimens were matched with post-chemotherapy retroperitoneal lymph node dissections to examine changes in expression.
  • There was considerable variation in the expression of topoisomerase I in different tumour types.
  • Both yolk sac tumours and teratoma, mature showed universal expression of topoisomerase I, while 38% of seminomas and 30% of embryonal carcinomas were positive.
  • There was a negative correlation between topoisomerase I and II alpha expression (P=0.004) and downregulation of topoisomerase II alpha after chemotherapy (P=0.02).
  • These results suggest that topoisomerase I inhibitors may be useful in chemorefractory germ cell tumours, especially yolk sac tumours and where there are unresectable residual teratoma, mature deposits.
  • [MeSH-major] Carcinoma, Embryonal / metabolism. DNA Topoisomerases, Type I / metabolism. DNA Topoisomerases, Type II / metabolism. Drug Resistance, Neoplasm. Seminoma / metabolism. Teratoma / metabolism. Testicular Neoplasms / metabolism
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Case-Control Studies. Cisplatin / administration & dosage. Down-Regulation. Etoposide / administration & dosage. Humans. Immunoenzyme Techniques. Ki-67 Antigen / metabolism. Male. Testis / chemistry. Testis / pathology

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  • (PMID = 12237772.001).
  • [ISSN] 0007-0920
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Scotland
  • [Chemical-registry-number] 0 / Ki-67 Antigen; 6PLQ3CP4P3 / Etoposide; EC 5.99.1.2 / DNA Topoisomerases, Type I; EC 5.99.1.3 / DNA Topoisomerases, Type II; Q20Q21Q62J / Cisplatin
  • [Other-IDs] NLM/ PMC2364243
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8. Sanchez D, Zudaire JJ, Fernandez JM, Lopez J, Arocena J, Sanz G, Gimenez M, Rosell D, Robles JE, Berian JM: 18F-fluoro-2-deoxyglucose-positron emission tomography in the evaluation of nonseminomatous germ cell tumours at relapse. BJU Int; 2002 Jun;89(9):912-6
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  • [Title] 18F-fluoro-2-deoxyglucose-positron emission tomography in the evaluation of nonseminomatous germ cell tumours at relapse.
  • OBJECTIVES: To compare the performance of 18F-fluoro-2-deoxyglucose-positron emission tomography (FDG-PET) and computed tomography (CT) in the follow-up of nonseminomatous germ cell tumours (NSGCT) in the retroperitoneum.
  • PATIENTS AND METHODS: FDG-PET was used 25 times in 15 patients diagnosed with NSGCT.
  • At the time of diagnosis five patients each were in stage I, II and III.
  • Five patients had pure embryonal carcinoma, two had yolk sac tumours, one choriocarcinoma and seven had mixed tumours.
  • RESULTS: Eleven patients either presented with retroperitoneal disease or this did not disappear after chemotherapy.
  • CONCLUSION: In these patients FDG-PET detected the retroperitoneal relapse of NSGCT, in advanced stages treated with surgery plus chemotherapy, earlier than did CT; it also detected the presence of mature teratoma in residual retroperitoneal masses more accurately than CT.
  • [MeSH-major] Fluorodeoxyglucose F18. Germinoma / radionuclide imaging. Radiopharmaceuticals. Retroperitoneal Neoplasms / radionuclide imaging. Testicular Neoplasms / radionuclide imaging. Tomography, Emission-Computed / methods
  • [MeSH-minor] Adolescent. Adult. Follow-Up Studies. Humans. Male. Neoplasm Recurrence, Local / radiography. Neoplasm Recurrence, Local / radionuclide imaging. Orchiectomy / methods

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  • (PMID = 12010239.001).
  • [ISSN] 1464-4096
  • [Journal-full-title] BJU international
  • [ISO-abbreviation] BJU Int.
  • [Language] eng
  • [Publication-type] Comparative Study; Evaluation Studies; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
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9. Pectasides D, Skarlos D, Dimopoulos AM, Farmakis D, Pectasides M, Fountzilas G, Aravantinos G: Two cycles of carboplatin-based adjuvant chemotherapy for high-risk clinical stage I and stage IM non-seminomatous germ cell tumours of the testis: a HECOG trial. Anticancer Res; 2003 Sep-Oct;23(5b):4239-44
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  • [Title] Two cycles of carboplatin-based adjuvant chemotherapy for high-risk clinical stage I and stage IM non-seminomatous germ cell tumours of the testis: a HECOG trial.
  • BACKGROUND: We investigated the efficacy and safety of 2 cycles of adjuvant chemotherapy with carboplatin, etoposide and bleomycin (CEB90) in patients with high-risk clinical stage I or stage IM non-seminomatous germ cell tumours (NSGCT).
  • PATIENTS AND METHODS: A total of 52 consecutive patients (22 patients with high-risk histological features [vascular invasion, presence of embryonal carcinoma, absence of yolk sac tumour] and 30 with tumour marker activity post-orchidectomy-stage IM) were entered into this prospective study.
  • Chemotherapy consisted of carboplatin 400 mg/m2 or AUC 5 (day 1), etoposide 165 mg/m2 (days 1-3) and bleomycin 30 mg (days 1, 8, 15).
  • Chemotherapy was repeated every 3 weeks.
  • These cases had a disseminated, marker-positive germ cell tumour (GCT), extensively involving both liver and lungs in the first case and para-aortic lymph nodes and lung in the second one; both patients died of the tumour after a number of salvage chemotherapy (including high-dose therapy) regimens.
  • CONCLUSION: Despite the general consensus that ciplatin-based chemotherapy is superior to carboplatin-containing regimens in testicular cancer, 2 cycles of CEB90 may be an equally effective treatment option as adjuvant therapy for high-risk clinical stage I and IM patients.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Germinoma / drug therapy. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Adult. Bleomycin / administration & dosage. Carboplatin / administration & dosage. Carcinoma, Embryonal / drug therapy. Carcinoma, Embryonal / pathology. Carcinoma, Embryonal / surgery. Chemotherapy, Adjuvant. Drug Administration Schedule. Etoposide / administration & dosage. Humans. Male. Neoplasm Staging. Orchiectomy. Prospective Studies

