scholarly journals Oligometastatic Growing Teratoma Syndrome: A Case for an Aggressive Surgical Approach

2015 ◽  
Vol 9 (3) ◽  
pp. 163-165 ◽  
Author(s):  
William S. Gange ◽  
Robert H. Blackwell ◽  
John Biemer ◽  
Güliz A. Barkan ◽  
Maria M. Picken ◽  
...  
Keyword(s):  
Surgical Approach ◽  
Clinical Stage ◽  
Mature Teratoma ◽  
Disease Free Survival ◽  
Testicular Germ Cell Tumor ◽  
Testicular Germ Cell ◽  
Growing Teratoma Syndrome ◽  
Aggressive Surgical Approach ◽  
Metastatic Sites

Growing teratoma syndrome is an infrequent presentation of testicular cancer. We present a case of growing teratoma syndrome in a patient who initially presented with clinical stage I nonseminomatous testicular germ cell tumor, who subsequently developed large volume oligometastases to the retroperitoneum, thorax, and thigh. Despite two regimens of chemotherapy, his disease progressed. Complete surgical extirpation of all gross tumors confirmed mature teratoma. An aggressive surgical approach, including postchemotherapy resection of all known metastatic sites, can provide long-term disease-free survival.

scholarly journals Growing teratoma syndrome: A case report

2016 ◽  
Author(s):  
Swati Gupta ◽  
Saritha Shamsunder ◽  
Roli Purwar ◽  
Vidya Jha ◽  
A. K. Yadav ◽  
...  
Keyword(s):  
Case Report ◽  
Adnexal Mass ◽  
Mature Teratoma ◽  
Pelvic Mass ◽  
Testicular Germ Cell Tumor ◽  
Conservative Surgery ◽  
Immature Teratoma ◽  
Testicular Germ Cell ◽  
Growing Teratoma Syndrome ◽  
Sporadic Cases

Introduction: Growing teratoma syndrome (GTS) or chemotherapeutic retro conversion is an extremely rare phenomenon seen in about 1.9-7.6% of patients being treated for non-seminomatous testicular germ cell tumor. It is even more rarely reported in females with only sporadic cases reported so far. It was described by logothetis et al and is described as conversion of immature teratoma to mature one after chemotherapy and presents as growing and metastasizing mass. Case Report: We report a case of 10 year old girl who underwent conservative surgery for an adnexal mass reported as immature teratoma on histopathology. Following which she was given chemotherapy for rapidly developing ascites. After four cycles of chemotherapy, the pelvic mass increased in size with metastatic deposits around the liver. Re-laparotomy and removal of the ovarian mass and metastatic deposits was carried out in stages. The histopathology showed mature teratoma. Conclusion: GTS is an extremely rare occurrence and it is important for the clinicians to know it to avoid misdiagnosis. Moreover, being a chemo-resistant tumor, early diagnosis and surgery are curative.

Salvage Cryotherapy for Recurrent Prostate Cancer After Radiotherapy: Variables Affecting Patient Outcome

2002 ◽  
Vol 20 (11) ◽  
pp. 2664-2671 ◽  
Author(s):  
Jonathan I. Izawa ◽  
Lydia T. Madsen ◽  
Shellie M. Scott ◽  
Jean-Paul Tran ◽  
Edward J. McGuire ◽  
...  
Keyword(s):  
Gleason Score ◽  
Clinical Stage ◽  
Specific Antigen ◽  
Disease Free Survival ◽  
Free Survival ◽  
Adenocarcinoma Of The Prostate ◽  
Salvage Cryotherapy ◽  
Locally Recurrent

