mercaptopurine and Uterine-Neoplasms

Thymic carcinoma associated with acute monocyte leukemia (AMoL) and a history of choriocarcinoma was diagnosed in a 58-year-old female. We found no other such case in a literature search. She was first treated with DCMP therapy: daunorubicin, cytosine arabinoside, 6MP-riboside, and prednisolone against AMoL. After induction chemotherapy, complete AMoL remission was attained. Chest CT scan after chemotherapy revealed regression of the mediastinal tumor. Resection of the tumor included the left upper lobe of the lung, phrenic nerve and pericardium. Pathological diagnosis showed poorly or moderately differentiated squamous cell carcinoma. Although the patient died of pneumonia during chemotherapy for relapsed AMoL, chest X-ray and CT revealed no recurrence of the mediastinal tumor after the original operation. Judging from this case and other successful cases of chemotherapy, we feel that intensive chemotherapy may be a beneficial strategy against thymic carcinoma.

Topics: Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Squamous Cell; Choriocarcinoma; Combined Modality Therapy; Cytarabine; Daunorubicin; Female; Humans; Leukemia, Monocytic, Acute; Mercaptopurine; Middle Aged; Neoplasms, Multiple Primary; Prednisolone; Thymus Neoplasms; Uterine Neoplasms

Trophoblastic tumors are among the rare diseases in this country. The most important clinical aspects are demonstrated by references and personal experiences in the treatment of trophoblastic tumors. In many countries (SU, USA, GB, Japan) the treatment of trophoblastic tumors has been centralized.--The therapeutical strategy is based on histology, stage and other important prognostic factors. Most important is chemotherapy with antineoplastic substances. Surgery and radiation are to be used only under appropriate indication. After treatment the control of the HCG-values by radioimmunassay is of high importance for the early diagnosis of relapse.--All facts demonstrate, that also in the GDR a stronger centralization of the treatment of trophoblastic tumors should be attained.

Topics: Choriocarcinoma; Chorionic Gonadotropin; Dactinomycin; Drug Therapy, Combination; Female; Humans; Mercaptopurine; Methotrexate; Neoplasm Invasiveness; Neoplasm Metastasis; Pregnancy; Prognosis; Trophoblastic Neoplasms; Uterine Neoplasms

Topics: Chemotherapy, Cancer, Regional Perfusion; Chlorambucil; Choriocarcinoma; Chorionic Gonadotropin; Cyclophosphamide; Dactinomycin; Drug Therapy, Combination; Female; Gonadal Steroid Hormones; Humans; Hysterectomy; Mercaptopurine; Methotrexate; Neoplasm Metastasis; Ovarian Neoplasms; Postoperative Care; Pregnancy; Trophoblastic Neoplasms; Uterine Neoplasms; Vinblastine

Topics: Alkylating Agents; Aminopterin; Chlorambucil; Choriocarcinoma; Chorionic Gonadotropin; Dactinomycin; Diet; Female; Hormones, Ectopic; Humans; Hydatidiform Mole; Hydatidiform Mole, Invasive; Isoantigens; Male; Mercaptopurine; Methotrexate; Neoplasm Metastasis; Pregnancy; Socioeconomic Factors; Testicular Neoplasms; Transplantation Immunology; Trophoblastic Neoplasms; Uterine Neoplasms; Vincristine

Advances in the management of gestational trophoblastic tumor have been made during the last three decades. Individualization of the therapy is one of the major advances. A number of risk factors has proved to predict accurately the prognosis of each patient. A few systems were currently in use, but difficult in putting them to practical use in the different geographical areas. At National Taiwan University Hospital from 1965 to 1979, 65 patients treated by chemotherapy were analyzed with respect of various prognostic factors. The score was assigned according to the mortality rate of each item to each prognostic factor, and thus established a scoring system which is suitable for the use in Taiwan. After establishment of our scoring system, 51 patients from 1980 to 1986 were treated according to the system and the appropriate therapeutic regimens. The outcome of these patients and toxicity of the different therapeutic regimens are presented.

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Choriocarcinoma; Cyclophosphamide; Doxorubicin; Drug Evaluation; Etoposide; Female; Humans; Leucovorin; Leukopenia; Liver; Mercaptopurine; Methotrexate; Middle Aged; Pregnancy; Pregnancy Complications, Neoplastic; Prognosis; Remission Induction; Risk Factors; Taiwan; Trophoblastic Neoplasms; Uterine Neoplasms

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Bone Marrow; Cytarabine; Daunorubicin; Drug Resistance; Female; Humans; Leukemia, Myeloid, Acute; Mercaptopurine; Remission Induction; Tumor Cells, Cultured; Uterine Neoplasms

Large dosage of 5-fluorouracil given by slow intravenous infusion has proved to be very effective in the treatment of gestational trophoblastic neoplasms. From 1965 through 1975, 5-fluorouracil was used as a single chemotherapeutic agent in 173 cases of invasive mole and 139 cases of choriocarcinoma. Complete remission was achieved in 84.9% of cases of invasive mole and in 59.3% of cases of choriocarcinoma when 5-fluorouracil was used as the initial treatment. Seven recurrences with three deaths occurred during follow-up in 216 patients who had achieved complete remission, providing a recurrence rate of 3.2% and recurrence death rate of 1.4%. All of the survivors were followed up for more than 5 years and 85.6% for more than 10 years. Toxicity of 5-fluorouracil was milder and less frequent than that of 6-mercaptopurine or methotrexate. The toxic reaction specific to 5-fluorouracil was diarrhea, which can result in pseudomembranous colitis if improperly treated. One of the two toxic deaths was due to this complication.