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  • (PMID = 14666633.001).
  • [ISSN] 0250-7005
  • [Journal-full-title] Anticancer research
  • [ISO-abbreviation] Anticancer Res.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] Greece
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; BG3F62OND5 / Carboplatin; JEB protocol
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10. Agarwal PK, Palmer JS: Testicular and paratesticular neoplasms in prepubertal males. J Urol; 2006 Sep;176(3):875-81
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  • [Title] Testicular and paratesticular neoplasms in prepubertal males.
  • PURPOSE: We reviewed the current diagnosis, staging and management of testicular and paratesticular neoplasms in prepubertal males.
  • MATERIALS AND METHODS: We performed a medical literature search in English using MEDLINE/PubMed that addressed testicular and/or paratesticular neoplasms in prepubertal males.
  • RESULTS: There is still a predominance of yolk sac tumors in prepubertal males, although some studies suggest that teratomas are more common but underreported due to their benign course in children.
  • A palpable, nontender mass suggests the diagnosis and prompts scrotal ultrasound and tumor markers.
  • Although treatment for most primary tumors has historically been radical inguinal orchiectomy, most benign tumors can now be managed by testis sparing surgery.
  • The addition of radiation, chemotherapy and/or retroperitoneal lymph node dissection depends on tumor stage and histological type.
  • CONCLUSIONS: Although it is rare in children, any solid scrotal mass in prepubertal males warrants evaluation for possible testicular or paratesticular neoplasm.
  • [MeSH-major] Testicular Neoplasms

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  • (PMID = 16890643.001).
  • [ISSN] 0022-5347
  • [Journal-full-title] The Journal of urology
  • [ISO-abbreviation] J. Urol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 50
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11. Dimov ND, Zynger DL, Luan C, Kozlowski JM, Yang XJ: Topoisomerase II alpha expression in testicular germ cell tumors. Urology; 2007 May;69(5):955-61
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Topoisomerase II alpha expression in testicular germ cell tumors.
  • OBJECTIVES: Inhibitors of topoisomerase II alpha (TopoIIalpha), an enzyme with a crucial role in DNA maintenance, are included in the chemotherapy protocols for testicular germ cell tumors (GCTs).
  • Despite the success of current chemotherapy regimens, a significant number of patients experience relapse.
  • We analyzed TopoIIalpha expression in primary and metastatic testicular GCTs because this enzyme is a target for some antineoplastic agents.
  • METHODS: Primary GCT specimens from 109 patients, including 57 seminomas and 52 mixed GCTs (41 embryonal carcinomas, 23 yolk sac tumors, 19 seminomas, 8 choriocarcinomas, 17 teratomas with immature elements, and 16 teratomas with mature elements), were obtained from our archives.
  • The metastatic lesions from 11 of the patients with mixed GCTs included seven teratomas with mature components, five embryonal carcinomas, one yolk sac tumor, one choriocarcinoma, and one teratoma with immature components.
  • RESULTS: Most embryonal carcinoma (100%), yolk sac tumor (95%), seminoma (88%), and choriocarcinoma (62%) components of the GCTs were TopoIIalpha immunoreactive.
  • CONCLUSIONS: The results of our study have shown that TopoIIalpha is expressed in most seminomas, embryonal carcinomas, yolk sac tumors, and choriocarcinomas, suggesting a possible mechanism of sensitivity of these components to TopoIIalpha inhibitors.
  • These findings imply that the variable chemoresponsiveness of testicular GCTs could have an underlying molecular basis.
  • [MeSH-major] Antigens, Neoplasm / metabolism. Biomarkers, Tumor / analysis. DNA Topoisomerases, Type II / metabolism. DNA-Binding Proteins / antagonists & inhibitors. DNA-Binding Proteins / metabolism. Neoplasms, Germ Cell and Embryonal / enzymology. Testicular Neoplasms / enzymology. Topoisomerase II Inhibitors
  • [MeSH-minor] Adolescent. Adult. Biopsy, Needle. Carcinoma, Embryonal / drug therapy. Carcinoma, Embryonal / enzymology. Carcinoma, Embryonal / pathology. Choriocarcinoma / drug therapy. Choriocarcinoma / enzymology. Choriocarcinoma / pathology. Endodermal Sinus Tumor / drug therapy. Endodermal Sinus Tumor / enzymology. Endodermal Sinus Tumor / pathology. Gene Expression Regulation, Neoplastic. Humans. Immunohistochemistry. Male. Middle Aged. Prognosis. Sampling Studies. Seminoma / drug therapy. Seminoma / enzymology. Seminoma / pathology. Sensitivity and Specificity. Teratoma / drug therapy. Teratoma / enzymology. Teratoma / pathology. Treatment Outcome

