title: Endodermal sinus tumor of the infant vagina treated exclusively with chemotherapy.
abstract: Endodermal sinus tumor (EST) of the vagina is a rare malignancy usually diagnosed before 3 years of age. Historically, the approach to therapy has included radical surgical resection, with adjuvant irradiation, and chemotherapy. An infant presented with vaginal bleeding, imaging evidence of a vaginal mass and an elevated alpha-fetoprotein level. Examination under anesthesia with vaginal biopsies confirmed the diagnosis of an EST (yolk sac) tumor of the vagina. After 5 cycles of chemotherapy, the alpha-fetoprotein had normalized and repeat vaginal biopsies for suspected residual disease was negative for malignancy. To allow preservation of sexual and reproductive function, chemotherapy as a sole modality of treatment for EST should be considered.
authors.affiliation: Division of Pediatric and Adolescent Gynecology, The Hospital for Sick Children, Toronto, Ontario, Canada. jalacy@stanford.edu
authors.forename: Judith
authors.initials: J
authors.lastname: Lacy
authors.forename: Michael
authors.initials: M
authors.lastname: Capra
authors.forename: Lisa
authors.initials: L
authors.lastname: Allen
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001761:Bleomycin / Q000627:therapeutic use; D002945:Cisplatin / Q000627:therapeutic use; D004334:Drug Administration Schedule; D018240:Endodermal Sinus Tumor / Q000175:diagnosis / Q000188:drug therapy*; D005047:Etoposide / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D014625:Vaginal Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D000509:alpha-Fetoproteins / Q000032:analysis*
chemical_list: D000509:alpha-Fetoproteins; D001761:Bleomycin; D005047:Etoposide; D002945:Cisplatin