title: [A case of a nonseminomatous germ cell tumor responding to MEA therapy].
abstract: We experienced a case of testicular cancer that was successfully treated by salvage chemotherapy comprised of methotrexate, actinomycin D and etoposide (MEA). A 25-year-old man was admitted to our hospital with a diagnosis of stage III B2 (JUA classification) testicular cancer. The patient had multiple lung metastases, and underwent a left orchiectomy. A histopathological examination revealed a choriocarcinoma, embryonal carcinoma, mature teratoma, and a yolk sac tumor. Tumor marker levels were elevated ; human chorionic gonadotropin β was 46 mIU/ml and alpha fetoprotein was 437 ng/ml. Although he was treated post-operatively with two courses of bleomycin, etoposide and cisplatin therapy, four courses of high-dose carboplatin, etoposide and iphosphamide (VIP) therapy, and two courses of CPT-11＋ cisplatin therapy, tumor maker levels remained elevated and lung metastases were stable. Accordingly, he received three courses of MEA therapy. MEA therapy is regimen used to treat gestational trophoblastic neoplasia. After MEA therapy, levels of the tumor markers normalized. He then underwent a partial resection of lung and enucleation of lung metastasis by the video assisted thoracoscopic surgery method. Histopathological examination of the lung metastasis revealed only necrotic tissue. Tumor recurrence has not been observed in the 14 months since the MEA therapy.
authors.affiliation: The Department of Urology, Kinki University School of Medicine.
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Nagai
authors.forename: Takafumi
authors.initials: T
authors.lastname: Minami
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Itami
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Shimizu
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Taiji
authors.initials: T
authors.lastname: Hayashi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nozawa
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yoshimura
authors.forename: Tokumi
authors.initials: T
authors.lastname: Ishii
authors.forename: Hirotugu
authors.initials: H
authors.lastname: Uemura
mesh_terms: D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003609:Dactinomycin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy* / Q000473:pathology; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000473:pathology
chemical_list: D000903:Antibiotics, Antineoplastic; D000964:Antimetabolites, Antineoplastic; D000972:Antineoplastic Agents, Phytogenic; D003609:Dactinomycin; D005047:Etoposide; D008727:Methotrexate