title: A Case of Mixed Germ Cell Tumor in the Intramedullary Spinal-cord.
abstract: A 28-year-old man was hospitalized with advancing paraplegia. Under the diagnosis of Guillain-Barre syndrome, steroid pulse therapy was administered and plasmapheresis was performed. However, the paraplegia gradually progressed. Subsequently, a spinal cord tumor was revealed by magnetic resonance imaging (MRI). The pathological diagnosis, obtained by open biopsy, confirmed a mixed germ cell tumor in the spinal cord. Multiple lung and lymph nodes metastases were also detected upon computed tomography, along with increased serum alpha-fetoprotein (33.9 ng/mL) and human chorionic gonadotropin (182.5 mIU/mL) levels. Consequently, he received chemotherapy comprising three courses of BEP (bleomycin, etoposide, and cisplatin) as first-line therapy, followed by four courses of TGN (paclitaxel, gemcitabine, and nedaplatin) as second-line treatment. As a result, the spinal cord lesion area was significantly decreased and the alpha-fetoprotein and human chorionic gonadotropin levels were normalized. Four years after chemotherapy, MRI revealed pituitary gland and pineal organ recurrence of the germ cell tumor and additional TGN chemotherapy was performed.
authors.affiliation: Department of Urology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan. masan@is.icc.u-tokai.ac.jp.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nitta
authors.forename: Akio
authors.initials: A
authors.lastname: Hoshi
authors.forename: Taro
authors.initials: T
authors.lastname: Higure
authors.forename: Yuki
authors.initials: Y
authors.lastname: Shimizu
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Nakajima
authors.forename: Kazuya
authors.initials: K
authors.lastname: Hanai
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kawamura
authors.forename: Toshiro
authors.initials: T
authors.lastname: Terachi
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000097:blood; D001706:Biopsy; D001761:Bleomycin / Q000008:administration & dosage; D006063:Chorionic Gonadotropin / Q000097:blood; D002945:Cisplatin / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005047:Etoposide / Q000008:administration & dosage; D020275:Guillain-Barre Syndrome / Q000150:complications; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000556:secondary; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D017239:Paclitaxel / Q000008:administration & dosage; D010264:Paraplegia / Q000209:etiology; D013120:Spinal Cord Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D014057:Tomography, X-Ray Computed; D000509:alpha-Fetoproteins / Q000032:analysis; D000093542:Gemcitabine
chemical_list: D014408:Biomarkers, Tumor; D006063:Chorionic Gonadotropin; D009944:Organoplatinum Compounds; D000509:alpha-Fetoproteins; D003841:Deoxycytidine; D001761:Bleomycin; D005047:Etoposide; C053989:nedaplatin; D017239:Paclitaxel; D002945:Cisplatin; D000093542:Gemcitabine