peplomycin and Endodermal-Sinus-Tumor

There is a therapeutic dilemma for the pregnant patient with malignancy requiring chemotherapy.. We had a case of a 30-year-old pregnant woman with a yolk sac tumor who underwent right salpingo-oophorectomy at 22 weeks gestation. Chemotherapy during pregnancy was postponed because of concern with the risks of the chemotherapy to the fetus. After the operation, L2 fraction of alpha-fetoprotein (AFP) depending on the affinity for Lens culinaris agglutinin (LCA) as an indicator for a maternal source of AFP had been detectable since 30 weeks gestation and elevated rapidly with advancing gestation. Tumor recurrence was confirmed clinically at 34 weeks gestation. She was induced, delivering a healthy baby, and received seven complete chemotherapy courses (cisplatin, etoposide, and peplomycin). Currently, the mother (39 months after last chemotherapy) and child are doing well.. AFP-L2 may be a sensitive indicator for a yolk sac tumor derived AFP, leading to an earlier detection of tumor recurrence during pregnancy.

Topics: Adult; alpha-Fetoproteins; Antineoplastic Combined Chemotherapy Protocols; Cisplatin; Endodermal Sinus Tumor; Etoposide; Female; Humans; Ovarian Neoplasms; Peplomycin; Plant Lectins; Pregnancy; Pregnancy Complications, Neoplastic

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Chemotherapy, Adjuvant; Cisplatin; Diagnosis, Differential; Endodermal Sinus Tumor; Etoposide; Female; Humans; Magnetic Resonance Imaging; Ovarian Neoplasms; Peplomycin; Teratoma

We report a case of pure yolk sac tumor of the left testis in a 22-year-old male. He consulted a physician with left back pain and induration of his left scrotal content in December, 1992. Intravenous pyelography (IVP) revealed left hydronephrosis. Computerized tomography (CT) revealed para-aortic lymph node swelling and lung metastases. Left high inguinal orchiectomy was performed. Histopathological diagnosis was pure yolk sac tumor. After two courses of "COMPE" chemotherapy consisting of cisplatin, vincristine, methotrexate, peplomycin and etoposide, two courses of "high dose "COMPE" chemotherapy and three courses of "high dose COME" chemotherapy without peplomycin, he achieved a partial response (the regression rate of the pulmonary metastases and the retroperitoneal lymph node metastasis were 100% and 96.0% on CT, respectively) and the residual masses in the retroperitoneum were removed. Necrosis and xanthogranulomatous fibrosis were found in the resected material. The patient showed no evidence of disease two years after chemotherapy.

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Cisplatin; Endodermal Sinus Tumor; Etoposide; Humans; Male; Methotrexate; Peplomycin; Remission Induction; Testicular Neoplasms; Vincristine

Primary endodermal sinus tumor (yolk sac tumor) of the mediastinum is uncommon. Most patients are young and male, and the great majority of tumors are found in the anterior mediastinum. We report a case of primary posterior mediastinal endodermal sinus tumor occurring in a female patient. Surgical excision was performed and three courses of combination chemotherapy were subsequently given. The serum alpha-fetoprotein level returned to normal.

Topics: Adolescent; alpha-Fetoproteins; Antineoplastic Combined Chemotherapy Protocols; Cisplatin; Combined Modality Therapy; Endodermal Sinus Tumor; Etoposide; Female; Humans; Mediastinal Neoplasms; Peplomycin

A case of metastatic infantile yolk sac tumor of testis is reported herein. The patient was 23 months old with a painless swelling of the right scrotal contents. Histological examination revealed yolk sac tumor. Six months later, the serum alpha-fetoprotein (AFP) was re-elevated and solitary lung metastasis had developed. After 4 courses of chemotherapy with cisplatin (CDDP), vincristine (VCR), methotrexate (MTX), peplomycin (PEP) and Etoposide (COMPE), serum AFP was normalized and lung metastasis disappeared. He has shown no evidence of disease for 5 years with normal physical growth. Aggressive chemotherapy including CDDP might be used for Stage III infantile testicular cancer.

Topics: Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cisplatin; Endodermal Sinus Tumor; Etoposide; Humans; Infant; Lung Neoplasms; Male; Methotrexate; Peplomycin; Remission Induction; Testicular Neoplasms; Vincristine