1/109. life-threatening germ cell tumor arising in cryptorchidism: a case report.We report a case of life-threatening germ cell tumor in abdominal cryptorchidism. A 32-year-old man presented with a three-month history of dyspnea, loss of appetite, general weakness and a large abdominal mass. physical examination revealed vacancy of the right scrotal contents. Chest radiograph showed massive left pleural effusion. Abdominal ultrasound revealed ascites, right hydronephrosis and the presence of an 18 x 15-cm heterogeneous echogenic mass in the upper abdomen and right iliac fossa. Abdominal computerized tomography (CT) revealed the presence of a large heterogeneous tumor and an enlarged (4 x 4-cm) retroperitoneal lymph node. Sonoguided needle biopsy of the abdominal mass demonstrated malignant cells of an uncertain type and origin. serum alpha-fetoprotein (AFP) and beta-human chorionic gonadotropin (beta-HCG) concentrations were elevated. Under the diagnosis of metastatic nonseminomatous germ cell tumor in abdominal cryptorchidism, the patient received three cycles of cisplatin-based combination chemotherapy followed by resection of the abdominal residual cryptorchid tumor. Histologically, the tumor showed marked necrosis without viable cancer. The patient had remained free of disease for seven months following surgery.- - - - - - - - - - ranking = 1keywords = cancer (Clic here for more details about this article) |
2/109. gonadoblastoma, mixed germ cell tumor, and Y chromosomal genotype: molecular analysis in four patients.This study reports on Y chromosomal genotypes of three patients with gonadoblastoma and one patient with gonadoblastoma and mixed germ cell tumor. Molecular analysis for 35 Y chromosomal loci was performed for dna samples taken from peripheral leukocytes and lymphoblastoid cell lines, showing that the four patients shared the region between DYS267 at interval 4A and DYF50S1 at interval 6D, with the exception of the region around DYS202 at interval 5K. In the patient with gonadoblastoma and mixed germ cell tumor, Y chromosomal material was preserved in the gonadoblastoma but was lost from the mixed germ cell tumor. The results, in conjunction with previous reports, suggest that GBY (gonadoblastoma locus on the y chromosome) may be located to a roughly 5-Mb pericentromeric region between DYS267 at interval 4A and DYS270 at interval 5A. The presence of Y chromosomal material in gonadoblastoma is consistent with GBY being involved in the development of gonadoblastoma, and the absence of Y chromosomal material in mixed germ cell tumor would be explained as a consequence of Y chromosomal loss from rapidly proliferating gonadal cancer cells.- - - - - - - - - - ranking = 1keywords = cancer (Clic here for more details about this article) |
3/109. Case of gonadoblastoma in a 9-year-old boy without physical abnormalities.BACKGROUND: A 9-year-old boy was admitted to Jikei University Hospital complaining of gradual enlarging of the left scrotal contents. methods/RESULTS: physical examination was significant for bilateral descended testicles. No abnormalities were detected in the testicles or along the spermatic cords. Scrotal ultrasound showed that hyperechoic shadows were recognized in the central area of the left testicle. Subsequent testicular biopsy and histopathological examination showed intratubular malignant germ cells in the testicular tubules. One week later, left orchiectomy was performed. CONCLUSIONS: Histopathological evaluation revealed gonadoblastoma. gonadoblastoma, a rare gonadal neoplasm, is composed of germ cells and sex cord derivatives and usually occurs in phenotypically female patients with gonadal dysgenesis. To date, only three cases of gonadoblastoma have been reported in anatomically normal male patients with scrotal testicles. We report on a case of gonadoblastoma unaccompanied by a germ cell tumor in a physically normal male.- - - - - - - - - - ranking = 0.080946041452195keywords = neoplasm (Clic here for more details about this article) |
