title: Successful treatment of mediastinal seminoma in a hemodialysis patient.
abstract: BACKGROUND
  Extragonadal germ cell tumors (GCTs) are relatively uncommon neoplasms, affecting primarily men during the third and fourth decades of life.
  
  
  METHODS
  We describe an unusual case of mediastinal seminoma in a 21-year-old male on chronic peritoneal dialysis for renal failure of uncertain etiology. The patient was treated with chemotherapy consisting of etoposide and cisplatin (EP) combined with hemodialysis. Cisplatin (20 mg/m(2)), and etoposide (50 mg/m(2)) were given on days 1, 3, and 5 for induction. Hemodialysis was started 1 h after completion of etoposide infusion. Following this course of treatment, another 4 cycles of cisplatin (20 mg/m(2)), and etoposide (50 mg/m(2)) were given on successive days from day 1 to 5. Hemodialysis was carried out daily, prior to the start of chemotherapy. Subcutaneous PEG-filgrastim was given on day 6 in all cycles. The patient's status after the first post-induction treatment was complicated by a pseudomonas infection. Tumor response to chemotherapy was prompt with remission lasting to date, 17 months after diagnosis.
  
  
  CONCLUSIONS
  This case report is the second description of chemotherapy given to a hemodialysis patient with extragonadal GCT. We suggest that treatment with EP combined with hemodialysis according to the presented protocol is feasible, and may result in a favorable outcome.
authors.affiliation: Department of Oncology, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel. irinalaz@Clalit.org.il
authors.forename: Irena
authors.initials: I
authors.lastname: Lazarev
authors.forename: Leonid
authors.initials: L
authors.lastname: Bogomolni
authors.forename: Noa
authors.initials: N
authors.lastname: Shani-Shrem
authors.forename: Alla
authors.initials: A
authors.lastname: Shnaider
authors.forename: Samuel
authors.initials: S
authors.lastname: Ariad
authors.forename: Wilmosh
authors.initials: W
authors.lastname: Mermershtain
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D002945:Cisplatin / Q000008:administration & dosage; D000075202:Contraindications; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000534:rehabilitation*; D008297:Male; D006435:Renal Dialysis; D018239:Seminoma / Q000150:complications / Q000188:drug therapy*; D013736:Testicular Neoplasms / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D005047:Etoposide; D002945:Cisplatin