PURPOSE: To determine the long-term disease-specific survival (DSS) and disease-free survival (DFS) rates after salvage cryotherapy for locally recurrent adenocarcinoma of the prostate and to identify pretreatment factors that have an impact on DSS and DFS. PATIENTS AND METHODS: Between July 1992 and January 1995, 131 patients who had received definitive radiation therapy (XRT) underwent salvage cryotherapy for locally recurrent adenocarcinoma of the prostate. Cryotherapy failure was defined as an increasing postcryotherapy prostate-specific antigen (PSA) level of ≥ 2 ng/mL above the postcryotherapy nadir, a positive prostate biopsy, or radiographic evidence of metastatic disease. Clinical variables were studied to determine whether there was an association with the DSS and DFS. RESULTS: The median follow-up was 4.8 years. The 5-year DSS rates were 87% for patients with a precryotherapy Gleason score ≤ 8 and 63% for those with Gleason scores of 9 and 10 (P = .012). The 5-year DFS rates were 57% for patients with a precryotherapy PSA level of ≤ 10 ng/mL and 23% for those with a PSA level greater than 10 ng/mL (P = .0004). The 5-year DSS rates for patients with a pre-XRT clinical stage of T1 to T2 and those with a clinical stage of T3 to T4 were 94% and 72%, respectively (P = .0041). The 5-year DFS rates for these groups were 90% and 69%, respectively (P = .0057). CONCLUSION: Androgen-independent local recurrences, Gleason score, and pre-XRT clinical stage were important factors that had an impact on DSS and DFS. The subset of patients cured by salvage cryotherapy seems to be small, and patient selection is important.

Breast-conserving surgery after neoadjuvant chemotherapy for stage III breast cancer patients.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11532-e11532
Author(s):  
Hee-Chul Shin ◽  
Wonshik Han ◽  
Hyeong-Gon Moon ◽  
Woo Kyung Moon ◽  
Seock-Ah Im ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Clinical Stage ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Stage Iii ◽  
Breast Cancer Patients ◽  
Free Survival ◽  
Stage Iii Breast Cancer

e11532 Background: Neoadjuvant chemotherapy (NCT) is a reasonable option for operable breast cancer in terms of downsizing large tumor and increasing the rate of breast-conserving surgery (BCS). However, BCS in patients with large breast tumors down-staged by NCT remains still controversial because of the possibility of residual tumor and resistance to NCT. Aims of this study were to evaluate the long-term survival results of patients who received NCT and BCS compared to patients who received BCS first and to compare recurrence and survival rates between patients who received preplanned BCS and those who received down-staged BCS among patients who underwent NCT. Methods: Between 2000 and 2007, 70 patients with clinical stage III breast cancer who received BCS after NCT (NCT group) and 72 patients with clinical stage III breast cancer who underwent BCS first (Surgery group) were retrospectively reviewed. Among 70 patients received NCT, 45 patients (64.3%) received preplanned BCS (preplanned BCS group) and 25 patients (35.7%) received down-staged BCS (down-staged BCS group). The long-term results including ipsilateral breast tumor recurrence (IBTR), locoregional recurrence (LRR), disease recurrence and survival rates were compared with groups. Results: There was no significant difference in IBTR-free survival, LRR-free survival rates, disease-free survival and overall survival rates between the NCT and the Surgery group (p=0.971, p=0.294, p=0.863 and p=0.933, respectively). Among patients who received NCT, IBTR-free survival, LRR-free survival, disease-free survival and overall survival rates was not also different between the preplanned BCS group and the down-staged BCS group (p=0.278, p=0.501, p=0.776 and p=0.412, respectively). Conclusions: Our study demonstrated that patients who received BCS after NCT showed similar long-term resutls compared to patients who received BCS first in clinical stage III breast cancer patients. Also, down-staged BCS shows is oncologically as safe as preplanned BCS in clinical stage III breast cancer patients in terms of recurrence and survival.

scholarly journals Clinical stage I synchronous bilateral testicular germ cell tumor with different histopathology: a case report

