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Journal of Pediatric Hematology/oncology Mar 2011Primary yolk sac tumor of the diaphragm in children is very rare, and diagnosis of a diaphragmatic tumor poses challenges to clinical physicians. Here, we report a... (Review)
Review
Primary yolk sac tumor of the diaphragm in children is very rare, and diagnosis of a diaphragmatic tumor poses challenges to clinical physicians. Here, we report a primary diaphragmatic yolk sac tumor in a 9-month-old girl, together with a review of 4 earlier reported cases in the English literature. Carboplatin-containing regimen successfully decreased the tumor size and a total resection of the tumor was made subsequently. The patient was disease-free 8 months after the completion of treatment.
Topics: Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carboplatin; Diaphragm; Endodermal Sinus Tumor; Etoposide; Female; Humans; Infant
PubMed: 21317810
DOI: 10.1097/MPH.0b013e3181ff0e17 -
Pediatric Surgery International Mar 2009The timing of surgery for malignant sacrococcygeal teratoma is controversial. The long-term outcomes and complications of surgery for this rare tumour are presented.
BACKGROUND
The timing of surgery for malignant sacrococcygeal teratoma is controversial. The long-term outcomes and complications of surgery for this rare tumour are presented.
METHODS
All cases of malignant sacrococcygeal teratoma in the 20-year period 1987-2006 were identified and the case notes retrieved. The age at diagnosis, investigations, presentation, type of surgery, early complications, recurrence rates, long-term complications and outcomes were recorded.
RESULTS
Twelve patients (three males, nine females) were identified. Mean age at presentation was 20.8 months (range: 12-39 months). All had the Carboplatin-Etoposide-Bleomycin chemotherapeutic protocol. The average time of follow-up was 10.6 years (range: 1-17 years). Ten patients had excision of their tumours following chemotherapy, whilst two patients had excision prior to chemotherapy. Two patients had recurrence of their tumours. There was one death (8%), which was due to disseminated metastasis. The other 11 children were all well at the last follow-up.
CONCLUSION
Surgery for malignant sacrococcygeal teratoma is safe and has a low complication rate. The long-term outcomes are favourable with minimal side effects.
Topics: Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carboplatin; Child, Preschool; Etoposide; Female; Follow-Up Studies; Humans; Infant; Male; Neoadjuvant Therapy; Sacrococcygeal Region; Spinal Neoplasms; Teratoma; Treatment Outcome; United Kingdom
PubMed: 19184053
DOI: 10.1007/s00383-009-2329-7 -
The Journal of Reproductive Medicine Jul 2008To review results in treatment of high-risk metastatic gestational trophoblastic neoplasia (GTN) in Hungary.
OBJECTIVE
To review results in treatment of high-risk metastatic gestational trophoblastic neoplasia (GTN) in Hungary.
STUDY DESIGN
Between January 1, 1977, and December 31, 2006, 142 patients with high-risk metastatic GTN were treated. Patients were 14-51 years of age (average 27.9). We selected primary chemotherapy based on patient GTN stage and prognostic score.
RESULTS
Methotrexate, actinomycin-D and cyclophosphamide (MAC) as a primary therapy was used in 100 cases and as second-line chemotherapy in 6 cases. Of the 100 cases, 95 achieved complete remission. Twenty-one high-risk patients were treated with etoposide, high-dose methotrexate with folinic acid rescue, actinomycin-D, cyclophosphamide and vincristine (EMA-CO). Of 17 primary therapies, 13 patients achieved complete remission. Primary cisplatin, etoposide and bleomycin (CEB) was successful in 12 of 14 high-risk cases. Hysterectomy was performed in 42 of 142 high-risk patients; metastases were resected in 26 of 142 of high-risk patients. Comparison of mean prognostic scores resulted in significant differences between CEB and MAC, CEB and EMA-CO and MAC and EMA-CO.
CONCLUSION
Results support that patients with high-risk metastatic GTN should primarily be treated with combination chemotherapy. Our data support the effectiveness of MAC, EMA-CO and CEB regimens.
Topics: Adolescent; Adult; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carboplatin; Cisplatin; Cyclophosphamide; Dactinomycin; Etoposide; Female; Gestational Trophoblastic Disease; Humans; Hungary; Hysterectomy; Methotrexate; Middle Aged; Pregnancy; Risk Factors; Vincristine; Young Adult
PubMed: 18720931
DOI: No ID Found -
Pelvic teratoma with extensive spinal involvement in a neonate: an important differential diagnosis.British Journal of Neurosurgery Jun 2008A 6-week-old girl presented with an abdominal mass and spinal cord compression. Clinical and radiological features indicated a diagnosis of congenital neuroblastoma....