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  • (PMID = 17482942.001).
  • [ISSN] 1527-9995
  • [Journal-full-title] Urology
  • [ISO-abbreviation] Urology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antigens, Neoplasm; 0 / Biomarkers, Tumor; 0 / DNA-Binding Proteins; 0 / Topoisomerase II Inhibitors; EC 5.99.1.3 / DNA Topoisomerases, Type II; EC 5.99.1.3 / DNA topoisomerase II alpha
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12. Lipphardt ME, Albers P: Late relapse of testicular cancer. World J Urol; 2004 Apr;22(1):47-54
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  • [Title] Late relapse of testicular cancer.
  • Due to its unique biological behavior, late relapse (LR) of testicular cancer has recently been described as an own tumor entity.
  • It is currently defined as tumor recurrence more than 2 years after complete remission following primary treatment including chemotherapy.
  • The incidence ranges from 2 to 6%, with a median relapse-free interval of 5.4-7.1 years from the initial treatment.
  • Although histology shows a germ cell tumor (GCT) origin, the clinical biology is different.
  • The dominant characteristics are slow tumor growth and chemoresistance.
  • Molecular analysis currently focuses on the mechanisms of drug resistance.
  • The initial response to chemotherapy is less than 30% and in most cases complete surgical resection remains the only treatment option with favorable long-term results.
  • The most common site of LR is the retroperitoneum, with undifferentiated cancer (yolk sac) being the most frequent histology.
  • The overall cure rate is only about 50%, hence, adequate treatment of the primary tumor is essential to prevent the development of LR.
  • [MeSH-major] Neoplasm Recurrence, Local. Testicular Neoplasms
  • [MeSH-minor] Cytogenetic Analysis. Follow-Up Studies. Germinoma / diagnosis. Germinoma / therapy. Humans. Male. Prognosis. Seminoma / diagnosis. Seminoma / therapy. Time Factors

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  • (PMID = 15064970.001).
  • [ISSN] 0724-4983
  • [Journal-full-title] World journal of urology
  • [ISO-abbreviation] World J Urol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Germany
  • [Number-of-references] 37
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13. Hirayama Y, Kubota M, Imamura M, Imai C, Okuyama N, Tsukada M, Kobayashi K, Sato K, Takachi T, Iwavuchi H, Uchiyama M: A 2-year-old boy with a stage III yolk sac tumor occurring in an intra-abdominal retained testis. J Pediatr Surg; 2009 Dec;44(12):2395-8
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  • [Title] A 2-year-old boy with a stage III yolk sac tumor occurring in an intra-abdominal retained testis.
  • We, herein, report the case of a 2-year-old boy who presented with a huge yolk sac tumor with retroperitoneal lymph nodes metastasis that originated in a left intra-abdominal undescended testis.
  • Computed tomography and magnetic resonance imaging showed a huge round tumor connecting to the left retroperitoneal lymph nodes with metastasis extending from the left pelvic region to the left renal hilum.
  • The right abdominal tumor appeared to be a giant testis that had strangulated at the neck of the cord.
  • The tumor had ruptured at the side of the left pelvic lymph node metastasis, and a yolk sac tumor was diagnosed from a histologic analysis of the resected specimens.
  • Postoperative PEB chemotherapy was effective, and a complete surgical resection of the tumor was performed 3 months after the initial laparotomy.
  • The pathologic findings showed fibrous tissue without any tumor cells.
  • This case might be a coincidental association of a yolk sac tumor occurring in an undescended testis, which thus caused a delay in making an accurate diagnosis.
  • [MeSH-major] Cryptorchidism / diagnosis. Endodermal Sinus Tumor / diagnosis. Testicular Neoplasms / diagnosis
  • [MeSH-minor] CA-125 Antigen / blood. Child, Preschool. Humans. Lymphatic Metastasis / diagnosis. Lymphatic Metastasis / pathology. Magnetic Resonance Imaging. Male. Neoplasm Staging. Preoperative Care. Retroperitoneal Neoplasms / secondary. Testis / pathology. Testis / surgery. Tomography, X-Ray Computed. alpha-Fetoproteins / analysis

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  • (PMID = 20006035.001).
  • [ISSN] 1531-5037
  • [Journal-full-title] Journal of pediatric surgery
  • [ISO-abbreviation] J. Pediatr. Surg.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / CA-125 Antigen; 0 / alpha-Fetoproteins
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14. Tröbs RB, Krauss M, Geyer C, Tannapfel A, Körholz D, Hirsch W: Surgery in infants and children with testicular and paratesticular tumours: a single centre experience over a 25-year-period. Klin Padiatr; 2007 May-Jun;219(3):146-51
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Surgery in infants and children with testicular and paratesticular tumours: a single centre experience over a 25-year-period.
  • Testicular and even more paratesticular tumours in children are rare.
  • The aim of the study is to characterise the spectrum of these lesions with focus on the feasibility and effectiveness of testis sparing surgery.
  • The spectrum of testicular tumours comprised 13 germ cell tumours (6 yolk sac tumours, 6 teratomas, 1 embryonal carcinoma) and 4 sex cord stromal tumours (2 Leydig's cell, Sertoli's cell, granulosa cell).
  • Further on, we observed 3 boys with paratesticular rhabdomyosarcoma (RMS), and three with testicular and paratesticular metastases (Wilms' tumour, neuroblastoma, leukaemia).
  • Serum alpha1-fetoprotein (AFP) was clearly elevated in 5 of 6 yolk sac tumours but remained within normal limits concerning the other entities.
  • Dependent on tumour histology, stage and the recommended treatment schedule postoperative chemotherapy was added.
  • Testis sparing surgery was performed in 3 boys with primary testicular tumours (2 Leydig's cell, mature cystic teratoma).
  • During a median follow up of 5 years all patients with primary testicular tumours survived event free.
  • Meta-analysis of the recent literature revealed that testis sparing surgery is feasible and save in prepubertal boys after exclusion of a malignant tumour.
  • If a testis sparing approach is planned, the following criteria are essential: 1.
  • 3. The presence of sufficient healthy testicular parenchyma.
  • However, the high rate of malignant or potentially malignant tumours suggests that high inguinal orchidectomy should remain the surgical standard of therapy.
  • [MeSH-major] Granulosa Cell Tumor / surgery. Leydig Cell Tumor / surgery. Neoplasms, Germ Cell and Embryonal / surgery. Sertoli Cell Tumor / surgery. Testicular Neoplasms / surgery
  • [MeSH-minor] Adolescent. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biomarkers, Tumor / blood. Chemotherapy, Adjuvant. Child. Child, Preschool. Chorionic Gonadotropin, beta Subunit, Human / blood. Combined Modality Therapy. Diagnostic Imaging. Feasibility Studies. Follow-Up Studies. Humans. Infant. Male. Neoplasm Staging. Orchiectomy / methods. Retrospective Studies. alpha-Fetoproteins / metabolism