2020 ◽  
Vol 37 ◽  
Author(s):  
Carlos Eduardo Salazar-Mejía ◽  
Blanca Otilia Wimer-Castillo ◽  
Gisela Otilia García-Arellano ◽  
Raquel Garza-Guajardo ◽  
Oscar Vidal-Gutiérrez ◽  
...  
Keyword(s):  
Case Report ◽  
Germ Cell ◽  
Germ Cell Tumor ◽  
Clinical Stage ◽  
Testicular Germ Cell Tumor ◽  
Cell Tumor ◽  
Stage I ◽  
Testicular Germ Cell

Testis cancer

2017 ◽  
Author(s):  
Axel Heidenreich
Keyword(s):  
Active Surveillance ◽  
Clinical Stage ◽  
Stage I ◽  
Individual Risk ◽  
Testis Cancer ◽  
Testicular Germ Cell ◽  
Term Survival ◽  
Testicular Germ Cell Tumours ◽  
Advanced Stages

Testicular germ cell tumours represent the most common solid neoplasms in the age group of 20 to 40 years. These cancers have an excellent prognosis, with a 90% long-term survival rate due to well-established, interdisciplinary guidelines for diagnosis and treatment. Independent on the clinical stage at time of diagnosis, treatment after orchidectomy is performed on an individual risk adapted approach. In clinical stage I seminoma, active surveillance is the recommended therapy and adjuvant chemotherapy with carboplatin remains an option in men not suitable for surveillance. Clinical stage IIA/B and IIC are treated by radiation therapy and by systemic chemotherapy following orchidectomy. Clinical stage I non-seminomas are either treated by active surveillance or by one cycle of adjuvant PEB chemotherapy. Clinical stages IIA-C and advanced stages of GCT are treated by 3-4 cycles of PEB chemotherapy depending on IGCCC risk profile. Relapsing cases should be treated at tertiary referral centres only.

Determining optimal first-line chemotherapy for good and intermediate prognosis testicular germ cell tumors using decision analysis.

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 209-209
Author(s):  
Sky Breeden Vanderburg ◽  
A. Lindsay Frazier ◽  
Jane Kim
Keyword(s):  
Life Expectancy ◽  
Germ Cell Tumors ◽  
Disease Free Survival ◽  
First Line ◽  
Testicular Germ Cell ◽  
Free Survival ◽  
First Line Therapy ◽  
Line Therapy ◽  
Disease Free

209 Background: Since 80-90% of testicular germ cell tumors (GCTs) are cured after first line therapy alone, minimizing toxicity should be an important consideration in the initial treatment decision between cisplatin and carboplatin. Cisplatin has been shown to be superior in 5-year disease-free survival, but cisplatin use confers a higher risk of key long-term toxicities. This study aims to quantify this trade-off between disease-free survival and toxicities using decision analysis. Methods: We developed a mathematical decision-analytic model that simulates competing strategies of initial treatment with cisplatin or carboplatin in terms of treatment response, long-term toxicity, and mortality associated with first, second, and third line therapies for patients with good and intermediate prognosis testicular GCTs and a median age of 20 years at diagnosis. Treatment toxicities included ototoxicity, neurotoxicity, and nephrotoxicity. Monthly probabilities were weighted means derived from a systematic review of total follow-up data reported in seminal clinical trials. The model projected life expectancies for each strategy. Sensitivity analysis was conducted to examine the impact of uncertain inputs and assumptions. Results: The life expectancies at diagnosis for cisplatin and carboplatin strategies were 436.1 months (36.3 years) and 663.2 months (55.3 years) respectively. Sensitivity analyses revealed life expectancy figures largely dependent on the risk of nephrotoxicity occurrence from first line therapy and death from nephrotoxicity. Unless these base monthly probabilities were reduced by 87% and 99% respectively, carboplatin consistently yielded higher life expectancy than cisplatin. Conclusions: Under the current model, first line carboplatin therapy yields longer life expectancy than cisplatin, but this difference is highly sensitive to variables concerning nephrotoxicity. These preliminary results suggest that first line carboplatin therapy could yield higher life expectancy, though this result may be mediated by inclusion of other factors in future analyses, including updated estimates of mortality from nephrotoxicity or other toxicities.

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