peplomycin and Teratoma

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

A 32-year-old man presented with a swelling of the left testis, for which he underwent high inguinal orchiectomy. Histopathological examination of the specimen revealed teratocarcinoma. Further evaluation revealed no metastasis (stage I), and he was followed-up by monthly examination without prophylactic chemotherapy (surveillance). Thirteen months after orchiectomy, AFP and hCG-beta were elevated at 133.8 ng/ml and 0.8 ng/ml respectively. Abdominal CT scan revealed para-aortic masses of recurrent tumor. Although the AFP and hCG-beta levels markedly declined after five courses of COMPE (CDDP, VCR, MTX, PEP, Etoposide) chemotherapy, the retroperitoneal masses had further enlarged and had undergone cystic change. Excision of the residual tumors was performed, and microscopic examination of specimens revealed mature teratoma without malignant components. The diagnosis of the growing teratoma syndrome was therefore made. The growing teratoma syndrome occurs in nonseminomatous testicular germ cell tumors following chemotherapy and is characterized by enlargement of metastatic lesions with normal tumor marker levels. Total surgical resection of the mass yields good results, and tumor is unresponsive to chemotherapy. Early recognition of this syndrome is important for successful treatment.

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Cisplatin; Combined Modality Therapy; Etoposide; Humans; Male; Methotrexate; Orchiectomy; Peplomycin; Syndrome; Teratoma; Testicular Neoplasms; Vincristine

A 32-year-old Japanese male consulted a clinic complaining of gynecomastia. Right painless scrotal swelling was also detected. Right high orchiectomy was performed, then the surgical specimen was histopathologically confirmed as choriocarcinoma and mature teratoma. The imaging revealed cerebral, pulmonary, retroperitoneal metastases. After 3 courses of combination chemotherapy with cisplatin, etoposide and peplomycin (PEP therapy), the brain metastasis completely disappeared and the serum titer of the tumor markers such as beta-HCG became normal. The regression rates of lung and retroperitoneal metastases were 68% and 27%, respectively. Therefore, retroperitoneal lymph node dissection was performed. After the 5th course of PEP therapy, lung metastases disappeared completely. Until the present, no evidence of disease has persisted. The PEP therapy, which is a salvage therapy for refractory testicular cancer, was performed as first-line chemotherapy in this case. It was an excellent modality against choriocarcinoma, along with the surgical treatment.

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Brain Neoplasms; Chemotherapy, Adjuvant; Choriocarcinoma; Cisplatin; Etoposide; Humans; Lung Neoplasms; Lymph Node Excision; Male; Neoplasms, Multiple Primary; Orchiectomy; Peplomycin; Remission Induction; Retroperitoneal Neoplasms; Teratoma; Testicular Neoplasms

PVP (CDDP, VBL, PEP) regimens were administered to a case of ovarian embryonal carcinoma (Higuchi-Kato) Group C, which had metastatic lesions of liver, lumbar bones, and paraaortic lymph nodes soon after operation, with good results.

Topics: Adolescent; alpha-Fetoproteins; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cisplatin; Female; Humans; Neoplasm Metastasis; Ovarian Neoplasms; Peplomycin; Remission Induction; Teratoma; Vinblastine

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

A 38-year-old man was admitted to Nara Medical University Hospital on Feb.7,1983, because of swelling of the scrotal contents on the right side and elevated serum AFP, beta-HCG and LDH suggestive of testicular tumor. Right orchiectomy was carried out and a pathological diagnosis of embryonal cell carcinoma of the right testis (pT3N0M1) was made. The patient, upon evidence of multiple pulmonary metastases, was treated with a combination chemotherapy of cis-Diamminedichloroplatinum, vincristine and peplomycin. After three courses of combination chemotherapy, pulmonary metastases were decreased, but their foci persisted. The patient was then treated with Etoposide 62 mg/m2 daily for 5 days every three weeks, and after this course, complete remission of pulmonary metastases was obtained. The patient recieved 3 courses of Etoposide and retroperitoneal lymph node dissection, and has since shown no evidence of disease for 2 years and 4 months after surgery.

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cisplatin; Combined Modality Therapy; Drug Administration Schedule; Etoposide; Humans; Lung Neoplasms; Lymph Node Excision; Male; Peplomycin; Podophyllotoxin; Teratoma; Testicular Neoplasms; Vincristine