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  • (PMID = 17525908.001).
  • [ISSN] 0300-8630
  • [Journal-full-title] Klinische Pädiatrie
  • [ISO-abbreviation] Klin Padiatr
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Chorionic Gonadotropin, beta Subunit, Human; 0 / alpha-Fetoproteins
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15. Mikuz G: [Testicular tumors. Predictive factors]. Pathologe; 2008 Nov;29 Suppl 2:270-2
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Testicular tumors. Predictive factors].
  • Patients with germ cell tumors of the testis can be given adjuvant treatment immediately after orchidectomy or put under surveillance with definitive treatment deferred until relapse.
  • Both therapies are equally successful (success rate 98-99%), with surveillance alone, however, only approximately 50% of cases need toxic chemotherapy.
  • In seminomas the strongest predictor of metastases is tumor invasion of the rete testis followed by the size (Ø > or =4 cm) of the tumor.
  • The presence of teratomas and yolk sac tumors are considered to be predictors of a favorable course of the disease.
  • [MeSH-major] Neoplasms, Germ Cell and Embryonal / pathology. Testicular Neoplasms / pathology
  • [MeSH-minor] Chemotherapy, Adjuvant. Combined Modality Therapy. Follow-Up Studies. Humans. Male. Neoplasm Invasiveness / pathology. Neoplasm Recurrence, Local / pathology. Orchiectomy. Prognosis. Testis / pathology

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  • (PMID = 18712393.001).
  • [ISSN] 1432-1963
  • [Journal-full-title] Der Pathologe
  • [ISO-abbreviation] Pathologe
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Germany
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16. 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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17. Stefka J, Cleveland JC, Lucia MS, Singh M: Sarcomatoid intracardiac metastasis of a testicular germ cell tumor closely resembling primary cardiac sarcoma. Hum Pathol; 2003 Oct;34(10):1074-7
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  • [Title] Sarcomatoid intracardiac metastasis of a testicular germ cell tumor closely resembling primary cardiac sarcoma.
  • This report describes a 40-year-old man with a remote history of testicular mixed nonseminomatous germ cell tumor (NSGCT) treated by surgery and chemotherapy.
  • The sarcomatous and myxomatous histological appearance of the neoplasm closely resembled a primary cardiac sarcoma.
  • However, immunohistochemical studies confirmed the diagnosis of metatstatic sarcomatoid germ cell tumor.
  • These neoplasms are thought to arise from the spindle cell component of the yolk sac tumor that is resistant to chemotherapy.
  • [MeSH-major] Germinoma / secondary. Heart Neoplasms / secondary. Sarcoma / secondary. Testicular Neoplasms / pathology
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Diagnosis, Differential. Echocardiography. Heart Atria / pathology. Humans. Immunohistochemistry. Male. Vena Cava, Inferior / pathology

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  • (PMID = 14608547.001).
  • [ISSN] 0046-8177
  • [Journal-full-title] Human pathology
  • [ISO-abbreviation] Hum. Pathol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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18. Michael H, Lucia J, Foster RS, Ulbright TM: The pathology of late recurrence of testicular germ cell tumors. Am J Surg Pathol; 2000 Feb;24(2):257-73
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The pathology of late recurrence of testicular germ cell tumors.
  • A total of 91 men had histologically documented late recurrences of testicular germ cell tumors characterized by a complete response to treatment with a subsequent disease-free interval of at least 2 years and no evidence of a second primary lesion.
  • Ninety percent of the patients for whom information was available received chemotherapy shortly after their initial diagnosis of testicular germ cell tumors; most of the other patients were known to have stage I disease initially.
  • Thus, teratoma was the most common type of neoplasm in late recurrences.
  • Excluding teratoma coexisting with other types of neoplasms, yolk sac tumor was the most frequent type of tumor in patients with late recurrence.
  • It occurred in 47% of patients, either alone or with teratoma, another nonteratomatous germ cell tumor type, or a "nongerm cell malignant tumor."
  • Unusual types of yolk sac tumor, including glandular, parietal, clear cell, and pleomorphic patterns, were seen frequently in late recurrences and often raised differential diagnostic problems with "nongerm cell" carcinomas.
  • A smaller number of late recurrences consisted of other types of neoplasms.
  • Twenty percent of patients with late recurrence had a nonteratomatous germ cell tumor other than yolk sac tumor, either alone, with yolk sac tumor, or with a "nongerm cell malignant tumor."
  • Most of these nonteratomatous germ cell tumors other than yolk sac tumor were embryonal carcinoma, although rarely seminoma and choriocarcinoma were encountered.
  • "Nongerm cell malignant tumors," including both sarcomas and carcinomas of various types, occurred in 23% of late-recurrence patients, either alone or with a nonteratomatous germ cell tumor.
  • Patients whose late recurrences consisted of pure "nongerm cell malignant tumor" or pure germ cell tumor (yolk sac tumor or other types) had a much worse prognosis: Only 36% to 37% were alive with no evidence of disease.
  • Patients with two different types of nonteratomatous malignancies in their late recurrences had a dismal clinical course: Only 17% with both yolk sac tumor and other nonteratomatous germ cell tumor had no evidence of disease, whereas no patient with both nonteratomatous germ cell tumor and "nongerm cell malignant tumor" was disease free.
  • Furthermore, late recurrence is not likely to respond to chemotherapy and is best treated by surgical excision when possible.
  • [MeSH-major] Germinoma / pathology. Neoplasm Recurrence, Local / pathology. Testicular Neoplasms / pathology
  • [MeSH-minor] Adolescent. Adult. Carcinoma, Embryonal / complications. Carcinoma, Embryonal / pathology. Carcinoma, Embryonal / therapy. Choriocarcinoma / complications. Choriocarcinoma / pathology. Choriocarcinoma / therapy. Endodermal Sinus Tumor / complications. Endodermal Sinus Tumor / pathology. Endodermal Sinus Tumor / therapy. Fluorescent Antibody Technique, Direct. Humans. Male. Neoplasm Staging. Neoplasms, Second Primary / pathology. Neoplasms, Second Primary / therapy. Sarcoma / complications. Sarcoma / pathology. Sarcoma / therapy. Seminoma / complications. Seminoma / pathology. Seminoma / therapy. Teratoma / complications. Teratoma / pathology. Teratoma / therapy

