peplomycin and Dysgerminoma

A case of bilateral testicular germ cell tumors in a 23-year-old male is reported. He was admitted to the Department of Urology, Yamagata Prefecture Kahoku Hospital with the chief complaint of painless swelling in the left intrascrotal contents. Left high inguinal orchiectomy was carried out. At the same time, right hydrocele operation and right testicular biopsy were performed. Subsequent histological examination revealed anaplastic seminoma in the left testis and typical seminoma in the right. On July 21, 1988, he was referred to our clinic and right high inguinal orchiectomy was carried out. Postoperative chemotherapy was performed with CDDP, VP-16 and peplomycin, and postoperative course was uneventful with no distant metastasis or local recurrence. A total of 136 cases of bilateral testicular germ cell tumors in the Japanese literature are reviewed.

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cisplatin; Combined Modality Therapy; Dysgerminoma; Humans; Male; Orchiectomy; Peplomycin; Testicular Neoplasms

The evolution of therapy for malignant ovarian germ cell tumors is one of the true success stories in oncology. Treatment outcome has improved greatly thanks to cisplatin-based combination chemotherapy. According to the well-established treatment guidelines for advanced cases, we treated a case of stage IV undifferentiated germ cell tumor in which we were able to preserve the patient's fertility. We concluded that the PEP regimen is an effective treatment for the patient with metastatic germ cell tumor.

Topics: Adult; Airway Obstruction; Antineoplastic Combined Chemotherapy Protocols; Cisplatin; Combined Modality Therapy; Diagnosis, Differential; Dysgerminoma; Etoposide; Female; Head and Neck Neoplasms; Humans; Neoplasm Staging; Peplomycin; Radionuclide Imaging; Tomography, X-Ray Computed

A 37-year-old male was presented with an upper abdominal mass. A retroperitoneal bulky tumor was detected and operative biopsy revealed seminoma. The right testis was undescended and atrophic which was located at the left inguinal lesion. Pathologically, the primary tumor cells were not found in the left orchiectomied testis, but only scar and fibrosis were compatible with a burned-out testicular tumor. This patient showed partial regression by multidisciplinary therapy including combined chemotherapy with CDDP, etoposide and peplomycin, and is still on the same condition and alive for 3 years. In case of extragonadal germ cell tumor without apparent testicular involvement, it is a problem to differentiate primary extragonadal germ cell tumor from occult and burned-out testicular tumor. Testis should be examined by all means available including careful exploration.

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cisplatin; Combined Modality Therapy; Cryptorchidism; Dysgerminoma; Etoposide; Humans; Male; Peplomycin; Radiotherapy Dosage; Retroperitoneal Neoplasms

A 28-year-old man, evidencing a painless swelling of the right scrotal content, was admitted and, after a diagnosis of a right testicular tumor, a right high orchiectomy was performed. A histological examination of the right testicular tumor revealed a seminoma. Eleven months after this operation, the patient returned, complaining of a painful swelling of the left testis. An examination revealed that his alpha-fetoprotein (AFP) was elevated (3319 ng/ml). A left high orchiectomy was performed after he was diagnosed as a non-seminomatous tumor. Later, a histological examination revealed, however, an embryonal carcinoma. Two months after the second operation, a metastases of right supra-clavicular lymph nodes was uncovered and adjuvant chemotherapy was started. Although he died from the progression of this metastases, at autopsy, the retroperitoneal and para-aortic metastatic lymph nodes revealed a mature teratomatous and embryonal carcinoma.

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cisplatin; Combined Modality Therapy; Dysgerminoma; Etoposide; Humans; Male; Neoplasms, Multiple Primary; Peplomycin; Teratoma; Testicular Neoplasms; Vinblastine

Topics: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cisplatin; Doxorubicin; Dysgerminoma; Humans; Male; Middle Aged; Peplomycin; Remission Induction; Teratoma; Testicular Neoplasms

Two patients with advanced germ cell tumor who entered complete remission following intensive combination chemotherapy, radiation therapy and surgical intervention are reported. A 28-year-old businessman presented with abdominal pain and masses associated with an elevated HCG level for which he underwent exploratory laparotomy. Large retroperitoneal masses were found and microscopical examination of the masses were revealed seminoma. Three courses of combination chemotherapy consisting of CDDP, VLB and PEP were given to the patient followed by radiation therapy to the parailiac, paraaortic, mediastinal and supraclavicular lymph nodes with boost irradiation to the paraaortic lymph nodes where the large masses were located. The other patient was a 21-year-old student who developed sharp precordial chest pain which proved to be due to a large mediastinal mass accompanied by an elevated AFP level. He was treated with radiation therapy to the mediastinum, surgical resection and combination chemotherapy. However, he showed recurrence in the lungs associated with rising AFP levels, and was given a salvage chemotherapy consisting of 3 courses of CDDP, ADR, PEP and Etoposide. Both patients were successfully treated with combined modalities of treatment including intensive chemotherapy and have been off therapy without recurrence for over 12 and 4 months, respectively.

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cisplatin; Combined Modality Therapy; Cryptorchidism; Doxorubicin; Dysgerminoma; Etoposide; Humans; Male; Mediastinal Neoplasms; Peplomycin; Retroperitoneal Neoplasms; Testicular Neoplasms

Topics: Adult; alpha-Fetoproteins; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cisplatin; Combined Modality Therapy; Dysgerminoma; Humans; Male; Mediastinal Neoplasms; Peplomycin; Vinblastine