Successful treatment of recurrent malignant germ cell tumors: report of two cases.
We report two patients with recurrent malignant germ cell tumors who were successfully treated with radiation therapy and cisplatin combination chemotherapy. Patient 1, who had a suprasellar mixed yolk sac tumor, had been free of tumor for 3.5 years after cisplatin/vinblastine/bleomycin combination chemotherapy alone but showed a recurrent tumor in the pineal region. In Patient 2, who had a pineal alpha-fetoprotein-producing tumor, recurrent tumors appeared in the lateral ventricle 3 years after the tumor was controlled by radiation and cisplatin/vinblastine/bleomycin therapy. They were treated successfully again by radiation therapy, followed by cisplatin and etoposide combination therapy, and they have been free of tumor for 5.5 and 7 years after recurrence, respectively. The total dose of cisplatin in both patients exceeded 1,000 mg/m2, which would have contributed to the control of the recurrent tumors. Anterior pituitary dysfunction observed in Patient 1 did not improve, even after tumor disappearance by chemotherapy, suggesting severe damage to the neurohypophysis by direct invasion of the tumor.
Matsutani
M
M
Department of Neurosurgery, Tokyo Metropolitan Komagome Hospital, Japan.
Asai
A
A
Fujimaki
T
T
Nakamura
O
O
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy; D002648:Child; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D018240:Endodermal Sinus Tumor / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy; D010870:Pineal Gland / Q000187:drug effects / Q000473:pathology / Q000528:radiation effects; D010871:Pinealoma / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy; D010902:Pituitary Gland / Q000473:pathology; D010911:Pituitary Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy; D011879:Radiotherapy Dosage; D014057:Tomography, X-Ray Computed