title: Salvage combination chemotherapy with docetaxel, ifosfamide and cisplatin (DIP): successful treatment of a case with metastatic testicular immature teratoma.
abstract: We present a case of metastatic testicular immature teratoma that was successfully treated despite resistance to standard chemotherapy and unsuccessful salvage surgery. At first, BEP (bleomycin, etoposide and cisplatin) treatment was performed but failed. The patient underwent incomplete retroperitoneal lymph node dissection. He was then referred to us. By the time of the referral lung and mediastinal lymph node metastasis had appeared and para-aortic lymph node metastasis had grown larger. We administered the DIP (docetaxel, ifosfamide and cisplatin) regimen as a second line chemotherapy, which was effective with 82% reduction of para-aortic lymph nodes, 88% of mediastinal lymph nodes and 85% of lung metastasis. We performed para-aortic lymph node dissection followed by resection of lung metastasis and mediastinal lymph node dissection. The patient is now followed-up at the outpatient clinic without evidence of recurrent disease 3.5 years after the last surgery.
authors.affiliation: Department of Urology, Tokyo University Hospital, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655, Japan. kume@kuc.biglobe.ne.jp
authors.forename: Haruki
authors.initials: H
authors.lastname: Kume
authors.forename: Shigenori
authors.initials: S
authors.lastname: Kakutani
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Tomita
authors.forename: Tadaichi
authors.initials: T
authors.lastname: Kitamura
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D000077143:Docetaxel; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000556:secondary; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008482:Mediastinum; D016879:Salvage Therapy / Q000379:methods*; D043823:Taxoids / Q000008:administration & dosage; D013724:Teratoma / Q000188:drug therapy* / Q000556:secondary; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000473:pathology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D043823:Taxoids; D000077143:Docetaxel; D002945:Cisplatin; D007069:Ifosfamide