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  • (PMID = 10680894.001).
  • [ISSN] 0147-5185
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] UNITED STATES
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19. Subramanian VS, Gilligan T, Klein EA: A case of spermatic cord teratoma in low-stage testicular cancer managed by surveillance. Nat Clin Pract Urol; 2008 Apr;5(4):220-3
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  • [Title] A case of spermatic cord teratoma in low-stage testicular cancer managed by surveillance.
  • BACKGROUND: A 25-year-old male presented to his local urologist with new-onset right testicular pain and swelling detected on self examination.
  • A scrotal ultrasound scan showed a right testicular mass, suspicious for neoplasm.
  • The patient underwent right inguinal orchiectomy and was diagnosed with nonseminomatous germ cell tumor of the right testis, composed of yolk sac tumor, teratoma, and embryonal carcinoma with no evidence of metastatic disease.
  • He opted to remain under surveillance rather than undergo primary chemotherapy or retroperitoneal lymph node dissection for his clinical stage I disease.
  • Serologic relapse at 4 months after orchiectomy was successfully treated with bleomycin, etoposide and cisplatin (BEP) chemotherapy.
  • Pathology of the testicular mass was reviewed.
  • DIAGNOSIS: A 1.7 cm nodule anterior to the right psoas muscle suspicious for metastatic disease that was seen on CT 16 months after orchiectomy was pathologically confirmed as recurrent mature teratoma in the spermatic cord.
  • The patient has since remained disease-free, with normal levels of serum tumor markers and no evidence of metastasis on chest X-ray and abdominal CT.
  • [MeSH-major] Genital Neoplasms, Male / therapy. Neoplasms, Germ Cell and Embryonal / surgery. Spermatic Cord / pathology. Teratoma / therapy
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chorionic Gonadotropin / blood. Disease Management. Humans. Lymph Node Excision. Lymphatic Metastasis. Male. Neoplasm Recurrence, Local / therapy. Orchiectomy. alpha-Fetoproteins / analysis

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  • (PMID = 18268549.001).
  • [ISSN] 1743-4289
  • [Journal-full-title] Nature clinical practice. Urology
  • [ISO-abbreviation] Nat Clin Pract Urol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Chorionic Gonadotropin; 0 / alpha-Fetoproteins
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20. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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.
  • Yolk sac tumors and/or teratomas occurred in the children, whereas mixed histologies, including embryonal carcinoma, were predominant in the adolescents.
  • 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.
  • Three of the 14 children (21.4%) relapsed 3, 7, and 8 months after orchiectomy: all 3 had yolk sac tumors and presented with increased alpha-fetoprotein levels.
  • 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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21. Amin RM, Kokubo T, Hiroshima K, Narita M, Itou K, Kuroki M, Tanizawa T, Nakatani Y: Metastatic germ cell tumor of the lung masquerading as primary rhabdomyosarcoma. Pathol Int; 2005 Oct;55(10):649-54
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  • [Title] Metastatic germ cell tumor of the lung masquerading as primary rhabdomyosarcoma.
  • Two years after testicular resection was carried out in a 40-year-old man that revealed mixed germ cell tumor of more than one histological type (seminoma, embryonal cell carcinoma, and yolk sac tumor), he presented with an asymptomatic pulmonary nodule in his left lower lobe.
  • Video-assisted thoracoscopic partial resection of the tumor revealed a 24 x 20 mm teratoma with somatic-type malignancy in which pleomorphic rhabdomyosarcoma was a major element.
  • One year later, asymptomatic tumor recurrence occurred at both edges of the stapler line as 22 x 20 mm and 10 x 5 mm nodules composed only of pleomorphic rhabdomyosarcoma.
  • Throughout the course there was no abdominal lymph node swelling detected by computed tomography (CT) and tumor markers were normal.
  • Adjuvant chemotherapy was started after the tumor recurrence.
  • Currently, the patient is still undergoing chemotherapy 5 months after the tumor recurrence.
  • In conclusion, despite the fact that primary pulmonary rhabdromyosarcoma is a rare neoplasm, metastatic pulmonary germ cell tumor with somatic-type malignancy showing predominantly rhabdomyosarcomatous differentiation should be considered in the differential diagnosis of such lesions of the lung.
  • [MeSH-major] Lung Neoplasms / diagnosis. Neoplasms, Germ Cell and Embryonal / diagnosis. Rhabdomyosarcoma / diagnosis. Testicular Neoplasms / diagnosis
  • [MeSH-minor] Adult. Biomarkers, Tumor / analysis. Chemotherapy, Adjuvant. Combined Modality Therapy. Diagnosis, Differential. Humans. Immunoenzyme Techniques. Male. Neoplasm Recurrence, Local. Tomography, X-Ray Computed