4/109. Actinomycin D revisited in testicular cancer. A case report.BACKGROUND: Between 20-30% of patients with advanced germ cell tumors relapse or fail to achieve a complete response to conventional cisplatin based chemotherapy. Ifosphamide has been used very effectively in combination with cisplatin and etoposide (VIP) or in combination with cisplatin and vinblastine (VeIP). Actinomycin D with chlorambucil and methotrexate was widely used in the 1960s with complete responses in 20% of patients and long term survival of 6-10%. There exists no information on the use of actinomycin as a salvage in cisplatin refractory patients. methods AND RESULTS: One patient with metastatic germ cell tumor who failed chemotherapy with cisplatin and ifosphamide was successfully treated with an actinomycin D based regimen. CONCLUSIONS: Actinomycin D is an active agent in testicular cancer and maybe used in patients refractory to platinum.- - - - - - - - - - ranking = 1419.8252259848keywords = testicular cancer, cancer (Clic here for more details about this article) |
5/109. Retroperitoneal germ cell tumor treated by PVeBV chemotherapy: a case report.The extragonadal germ cell tumor are uncommon neoplasms which account for only 1-5% of germ cell tumors, and its prognosis is poor. We report here the use of combination chemotherapy with cisplatin, etoposide, bleomycin, and vinblastine (PVeBV) for the treatment of retroperitoneal germ cell tumor. A 28-year-old male with complaints of abdominal pain and lumbago, without any abnormality in both testes by physical and ultrasonographic examination, showed retroperitoneal tumor by abdominal computed tomography. The serum alpha-fetoprotein and lactate dehydrogenase were elevated. The retroperitoneal tumor was treated surgically. The pathological diagnosis was mixed germ cell tumor. The lung and supraclavicular lymph node metastases disappeared completely after 3 courses of PVeBV chemotherapy with cisplatin (40 mg/m2 per day) and etoposide (100 mg/m2 per day) for 5 consecutive days, with vinblastine (0.2 mg/kg) on day 1, and bleomycin (30 mg/body) given on days 1, 8, and 15. granulocyte colony-stimulating factor and serotonin receptor antagonist application were available on acute phase toxic effects. The patient is now alive and well, without recurrence, more than 26 months after the operation.- - - - - - - - - - ranking = 0.080946041452195keywords = neoplasm (Clic here for more details about this article) |
6/109. Diagnostic value of anti-alpha FP antibody levels in a metastatic germ cell tumor of unknown primary site.BACKGROUND: A 21 year old man with a metastatic germ cell tumor of unknown primary not responding to chemotherapy was scheduled to have a blind bilateral orchiectomy to eradicate the possible primary site although palpation and ultrasonography of the testicles had always been normal. METHOD: The patient underwent a radioimmunoscintigraphy with Anti-alpha FP antibody scan (AFP-Scan). RESULTS: On the basis of the scintigraphic results the patient underwent a left orchiectomy and additionally removal of the lymph node metastases. histology revealed the presence of an in situ carcinoma in the left testis and a mixed tumor present in the abdominal lymph node metastases. Fluorescent in situ hybridization on tumor cells did not show any abnormalities related to chromosome 12, a finding connected with the somatic type of germ cell tumors. CONCLUSION: Anti-alpha FP antibody scan was helpful in detecting the primary site and saving the life of the patient without resulting in hypogonadism.- - - - - - - - - - ranking = 27.910082278626keywords = testis (Clic here for more details about this article) |
7/109. Acute myelogenous leukemia after treatment for malignant germ cell tumors in children.PURPOSE: To identify the long-term sequelae of therapy for malignant germ cell tumors (GCTs). patients AND methods: Between 1980 and 1998, 1,132 patients were prospectively enrolled onto the German nontesticular GCT studies. A total of 442 patients received chemotherapy using combinations of the drugs cisplatin, ifosfamide, etoposide, vinblastine, and bleomycin, and 174 patients were treated with a combination of chemotherapy and radiotherapy. Median follow-up duration was 38 months (range, 6 to 199 months). RESULTS: Six patients developed therapy-related acute myelogenous leukemia (t-AML). There was no t-AML among patients treated with surgery (n = 392) or radiotherapy only (n = 124). The Kaplan-Meier estimates of the cumulative incidence (at 10 years) of t-AML were 1.0% for patients treated with chemotherapy (three of 442) and 4.2% for patients treated with combined