Endodermal sinus tumor of the vagina: radiation therapy and progeny.
BACKGROUND
Extraovarian endodermal sinus tumor generally originates in the vagina or cervix of young girls. Some 50 cases are known, all younger than 3 years of age. Many were treated with outdated regimens, and there are 5-year survival data on only nine of them. We describe a curative outcome of primary radiation only.


METHODS
A 40-year-old woman had a history of localized endodermal sinus tumor of the vagina, stage I, treated by brachytherapy at the age of 6 months. Radiation had a severe impact upon the later functioning of her pelvic organs, with marked deformity of the pelvic floor, vagina, urethra, and bones of the pelvic outlet. She conceived by homologous insemination at the age of 34. Delivery was by cesarean at 31.5 weeks' gestation.


CONCLUSIONS
Current forms of management give preference to limited excisional surgery and multi-agent chemotherapy, analogous to that used for the treatment of endodermal sinus tumor of the ovary. This is the first report of a patient treated by radium needles and the only known patient who had a subsequent pregnancy.
Aartsen
E J
EJ
Netherlands Cancer Institute, Amsterdam.
Delemarre
J F
JF
Gerretsen
G
G
D000328:Adult; D001918:Brachytherapy / Q000009:adverse effects*; D002585:Cesarean Section; D005260:Female; D005836:Genitalia, Female / Q000528:radiation effects; D006801:Humans; D007317:Insemination, Artificial, Homologous; D008649:Mesonephroma / Q000453:epidemiology / Q000532:radiotherapy*; D011247:Pregnancy; D011788:Quality of Life; D011832:Radiation Injuries / Q000209:etiology*; D013997:Time Factors; D014625:Vaginal Neoplasms / Q000453:epidemiology / Q000532:radiotherapy*