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  • (PMID = 16185296.001).
  • [ISSN] 1320-5463
  • [Journal-full-title] Pathology international
  • [ISO-abbreviation] Pathol. Int.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Australia
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
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22. Beck SD, Foster RS, Bihrle R, Cheng L, Donohue JP: Does the histology of nodal metastasis predict systemic relapse after retroperitoneal lymph node dissection in pathological stage B1 germ cell tumors? J Urol; 2005 Oct;174(4 Pt 1):1287-90; discussion 1290
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • PURPOSE: We evaluated the prognostic significance of the histology of metastatic lymph nodes to predict postoperative relapse in pathological stage B1 nonseminomatous germ cell tumor (NSGCT).
  • MATERIALS AND METHODS: A retrospective review of the testicular cancer database was performed to identify all patients with clinical stage A NSGCT who underwent primary retroperitoneal lymph node dissection and were found to have pathological stage B1 disease.
  • No patient received adjuvant chemotherapy and minimal followup was 24 months.
  • Embryonal cell carcinoma was identified in 92 of 118 (77%) surgical specimens, which was significantly greater than the presence of teratoma (22%), seminoma (16%) and yolk sac (14.4%, p < or = 0.001) with no difference in 5-year DFS comparing the presence or absence of each histology.
  • Embryonal cell carcinoma was the most common single histology identified at surgery at 64 of 88 (73%), with the incidence of seminoma, teratoma and yolk sac being 12.5%, 9.0% and 5.5%, respectively (p < or = 0.001).
  • [MeSH-major] Lymph Node Excision. Lymphatic Metastasis. Neoplasm Recurrence, Local / pathology. Neoplasms, Germ Cell and Embryonal / pathology. Testicular Neoplasms / pathology

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  • (PMID = 16145394.001).
  • [ISSN] 0022-5347
  • [Journal-full-title] The Journal of urology
  • [ISO-abbreviation] J. Urol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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23. Carver BS, Bianco FJ Jr, Shayegan B, Vickers A, Motzer RJ, Bosl GJ, Sheinfeld J: Predicting teratoma in the retroperitoneum in men undergoing post-chemotherapy retroperitoneal lymph node dissection. J Urol; 2006 Jul;176(1):100-3; discussion 103-4
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  • [Title] Predicting teratoma in the retroperitoneum in men undergoing post-chemotherapy retroperitoneal lymph node dissection.
  • We evaluated patients undergoing post-chemotherapy retroperitoneal lymph node dissection for nonseminomatous germ cell tumors to determine predictors of teratomatous elements in the retroperitoneum.
  • MATERIALS AND METHODS: We identified 532 patients from 1989 to 2003 who underwent retroperitoneal lymph node dissection following chemotherapy for nonseminomatous germ cell tumors at our institution.
  • RESULTS: Of the 532 patients in our series 450 (85%) received only induction chemotherapy and 82 (15%) required salvage chemotherapy.
  • By multivariate analysis testicular yolk sac tumor (p = 0.046), teratoma in the orchiectomy specimen (p <0.005), relative change in nodal size before and after chemotherapy (p <0.005), and no requirement for salvage chemotherapy (p = 0.03) were independent predictors for the presence of teratoma in the retroperitoneum.
  • CONCLUSIONS: Teratoma remains a common histological finding in the retroperitoneal lymph nodes following chemotherapy.
  • We have identified several pre-retroperitoneal lymph node dissection variables that predict the finding of teratoma in the retroperitoneum for men treated with chemotherapy for metastatic nonseminomatous germ cell tumors.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Lymph Node Excision. Teratoma / secondary. Testicular Neoplasms / pathology
  • [MeSH-minor] Humans. Logistic Models. Lymphatic Metastasis. Male. Multivariate Analysis. Retroperitoneal Space. Salvage Therapy

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  • (PMID = 16753380.001).
  • [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 / Antineoplastic Agents
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24. Ross JH, Rybicki L, Kay R: Clinical behavior and a contemporary management algorithm for prepubertal testis tumors: a summary of the Prepubertal Testis Tumor Registry. J Urol; 2002 Oct;168(4 Pt 2):1675-8; discussion 1678-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Clinical behavior and a contemporary management algorithm for prepubertal testis tumors: a summary of the Prepubertal Testis Tumor Registry.
  • PURPOSE: The Prepubertal Testis Tumor Registry was established by the Urologic Section of the American Academy of Pediatrics in 1980 to record data on a large number of prepubertal testis tumors regarding presentation, treatment and outcome to define appropriate management better.
  • MATERIALS AND METHODS: Relevant data in the prepubertal testis tumor registry were tabulated and analyzed.
  • RESULTS: There were 395 prepubertal patients who had a primary testis tumor.
  • Of the patients with yolk sac tumor 80% presented with stage 1 disease and overall survival was excellent.
  • Of all patients with stromal tumors metastases developed in only 1.
  • CONCLUSIONS: We recommend initial excisional biopsy for all amenable prepubertal testis tumors, except those with an alpha-fetoprotein level that is clearly increased for patient age.
  • Patients with stage I yolk sac tumor should be monitored closely, and those with recurrent or metastatic yolk sac tumor should be treated with chemotherapy.
  • Retroperitoneal lymph node dissection is reserved for patients with recurrent retroperitoneal masses following chemotherapy.
  • Aggressive treatment of metastatic Sertoli cell or undifferentiated stromal tumors is warranted.
  • [MeSH-major] Registries / statistics & numerical data. Testicular Neoplasms / congenital
  • [MeSH-minor] Algorithms. Child. Child, Preschool. Combined Modality Therapy. Endodermal Sinus Tumor / congenital. Endodermal Sinus Tumor / mortality. Endodermal Sinus Tumor / pathology. Endodermal Sinus Tumor / therapy. Humans. Infant. Male. Neoplasm Staging. Prognosis. Sertoli Cell Tumor / congenital. Sertoli Cell Tumor / mortality. Sertoli Cell Tumor / pathology. Sertoli Cell Tumor / therapy. Sex Cord-Gonadal Stromal Tumors / congenital. Sex Cord-Gonadal Stromal Tumors / mortality. Sex Cord-Gonadal Stromal Tumors / pathology. Sex Cord-Gonadal Stromal Tumors / therapy. Survival Rate. United States. alpha-Fetoproteins / metabolism