chemotherapy and radiotherapy (three of 174). Notably, four of these six patients had been treated according to a standard protocol with modest cumulative chemotherapy doses. Five patients had received less than 2 g/m(2) epipodophyllotoxins, and four patients had received less than 20 g/m(2) ifosfamide. Four patients presented with AML, two with myelodysplasia in transformation to AML. In five patients, cytogenetic aberrations were found, four of which were considered characteristic for t-AML. Four patients died despite antileukemic therapy. One patient is alive but suffered a relapse of his GCT, and one patient is alive and well. No secondary solid neoplasm was observed. CONCLUSION: In patients with AML after treatment for GCT, several pathogenetic mechanisms must be considered. AML might evolve from a malignant transformation of GCT components without any influence of the chemotherapy. On the other hand, the use of alkylators and topoisomerase ii inhibitors is associated with an increased risk of t-AML. Future studies will show if the reduction of treatment intensity in the current protocol reduces the risk of secondary leukemia in these patients.- - - - - - - - - - ranking = 0.080946041452195keywords = neoplasm (Clic here for more details about this article) |
8/109. A case of jejunal intussusception with gastrointestinal bleeding caused by metastatic testicular germ cell cancer.BACKGROUND/AIM: We report an unusual case of metastatic testicular germ cell tumor with its unusual presentation. METHOD: A patient presented to the San Joaquin General Hospital with gastrointestinal bleeding and obstruction and a testicular mass is described. The patient's clinical course is followed and the literature reviewed. RESULTS: The patient presented with jejunal intussusception due to metastatic testicular cancer. He was treated with orchiectomy and bowel resection followed by postoperative chemotherapy. CONCLUSION: This case illustrates the need to consider metastatic small-bowel obstruction and/or intussusception in patients presenting with testicular mass and abdominal pain. copyright copyright 1999 S. Karger AG, Basel- - - - - - - - - - ranking = 287.96504519696keywords = testicular cancer, cancer (Clic here for more details about this article) |
9/109. Rethinking nonseminomatous testicular cancer in U.S. air Force pilots: case presentation and literature review.A U.S. air Force F-15 pilot presented with a painless testicular mass. Nonseminomatous germ cell tumor (NSGCT) of the testis was diagnosed at orchiectomy. Retroperitoneal lymph node dissection (RPLND) yielded pathology stage IIa disease when 2 of 21 abdominal lymph nodes were positive. The patient immediately underwent adjuvant chemotherapy consisting of etoposide and cisplatin. Follow-up tumor markers, abdominal and chest CT scans were negative. Randomized, prospective studies have shown excellent response rates to low volume metastatic disease. This pilot's risk of sudden incapacitation due to this tumor following orchiectomy, RPLND, and immediate adjuvant chemotherapy is below the 1% threshold set forth by the U.S. air Force for unrestricted flying waiver. Chemotherapy for testicular cancer carries significant morbidity risks that may complicate a pilot's return to status and these are reviewed. The overall recovery from chemotherapy is poorly quantified and needs to be further evaluated to optimize a pilot's return to flying status.- - - - - - - - - - ranking = 1447.7353082634keywords = testicular cancer, testis, cancer (Clic here for more details about this article) |
10/109. A lesson in the management of testicular cancer in a patient with a solitary testis.Five per cent of patients with germ cell tumours of the testis will develop a further tumour in the contralateral testis. Standard treatment in such cases is a second orchidectomy, resulting in infertility, hormone replacement, and psychological morbidity. In this case report we explore the role of testis conservation in these patients and also show that there is a risk of removing a potentially normal testis if a histological diagnosis is not sought prior to orchidectomy.- - - - - - - - - - ranking = 1359.1408390168keywords = testicular cancer, testis, cancer (Clic here for more details about this article) |
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