Topics: Choriocarcinoma; Diarrhea; Female; Fluorouracil; Follow-Up Studies; Humans; Hydatidiform Mole, Invasive; Mercaptopurine; Methotrexate; Neoplasm Recurrence, Local; Pregnancy; Uterine Neoplasms

Trophoblastic disease of pregnancy presents a continuous spectrum ranging from the non-invasive mole to the choriocarcinoma; modern chemotherapy has radically changed the prognosis of the latter. A pregnancy without mole was followed by choriocarcinoma with a high titer of chorionic gonadotrophin and vaginal, pelvic, and pulmonary metastasis, clinically apparent shortly after premature delivery. Neurologic phocality was manifested a few days before the onset of labour, and its relationship with the basic disease is discussed. A definitive cure was obtained by intermittent massive chemotherapy along with surgical resection of an isolated thyroid metastasis (a previously unreported location) and, posteriorly, of a pulmonary metastasis, both appearing during chemotherapy. The control of the therapeutic response by periodical monitoring of chorionic gonadotrophin levels is necessary in order to detect resistance to therapy and, eventually, to confirm definitive cure of the disease.

Topics: Adult; Antineoplastic Agents; Choriocarcinoma; Chorionic Gonadotropin; Cyclophosphamide; Dactinomycin; Drug Therapy, Combination; Female; Humans; Mercaptopurine; Methotrexate; Neoplasm Metastasis; Pregnancy; Pregnancy Complications; Uterine Neoplasms

Topics: Chorionic Gonadotropin; Dactinomycin; Drug Therapy, Combination; Female; Humans; Mercaptopurine; Methotrexate; Pregnancy; Trophoblastic Neoplasms; Uterine Neoplasms

The reproductive performance of 36 women who had been successfully treated for gestational trophoblastic tumors with multiple courses of cytotoxic agents including methotrexate, 6-mercaptopurine, actinomycin D, and 6-azauridine, between 1962 and 1972, has been studied in comparison with 36 patients who had spontaneously aborted a hydatidiform mole but received no treatment and a control group consisting of 36 women attending an antenatal clinic. The majority of patients who wanted further pregnancies following chemotherapy had one or more successful conceptions. The incidence of abnormal pregnancies in the treated group was higher than that of the control group. Similarly, there was a higher number of abnormal pregnancies in the untreated mole patients when compared with the control group. This suggests that patients who develop trophoblastic tumors tend to have a poor obstetric history and that this is not significantly worsened by chemotherapy.

Topics: Abnormalities, Drug-Induced; Antineoplastic Agents; Azauridine; Child; Child, Preschool; Dactinomycin; Drug Therapy, Combination; Female; Follow-Up Studies; Humans; Hydatidiform Mole; Infant; Infant, Newborn; Leucovorin; Male; Mercaptopurine; Methotrexate; Pregnancy; Pregnancy Complications; Trophoblastic Neoplasms; Uterine Neoplasms

Gestational trophoblastic malignancy, although rare, offers the clinician the opportunity of being able to cure a malignant disease with cytotoxic chemotherapy. Such an opportunity is fulfilled only when the progress of the post-molar patients is monitored and chemotherapy instituted as soon as the malignant transformation of the mole is documented. The management and treatment of nine cases is presented and discussed.

Topics: Adult; Choriocarcinoma; Female; Humans; Hysterectomy; Leucovorin; Mercaptopurine; Methotrexate; Pregnancy; Uterine Neoplasms

Topics: Adult; Antineoplastic Agents; Choriocarcinoma; Colchicine; Dactinomycin; Daunorubicin; Female; Flavonoids; Humans; Lung Neoplasms; Melphalan; Mercaptopurine; Methotrexate; Middle Aged; Mitomycins; Neoplasm Metastasis; Olivomycins; Pneumonectomy; Pregnancy; Uterine Neoplasms; Vinblastine

Topics: Adult; Choriocarcinoma; Dactinomycin; Drug Therapy, Combination; Female; Humans; Mercaptopurine; Methotrexate; Neoplasm Metastasis; Pregnancy; Russia; Streptonigrin; Time Factors; Trophoblastic Neoplasms; Uterine Neoplasms