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  • (PMID = 12352332.001).
  • [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 / alpha-Fetoproteins
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25. Yang WP, Zou Y, Huang CS, Zhang SZ, Xiao Q, Dai KL, Zhong HS, Xiong XJ: [Clinicopathologic and prognostic study of pediatric immature teratoma]. Zhonghua Bing Li Xue Za Zhi; 2007 Oct;36(10):666-71
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  • RESULTS: Amongst the 39 cases studied, 12 arose in the sacrococcygeal region, 12 in testis, 5 in retroperitoneum, 4 in ovary, 4 in abdomen and 2 in mediastinum.
  • Seven of the cases contained foci of yolk sac tumor.
  • Immature neuroepithelial features used in histologic grading included the presence of primitive neural tubules, immature rosettes, undifferentiated neuroblastoma cells and primitive neuroectodermal structures.
  • Three of them, including 2 cases with histologic grade 3 (with or without yolk sac tumor component), recurred after operation.
  • On the other hand, p27 overexpression shows little correlation with tumor grade.
  • Sacrococcygeal immature teratoma occurring in patients younger than 1 year old and with low histologic grade do not require postoperative chemotherapy if the tumor is completely excised.
  • Similarly, for testicular immature teratoma occurring in patients below 1 year of age, regardless of tumor grading, need no adjunctive therapy.
  • On the other hand, ovarian immature teratoma with high histologic grade requires postoperative chemotherapy, regardless of age of the patients.
  • The presence of microscopic foci of yolk sac tumor is a useful predictor of recurrence in pediatric immature teratoma.
  • [MeSH-major] Ovarian Neoplasms / pathology. Retroperitoneal Neoplasms / pathology. Teratoma / pathology. Testicular Neoplasms / pathology
  • [MeSH-minor] Adolescent. Cyclin D1 / metabolism. Endodermal Sinus Tumor / drug therapy. Endodermal Sinus Tumor / metabolism. Endodermal Sinus Tumor / pathology. Endodermal Sinus Tumor / surgery. Female. Follow-Up Studies. Humans. Infant. Infant, Newborn. Ki-67 Antigen / metabolism. Male. Mediastinal Neoplasms / drug therapy. Mediastinal Neoplasms / metabolism. Mediastinal Neoplasms / pathology. Mediastinal Neoplasms / surgery. Neoplasm Recurrence, Local. Neoplasm Staging. Proliferating Cell Nuclear Antigen / metabolism. Sacrococcygeal Region. Survival Rate. alpha-Fetoproteins / metabolism

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  • (PMID = 18194599.001).
  • [ISSN] 0529-5807
  • [Journal-full-title] Zhonghua bing li xue za zhi = Chinese journal of pathology
  • [ISO-abbreviation] Zhonghua Bing Li Xue Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Ki-67 Antigen; 0 / Proliferating Cell Nuclear Antigen; 0 / alpha-Fetoproteins; 0 / p27 antigen; 136601-57-5 / Cyclin D1
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26. Porcaro AB, Zecchini Antoniolli S, Novella G, Martignoni G, Bassetto MA, Poli A, Schiavone D, Tallarigo C, D'Amico A, Ficarra V, Curti P: [Histopathologic risk factors in patients with non-seminomatous germ tumors of the testis in clinical stage 1. Retrospective study of 75 patients]. Arch Ital Urol Androl; 2001 Dec;73(4):177-80
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  • [Title] [Histopathologic risk factors in patients with non-seminomatous germ tumors of the testis in clinical stage 1. Retrospective study of 75 patients].
  • [Transliterated title] Fattori istopatologici di rischio in pazienti con tumore germinale non seminomatoso del testicolo in stadio clinico 1. Uno studio retrospettivo su 75 pazienti.
  • OBJECTIVES: This retrospective study was performed to evaluate histopathologic prognostic risk factors in 75 patients on clinical stage 1 nonseminomatous germ cell cancer of the testis (NSGCTT).
  • After orchiectomy, therapeutic options included retroperitoneal lymph node dissection (RLND) for 44 patients (58.6%), surveillance for 26 (34.6%) and neoadjuvant chemotherapy for 5 (6.6%).
  • Testis primary tumor samples were assessed for studying prognostic risk factors that included vascular and/or lymphatic invasion (IV/IL+), percentage of embryonal carcinoma (%EC) and absence of yolk sac tumor (YS-).
  • CONCLUSIONS: EC% > 80 is a prognostic risk factor for disease relapse in patients with clinical stage 1 NSGCT who are selected in a high risk group requiring RPLND or neoadjuvant chemotherapy as therapeutical option.

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  • (PMID = 11822063.001).
  • [ISSN] 1124-3562
  • [Journal-full-title] Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica
  • [ISO-abbreviation] Arch Ital Urol Androl
  • [Language] ITA
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Italy
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27. Malagón HD, Valdez AM, Moran CA, Suster S: Germ cell tumors with sarcomatous components: a clinicopathologic and immunohistochemical study of 46 cases. Am J Surg Pathol; 2007 Sep;31(9):1356-62
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  • The germ cell component consisted of pure mature or immature teratoma (23 cases), teratoma mixed with other seminomatous or nonseminomatous components (17), pure seminoma (2), intratubular germ cell neoplasia (1), and yolk sac tumor (1).
  • The SC included embryonal rhabdomyosarcoma (29), angiosarcoma (6), leiomyosarcoma (4), undifferentiated sarcoma (3), myxoid liposarcoma (1), malignant peripheral nerve sheath tumor (1), malignant "triton" tumor (1), and epithelioid hemangioendothelioma (1).
  • All patients were treated by cisplatinum-based chemotherapy plus other agents followed by surgery.
  • Thirty-two of 40 patients either died of tumor (25/40; 62.5%) or were alive with advanced, progressive disease (7/40; 17.5%), and only 8/40 (20%) were alive and free of disease between 5 to 40 months (mean=18 mo).
  • [MeSH-major] Immunohistochemistry. Mediastinal Neoplasms / diagnosis. Neoplasms, Germ Cell and Embryonal / diagnosis. Ovarian Neoplasms / diagnosis. Retroperitoneal Neoplasms / diagnosis. Sarcoma / diagnosis. Testicular Neoplasms / diagnosis
  • [MeSH-minor] Adolescent. Adult. Aged. Antineoplastic Combined Chemotherapy Protocols. Disease-Free Survival. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Metastasis. Neoplasm Staging. Orchiectomy. Ovariectomy. Time Factors. Treatment Outcome

