title: [A non-seminomatous extra-gonadal germ cell tumor responding to intensive treatment: a case report].
abstract: A 23-year-old man presented with lumbago as a chief complaint. Computed tomographic (CT) scan revealed multiple lung tumors, multiple liver tumors, bulky retroperitoneal tumors with marked elevation of serum lactic dehydrogenase (LDH), alpha-fetoprotein, and beta subunit of human chorionic gonadotropin (HCG-beta). The patient was referred to our hospital for treatment. Scrotal ultrasonography and physical examination revealed bilateral normal testes. Because of bulky retroperitoneal masses with elevated specific tumor markers as well as bilateral normal testes, our diagnosis led to extra-gonadal germ cell tumor. Because the pulmonary lesion had increased rapidly, chemotherapy was performed without the tumor biopsy. After multiple chemotherapy regimens including BEP (bleomycin, etoposide, cisplatin), high-dose chemotherapy, and TIN (paclitaxel, ifosfamide, nedaplatin), all tumor marker levels fell into within the normal range. The tumor size was decreased remarkably on CT. Then, retroperitoneal lymphadenectomy were performed to confirm whether they still contained viable tumor cells. They contained only necrotic tissues without viable cancer cells by pathological examination. Consequently, the patient has been free of recurrence for 18 months after intensive treatment.
authors.affiliation: The Department of Urology, The University of Tokushima.
authors.forename: Akinori
authors.initials: A
authors.lastname: Harada
authors.forename: Yasuyo
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Taue
authors.forename: Tomoteru
authors.initials: T
authors.lastname: Kishimoto
authors.forename: Shuji
authors.initials: S
authors.lastname: Tanimoto
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Izaki
authors.forename: Masayuki
authors.initials: M
authors.lastname: Takahashi
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Fukumori
authors.forename: Masa-aki
authors.initials: MA
authors.lastname: Nishitani
authors.forename: Hiro-omi
authors.initials: HO
authors.lastname: Kanayama
authors.forename: Hideki
authors.initials: H
authors.lastname: Hayashi
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001761:Bleomycin / Q000627:therapeutic use; D002945:Cisplatin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005047:Etoposide / Q000627:therapeutic use; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000628:therapy; D008175:Lung Neoplasms / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000175:diagnosis / Q000628:therapy*; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D017239:Paclitaxel / Q000008:administration & dosage; D012186:Retroperitoneal Neoplasms / Q000175:diagnosis / Q000628:therapy*
chemical_list: D009944:Organoplatinum Compounds; D001761:Bleomycin; D005047:Etoposide; C053989:nedaplatin; D017239:Paclitaxel; D002945:Cisplatin; D007069:Ifosfamide