title: Alpha-fetoprotein surge following high-dose chemotherapy in germ cell tumours.
abstract: In patients with non-seminomatous germ cell tumours (NSGCTs) who receive chemotherapy and have residual disease, a persistently elevated serum marker level after induction chemotherapy indicates active and progressive disease. High-dose chemotherapy (HDCT) is the standard treatment for patients with relapsed NSGCT. We present a case of a patient with residual disease from NSGCT who showed an increase in serum alpha-fetoprotein levels after HDCT, mimicking progression. Resection of the mass did not show viable cells in the tumour specimen, thus suggesting that the elevated level of the marker was expression of hepatic reconstitution after drug-induced liver damage. HDCT is increasingly used in cases of relapsed NSGCT, and the possibility of treatment-induced alpha-fetoprotein elevation must be taken into account in patient management.
authors.affiliation: Department of Medical Oncology, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Meldola, Italy. g.tierney@irst.emr.it
authors.forename: Salvatore Luca
authors.initials: SL
authors.lastname: Burgio
authors.forename: Cecilia
authors.initials: C
authors.lastname: Menna
authors.forename: Giorgio
authors.initials: G
authors.lastname: Papiani
authors.forename: Andrea
authors.initials: A
authors.lastname: Casadei Gardini
authors.forename: Nicoletta
authors.initials: N
authors.lastname: De Luigi
authors.forename: Roberto
authors.initials: R
authors.lastname: Corsi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Rosti
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology*; D006801:Humans; D008297:Male; D008479:Mediastinal Neoplasms / Q000097:blood* / Q000188:drug therapy*; D009373:Neoplasms, Germ Cell and Embryonal / Q000097:blood* / Q000188:drug therapy*; D000509:alpha-Fetoproteins / Q000032:analysis*
chemical_list: D000970:Antineoplastic Agents; D000509:alpha-Fetoproteins