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  • (PMID = 17721191.001).
  • [ISSN] 0147-5185
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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28. Lim LP, Tan AM, Chan MY, Rajalingam V, Lou J, Tan CL: Paediatric extracranial germ cell tumours: a retrospective review. Ann Acad Med Singapore; 2002 Mar;31(2):206-11
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  • The median age at diagnosis was 1.7 years (0 to 13 years).
  • Eighteen patients (47.3%) had teratomas, 16 (42.1%) had yolk sac tumours, 1 (2.6%) had dysgerminoma and 3 (7.9%) had mixed GCTs.
  • Complete tumour resection was achieved in 36 of the 38 patients (95%).
  • Cisplatin-based combination chemotherapy was given to 11 patients (28.9%).
  • Complications from chemotherapy included anaemia requiring packed red cell transfusion (n = 3), Port-a-cath sepsis requiring removal (n = 1), febrile neutropenia (n = 1) and nephropathy (n = 1).
  • [MeSH-major] Germinoma / epidemiology. Ovarian Neoplasms / epidemiology. Testicular Neoplasms / epidemiology
  • [MeSH-minor] Adolescent. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Child. Child, Preschool. Female. Humans. Infant. Infant, Newborn. Male. Neoplasm Staging. Retrospective Studies. Singapore / epidemiology

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  • (PMID = 11957559.001).
  • [ISSN] 0304-4602
  • [Journal-full-title] Annals of the Academy of Medicine, Singapore
  • [ISO-abbreviation] Ann. Acad. Med. Singap.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Singapore
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29. Robertson KA, Bullock HA, Xu Y, Tritt R, Zimmerman E, Ulbright TM, Foster RS, Einhorn LH, Kelley MR: Altered expression of Ape1/ref-1 in germ cell tumors and overexpression in NT2 cells confers resistance to bleomycin and radiation. Cancer Res; 2001 Mar 1;61(5):2220-5
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  • In a pilot study, we have examined Ape1/ref-1 expression by immunohistochemistry in sections of germ cell tumors (GCTs) from 10 patients with testicular cancer of various histologies including seminomas, yolk sac tumors, and malignant teratomas.
  • Ape1/ref-1 was expressed at relatively high levels in the tumor cells of nearly all sections.
  • We hypothesized that elevated expression of Ape1/ref-1 is responsible in part for the resistance to therapeutic agents.
  • (b) elevated expression of Ape1/ref-1 in testicular cancer cell lines results in resistance to certain therapeutic agents; and (c) Ape1/ref-1 expression in GCT cell lines determined by immunohistochemistry and repair activity assays parallels the level of protection from bleomycin.
  • We further hypothesize that elevated Ape1/ref-1 levels observed in human testicular cancer may be related to their relative resistance to therapy and may serve as a diagnostic marker for refractory disease.
  • [MeSH-minor] DNA Repair. DNA-(Apurinic or Apyrimidinic Site) Lyase. Deoxyribonuclease IV (Phage T4-Induced). Drug Resistance, Neoplasm. Gene Transfer Techniques. Humans. Retroviridae / genetics. Tumor Cells, Cultured

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  • (PMID = 11280790.001).
  • [ISSN] 0008-5472
  • [Journal-full-title] Cancer research
  • [ISO-abbreviation] Cancer Res.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA76643; United States / NINDS NIH HHS / NS / NS38506; United States / NCI NIH HHS / CA / R43 CA83507; etc
  • [Publication-type] 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 / Antimetabolites, Antineoplastic; 11056-06-7 / Bleomycin; EC 3.1.21.2 / Deoxyribonuclease IV (Phage T4-Induced); EC 4.2.- / Carbon-Oxygen Lyases; EC 4.2.99.18 / APEX1 protein, human; EC 4.2.99.18 / DNA-(Apurinic or Apyrimidinic Site) Lyase
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30. Divrik RT, Akdoğan B, Ozen H, Zorlu F: Outcomes of surveillance protocol of clinical stage I nonseminomatous germ cell tumors-is shift to risk adapted policy justified? J Urol; 2006 Oct;176(4 Pt 1):1424-29; discussion 1429-30
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  • PURPOSE: We evaluated the potential risk factors for disease relapse in patients with clinical stage I nonseminomatous germ cell tumors treated with surveillance and reevaluated our treatment of these patients.
  • Risk factors evaluated were presence of vascular invasion, proportion of embryonal carcinoma, age, tumor size, preoperatively increased serum alpha-fetoprotein and the absence of yolk sac component.
  • The first evidence of relapse was most commonly the increase in serum tumor markers alone (28.8%) or in combination with other modalities (66.7%, overall 95.5%).
  • CONCLUSIONS: In light of our results we suggest that all patients with vascular invasion should receive chemotherapy.
  • [MeSH-major] Neoplasms, Germ Cell and Embryonal / secondary. Population Surveillance. Testicular Neoplasms / pathology
  • [MeSH-minor] Adolescent. Adult. Child. Child, Preschool. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Invasiveness. Neoplasm Staging. Orchiectomy. Program Evaluation. Retrospective Studies. Risk Factors. Treatment Outcome

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  • (PMID = 16952649.001).
  • [ISSN] 0022-5347
  • [Journal-full-title] The Journal of urology
  • [ISO-abbreviation] J. Urol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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