A 6-week-old girl presented with an abdominal mass and spinal cord compression. Clinical and radiological features indicated a diagnosis of congenital neuroblastoma. Histology revealed a diagnosis of germ cell tumour after therapy for neuroblastoma had been commenced. This is, to the authors' knowledge, the first reported case of paediatric dumbbell retroperitoneal teratoma.
Topics: Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carboplatin; Diagnosis, Differential; Etoposide; Female; Humans; Hypertension; Infant; Neoplasm, Residual; Neuroblastoma; Pelvic Neoplasms; Retroperitoneal Neoplasms; Spinal Cord Compression; Teratoma; Treatment Outcome
PubMed: 18568732
DOI: 10.1080/02688690701704531 -
Journal of Pediatric Surgery Mar 2005The authors report a case of a 9-year-old girl with a mediastinal germinoma that required emergent surgical extirpation because of tracheal compression and asphyxia. The...
The authors report a case of a 9-year-old girl with a mediastinal germinoma that required emergent surgical extirpation because of tracheal compression and asphyxia. The tumor was successfully debulked under general anesthesia with the capability of extracorporeal circulation immediately available. Postoperatively, the tumor responded to adjuvant chemotherapy and irradiation and the patient survived without evidence of recurrence.
Topics: Airway Obstruction; Anesthesia, General; Antineoplastic Combined Chemotherapy Protocols; Asphyxia; Asthma; Bleomycin; Carboplatin; Chemotherapy, Adjuvant; Child; Combined Modality Therapy; Contraindications; Diagnostic Errors; Dyspnea; Emergencies; Epilepsy, Generalized; Etoposide; Female; Germinoma; Humans; Hypoxia; Mediastinal Neoplasms; Radiotherapy, Adjuvant; Remission Induction; Tomography, X-Ray Computed; Tracheal Stenosis
PubMed: 15793744
DOI: 10.1016/j.jpedsurg.2004.11.021 -
Anticancer Research 2003We investigated the efficacy and safety of 2 cycles of adjuvant chemotherapy with carboplatin, etoposide and bleomycin (CEB90) in patients with high-risk clinical stage... (Clinical Trial)
Clinical Trial
BACKGROUND
We investigated the efficacy and safety of 2 cycles of adjuvant chemotherapy with carboplatin, etoposide and bleomycin (CEB90) in patients with high-risk clinical stage I or stage IM non-seminomatous germ cell tumours (NSGCT).
PATIENTS AND METHODS
A total of 52 consecutive patients (22 patients with high-risk histological features [vascular invasion, presence of embryonal carcinoma, absence of yolk sac tumour] and 30 with tumour marker activity post-orchidectomy-stage IM) were entered into this prospective study. Chemotherapy consisted of carboplatin 400 mg/m2 or AUC 5 (day 1), etoposide 165 mg/m2 (days 1-3) and bleomycin 30 mg (days 1, 8, 15). Chemotherapy was repeated every 3 weeks.
RESULTS
During a median follow-up of 112 months (range, 10 to 174 months), two patietns with stage IM relapsed. These cases had a disseminated, marker-positive germ cell tumour (GCT), extensively involving both liver and lungs in the first case and para-aortic lymph nodes and lung in the second one; both patients died of the tumour after a number of salvage chemotherapy (including high-dose therapy) regimens. Fifty patients (96%) are alive and disease-free. Two cycles of CEB90 were well tolerated and the only side-effects were myelotoxicity and alopecia.
CONCLUSION
Despite the general consensus that ciplatin-based chemotherapy is superior to carboplatin-containing regimens in testicular cancer, 2 cycles of CEB90 may be an equally effective treatment option as adjuvant therapy for high-risk clinical stage I and IM patients.
Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carboplatin; Carcinoma, Embryonal; Chemotherapy, Adjuvant; Drug Administration Schedule; Etoposide; Germinoma; Humans; Male; Neoplasm Staging; Orchiectomy; Prospective Studies; Testicular Neoplasms
PubMed: 14666633
DOI: No ID Found -
The Netherlands Journal of Medicine Feb 2003Bleomycin is to treat patients with testicular cancer and lymphoma. Bleomycin can bind to DNA and chelate iron. The resulting complex can form an intermediate capable of...
