title: Successful treatment of mixed yolk sac tumor and mature teratoma in the spinal cord: case report.
abstract: Primary spinal germ cell tumors are rare, and spinal nongerminomatous germ cell tumors represent an even rarer subset for which no standard therapy has been established. The authors report the case of a 24-year-old woman with multifocal primary spinal germ cell tumors scattered from T-12 to L-5 that consisted of yolk sac tumor and mature teratoma. After diagnostic partial resection, the patient was treated with 30 Gy of craniospinal irradiation and 30 Gy of local spinal irradiation, followed by 8 courses of chemotherapy based on ifosfamide, cisplatin, and etoposide (ICE). Salvage surgery was also performed for residual mature teratoma components after the third course of ICE chemotherapy. Chemotherapy was continued after the operation, but ifosfamide was entirely eliminated from the ICE regimen because severe myelosuppression was observed after previous courses. The patient remains recurrence free as of more than 5 years after the completion of chemotherapy. This case suggests that this treatment strategy is an effective option for primary spinal yolk sac tumor.
authors.affiliation: Departments of 1 Neurosurgery.
authors.forename: Akitake
authors.initials: A
authors.lastname: Mukasa
authors.affiliation: Departments of 1 Neurosurgery.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Yanagisawa
authors.affiliation: Departments of 1 Neurosurgery.
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Saito
authors.affiliation: Departments of 1 Neurosurgery.
authors.forename: Shota
authors.initials: S
authors.lastname: Tanaka
authors.affiliation: Departments of 1 Neurosurgery.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Takai
authors.affiliation: Pathology, and.
authors.forename: Junji
authors.initials: J
authors.lastname: Shibahara
authors.affiliation: Orthopaedic Surgery and Spinal Surgery, The University of Tokyo Hospital, Tokyo; and.
authors.forename: Masachika
authors.initials: M
authors.lastname: Ikegami
authors.affiliation: Orthopaedic Surgery and Spinal Surgery, The University of Tokyo Hospital, Tokyo; and.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Nakao
authors.affiliation: Orthopaedic Surgery and Spinal Surgery, The University of Tokyo Hospital, Tokyo; and.
authors.forename: Katsushi
authors.initials: K
authors.lastname: Takeshita
authors.affiliation: Department of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Center, Hidaka, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Matsutani
authors.affiliation: Departments of 1 Neurosurgery.
authors.forename: Nobuhito
authors.initials: N
authors.lastname: Saito
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000473:pathology / Q000628:therapy; D002945:Cisplatin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D018240:Endodermal Sinus Tumor / Q000175:diagnosis / Q000628:therapy*; D005047:Etoposide / Q000627:therapeutic use; D005260:Female; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000628:therapy*; D013120:Spinal Cord Neoplasms / Q000175:diagnosis / Q000628:therapy*; D013724:Teratoma / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D005047:Etoposide; D002945:Cisplatin
keywords: AFP = alpha-fetoprotein; BEP = bleomycin, etoposide, and cisplatin; CE = carboplatin and etoposide; CNS = central nervous system; ICE = ifosfamide, cisplatin, and etoposide; JPBTSG = Japanese Pediatric Brain Tumor Study Group; NGGCT = nongerminomatous germ cell tumor; OS = overall survival rate; PE = cisplatin and etoposide; PVB = cisplatin, vinblastine, and bleomycin; STGC = syncytiotrophoblastic giant cell; chemotherapy; germ cell tumor; oncology; radiotherapy; spinal cord; teratoma; yolk sac tumor