Pediatric Vaginal Yolk Sac Tumor: Reappraisal of Treatment Strategy in a Rare Tumor at a Unique Location.
Review of the management of 6 young girls with vaginal yolk sac tumor over 25 years showed that the α-fetoprotein levels normalized in 5/6 within 4 cycles of primary cisplatin, bleomycin, etoposide (PEB)/carboplatin, etoposide, bleomycin (JEB)/cisplatin, vinblastine, bleomycin (PVB) chemotherapy. Radioimaging revealed residual tissue but viable tumor was found in only 1 of 2 biopsied. Resection/biopsy is necessary to avoid giving additional primary chemotherapy or to identify patients who need different treatment. If markers do not decay appropriately, PEB/JEB/PVB chemotherapy should not be continued. Taxol-containing salvage chemotherapy regimens, adjuvant modern radiotherapeutic treatment, and fertility-saving curative surgery should then be considered. Despite having mostly advanced disease, 5/6 patients were cured, 2 with chemotherapy alone.
*Department of Paediatrics, University of Malaya Medical Centre †University of Malaya Cancer Research Institute, University of Malaya, Kuala Lumpur ‡Department of Paediatrics, Subang Jaya Medical Centre, Subang Jaya, Selangor, Malaysia.
Revathi
R
Rajagopal
Hany
H
Ariffin
Shekhar
S
Krishnan
Wan A
WA
Abdullah
Hai Peng
HP
Lin
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001918:Brachytherapy; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D018240:Endodermal Sinus Tumor / Q000473:pathology* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007223:Infant; D016896:Treatment Outcome; D014625:Vaginal Neoplasms / Q000473:pathology* / Q000628:therapy*; D055815:Young Adult