Bleomycin is to treat patients with testicular cancer and lymphoma. Bleomycin can bind to DNA and chelate iron. The resulting complex can form an intermediate capable of interacting with oxygen to produce reactive oxygen species, particularly superoxide. Administrating high-inspired oxygen concentrations (e.g. during anaesthesia or acute illness) has been reported to exacerbate pulmonary injury. The duration of risk after bleomycin chemotherapy is unknown. Here we discuss our advice to a young male patient, who was successfully treated with bleomycin for testicular cancer, concerning the safety to return to scuba diving. Since scuba divers are exposed to high partial oxygen pressures (depending on the depth of the dive) we discouraged this patient from resuming scuba diving.
Topics: Adult; Antibiotics, Antineoplastic; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carboplatin; Choriocarcinoma; Diving; Etoposide; Humans; Lung Diseases; Male; Orchiectomy; Testicular Neoplasms
PubMed: 12735422
DOI: No ID Found -
European Neurology 2002
Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cannabis; Carboplatin; Drug Interactions; Etoposide; Fatal Outcome; Humans; Male; Neoplasms, Germ Cell and Embryonal; Stroke; Testicular Neoplasms
PubMed: 12373036
DOI: 10.1159/000065511 -
Medical and Pediatric Oncology May 2002
Topics: Abdomen; Adolescent; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carboplatin; Diagnosis, Differential; Etoposide; Humans; Immunohistochemistry; Liver Neoplasms; Magnetic Resonance Imaging; Male; Neoplasms, Germ Cell and Embryonal; Pancreatic Neoplasms; Pancreaticoduodenectomy; Status Epilepticus; alpha-Fetoproteins
PubMed: 11979462
DOI: 10.1002/mpo.1345 -
Journal of Clinical Oncology : Official... Nov 2000To evaluate carboplatin, etoposide, and bleomycin (JEB) in children with malignant extracranial germ cell tumors (GCTs). (Clinical Trial)
Clinical Trial
The United Kingdom Children's Cancer Study Group's second germ cell tumor study: carboplatin, etoposide, and bleomycin are effective treatment for children with malignant extracranial germ cell tumors, with acceptable toxicity.
PURPOSE
To evaluate carboplatin, etoposide, and bleomycin (JEB) in children with malignant extracranial germ cell tumors (GCTs).
PATIENTS AND METHODS
Malignant GCTs in children aged 0 to 16 years were excised without major morbidity or otherwise biopsied. Stage I testicular and some ovarian GCTs were resected and monitored with alpha-fetoprotein (AFP) ("watch-and-wait" approach). Patients with recurrent stage I disease and all other patients received JEB (etoposide 120 mg/m(2) on days 1 through 3, carboplatin 600 mg/m(2) on day 2, and bleomycin 15 mg/m(2) on day 3). Courses were administered every 3 to 4 weeks until remission, and then two more courses were given. Chemotherapy toxicities were assessed using World Health Organization or Brock grading.
RESULTS
Between January 1989 and December 1997, 192 patients were registered. Eight were excluded because either there was no histologic diagnosis (n = 3) or chemotherapy was given off-study (n = 5). The remaining 184 patients had germinoma (n = 20), malignant teratoma (n = 55), embryonal carcinoma (n = 1), yolk sac tumor (n = 107), or choriocarcinoma (n = 1). Forty-seven patients were treated with surgery alone, and 137 patients received JEB. The 5-year survival rate in March 1999 for all 184 patients was 93.2% (95% confidence interval [CI], 87.9% to 96.3%); for the 137 JEB-treated patients, it was 90.9% (95% CI, 83.9% to 95.0%), with an event-free survival rate of 87.8% (95% CI, 81.1% to 92.4%). The median follow-up after JEB treatment was 53 months (range, 0 to 109 months); the median number of courses was five (range, three to eight). Site, stage, and AFP level had prognostic significance. Nonfatal hematologic toxicity was common, but deafness and pulmonary and renal toxicities were rare. One child died of a thoracic tumor and bronchopulmonary dysplasia, and another died of acute myeloid leukemia.
CONCLUSION
Conservative surgery, a watch-and-wait approach after complete excision, and JEB for those requiring chemotherapy produced high cure rates and few serious complications.
Topics: Adolescent; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carboplatin; Child; Child, Preschool; Chorionic Gonadotropin; Combined Modality Therapy; Etoposide; Female; Germinoma; Humans; Infant; Infant, Newborn; Male; Ovarian Neoplasms; Prognosis; Survival Analysis; Testicular Neoplasms; alpha-Fetoproteins
PubMed: 11078494
DOI: 10.1200/JCO.2000.18.22.3809