peplomycin and Mediastinal-Neoplasms

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 17 year old male with mediastinal yolk sac tumor is herein reported. His chief complaint was anterior chest pain. Chest X-ray and chest CT indicated a 8 cm diameter mass in the anterior mediastinum. Laboratory analysis revealed 2,578 ng/ml for AFP and 54% for LDH I. HCG and CEA values were normal. Yolk sac tumor was cytologically suspected on needle aspiration specimen. Combined chemotherapy with CDDP, VP16, and PEP brought the AFP and LDH 1 values down to 10 ng/ml and 27%, respectively. The diameter of the mass decreased to 6 cm. The mass was removed together with the thymus and the right upper lobe of the lung. A post operative histological examination of the mass revealed total necrosis. Nine months after the initiation of the therapy, his AFP level was within normal limits. The patient is doing well.

Topics: Adolescent; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cisplatin; Etoposide; Humans; Male; Mediastinal Neoplasms; Mesonephroma; Necrosis; Peplomycin; Remission Induction

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