Topics: Adolescent; Adult; Antineoplastic Agents; Choriocarcinoma; Cyclophosphamide; Dactinomycin; Female; Follow-Up Studies; Head and Neck Neoplasms; Hemangiosarcoma; Humans; Infant; Lung Neoplasms; Male; Mechlorethamine; Mercaptopurine; Methotrexate; Middle Aged; Neoplasm Metastasis; Pregnancy; Prostatic Neoplasms; Sarcoma; Teratoma; Testicular Neoplasms; Thoracic Neoplasms; Thyroid Neoplasms; Triaziquone; Uterine Neoplasms; Vinblastine

Topics: Adult; Angiography; Choriocarcinoma; Dactinomycin; Female; Humans; Iliac Vein; Mercaptopurine; Phlebography; Pregnancy; Pulmonary Artery; Pulmonary Embolism; Radionuclide Imaging; Uterine Neoplasms; Vena Cava, Inferior

Topics: Adult; Female; Humans; Mercaptopurine; Methotrexate; Neoplasm Metastasis; Pregnancy; Pregnancy Complications; Prognosis; Trophoblastic Neoplasms; Uterine Neoplasms

Topics: Adult; Choriocarcinoma; Female; Humans; Hydatidiform Mole; Hysterectomy; Mercaptopurine; Methotrexate; Neoplasm Metastasis; Postoperative Complications; Pregnancy; Remission, Spontaneous; Thoracic Neoplasms; Uterine Neoplasms

Topics: Adult; Blood Transfusion; Brain; Brain Neoplasms; Cerebral Angiography; Cerebrovascular Disorders; Choriocarcinoma; Dactinomycin; Encephalitis; Female; Headache; Hemiplegia; Humans; Mercaptopurine; Methotrexate; Middle Aged; Neoplasm Metastasis; Neurologic Manifestations; Pregnancy; Seizures; Uterine Neoplasms

Topics: Adult; Castration; Choriocarcinoma; Female; gamma-Globulins; Humans; Hysterectomy; Mercaptopurine; Methotrexate; Pregnancy; Uterine Neoplasms

Topics: Adenocarcinoma; Antineoplastic Agents; Chlorambucil; Colchicine; Culture Techniques; Cyclophosphamide; Dactinomycin; Female; Floxuridine; Fluorouracil; Hodgkin Disease; Humans; Melphalan; Mercaptopurine; Methotrexate; Nandrolone; Neoplasms; Nitrogen Mustard Compounds; Norethindrone; Prednisolone; Progesterone; Testosterone; Thiotepa; Uterine Neoplasms; Vinblastine

Topics: Abortion, Missed; Abortion, Threatened; Adult; Choriocarcinoma; Chorionic Gonadotropin; Diagnosis, Differential; Female; Humans; Hysterectomy; Mercaptopurine; Methotrexate; Neoplasm Metastasis; Pregnancy; Uterine Neoplasms; Vaginal Neoplasms

Topics: Adult; Angiography; Antineoplastic Agents; Chorionic Gonadotropin; Female; Humans; Infusions, Parenteral; Leucovorin; Mercaptopurine; Methotrexate; Pregnancy; Trophoblastic Neoplasms; Uterine Neoplasms

Topics: Antineoplastic Agents; Choriocarcinoma; Cyclophosphamide; Dactinomycin; Female; Humans; Hydatidiform Mole; Hydatidiform Mole, Invasive; Mechlorethamine; Mercaptopurine; Methotrexate; Pregnancy; Uterine Neoplasms; Vinblastine

Topics: Antisepsis; Choriocarcinoma; England; Female; Hospitals; Humans; Hydatidiform Mole; Intensive Care Units; Mercaptopurine; Methotrexate; Pregnancy; Toxicology; Trophoblastic Neoplasms; Uterine Neoplasms

Topics: Choriocarcinoma; Female; Humans; Hydatidiform Mole, Invasive; Lung Neoplasms; Mercaptopurine; Neoplasm Metastasis; Neoplasms; Pregnancy; Prognosis; Surgical Procedures, Operative; Uterine Neoplasms

Topics: Angiography; Choriocarcinoma; Chorion; Female; Humans; Hydatidiform Mole; Mercaptopurine; Methotrexate; Neoplasms; Pregnancy; Surgical Procedures, Operative; Uterine Neoplasms; Vinblastine

Topics: Antineoplastic Agents; Choriocarcinoma; Female; Humans; Hydatidiform Mole, Invasive; Mercaptopurine; Pregnancy; Uterine Neoplasms

Topics: Antineoplastic Agents; Brain Neoplasms; Castration; Choriocarcinoma; Female; Humans; Hydatidiform Mole, Invasive; Hysterectomy; Lung Neoplasms; Mercaptopurine; Methotrexate; Neoplasm Metastasis; Neoplasms; Pregnancy; Trophoblastic Neoplasms; Uterine Neoplasms

Topics: Choriocarcinoma; Electrocardiography; Female; Humans; Hydatidiform Mole; Lung Neoplasms; Mercaptopurine; Methotrexate; Neoplasm Metastasis; Pregnancy; Uterine Neoplasms