title: Therapy-associated secondary tumors in patients with non-germinomatous malignant germ cell tumors.
abstract: We report three patients with non-germinomatous malignant germ cell tumor (NGMGCT) who developed therapy-associated secondary tumors. They were diagnosed as having NGMGCT by elevated serum levels of α-fetoprotein (AFP), human chorionic gonadotropin (HCG), or β-HCG. Preoperatively, all patients received a combination of etoposide and platinum-based chemotherapy and radiotherapy; neo-adjuvant therapy (NAT) was followed by complete excision of the residual tumor. Postoperatively, all underwent maintenance chemotherapy and all remained free of NGMGCT without recurrence. However, they developed therapy-associated secondary tumors, i.e. glioblastoma, meningioma, or cavernous angioma after 10.1, 9.8, and 8.2 years, respectively. The patient with glioblastoma died one year after its detection. The other two patients are currently alive; the meningioma was completely removed and the cavernous angioma is being monitored without additional treatment. To the best of our knowledge, therapy-associated secondary tumors in patients treated for NGMGCT are rare.
authors.affiliation: Department of Neurosurgery, Graduate School of Life Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan. hnakamur@fc.kuh.kumamoto-u.ac.jp
authors.forename: Hideo
authors.initials: H
authors.lastname: Nakamura
authors.forename: Keishi
authors.initials: K
authors.lastname: Makino
authors.forename: Yukitaka
authors.initials: Y
authors.lastname: Ushio
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Arima
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Kuratsu
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000378:metabolism; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D005909:Glioblastoma / Q000209:etiology*; D006392:Hemangioma, Cavernous / Q000209:etiology*; D006801:Humans; D060046:Maintenance Chemotherapy; D008297:Male; D008577:Meningeal Neoplasms / Q000209:etiology*; D018365:Neoplasm, Residual / Q000139:chemically induced; D009373:Neoplasms, Germ Cell and Embryonal / Q000150:complications* / Q000628:therapy*; D016609:Neoplasms, Second Primary / Q000209:etiology*; D011379:Prognosis; D015996:Survival Rate; D055815:Young Adult; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: D014408:Biomarkers, Tumor; D018997:Chorionic Gonadotropin, beta Subunit, Human; D000509:alpha-Fetoproteins; D005047:Etoposide; D002945:Cisplatin