scholarly journals Regulation of Serum Sodium Levels during Chemotherapy Using Selective Arginine Vasopressin V2-Receptor Antagonist Tolvaptan in a Four-Year-Old Girl with a Suprasellar Germ Cell Tumor

Children ◽  
2021 ◽  
Vol 8 (4) ◽  
pp. 293
Author(s):  
Shota Hiroshima ◽  
Hiromi Nyuzuki ◽  
Sunao Sasaki ◽  
Yohei Ogawa ◽  
Keisuke Nagasaki
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumor ◽  
Serum Sodium ◽  
Hormone Secretion ◽  
Urine Volume ◽  
Cell Tumor ◽  
Sodium Balance ◽  
Infusion Therapy ◽  
Inappropriate Antidiuretic Hormone Secretion ◽  
Control Serum

There are limited reports on the use of tolvaptan for syndrome of inappropriate antidiuretic hormone secretion (SIADH) in children. Managing serum sodium levels in SIADH patients during chemotherapy is often difficult because of the need for massive fluid infusions. We report the course of the use of tolvaptan for the treatment of hyponatremia during chemotherapy in a four-year-old girl with a suprasellar germ cell tumor. The patient was a Japanese girl who presented with left ptosis with a mass in the pituitary gland and cavernous sinus. She was diagnosed with an intermediate-grade germ cell tumor and was treated with carboplatin and etoposide combination chemotherapy. She developed hyponatremia due to SIADH caused by intravenous infusion therapy before chemotherapy. Subsequently, tolvaptan (3.25 mg; 0.20 mg/kg/dose) was administered orally to control serum sodium levels. After 4 h of administration, a marked increase in urine volume of up to 15 mL/kg/h was observed, and serum sodium level increased from 126 to 138 mEq/L after 10 h of tolvaptan administration, followed by a decrease in urine volume. The use of tolvaptan in pediatric patients with SIADH who require intravenous hydration during chemotherapy can be useful for the management of serum sodium balance.

The case of prenatal diagnosis of a germ cell tumor of the fetal ovary

2018 ◽  
Author(s):  
N.N. Bondarenko, E.Yu. Andreeva , N.B. Filippova
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumor ◽  
Ovarian Tumor ◽  
Ultrasound Examination ◽  
Abdominal Mass ◽  
Abdominal Cavity ◽  
Cell Tumor ◽  
Fetal Ovary ◽  
Entire Abdominal Cavity ◽  
Spontaneous Delivery

A case of prenatal ultrasound diagnosis of a rare congenital ovarian tumor is presented. By ultrasound examination at 36–37 weeks of gestation the intra-abdominal mass 66  47  74 mm occupying the entire abdominal cavity was discovered. At 38 weeks of pregnancy spontaneous delivery occurred with girl weight 2840 g. On the eighth day after birth the child has been successfully undergone surgery. Histological examination revealed congenital germ-cell tumor with structures of dysgerminoma and yolk sac tumor.

Prognostic Impact of Lymphadenectomy in Different Stages of Malignant Germ Cell Tumor of the Ovary Based on Propensity Score Matching

2019 ◽  
Vol 21 (9) ◽  
pp. 652-661 ◽  
Author(s):  
Ying Chen ◽  
Yang Ning ◽  
Qinghua Zhang ◽  
Ying Xie
Keyword(s):  
Lymph Node ◽  
Propensity Score ◽  
Germ Cell ◽  
Propensity Score Matching ◽  
Germ Cell Tumor ◽  
Cell Tumor ◽  
Stage I ◽  
Prognostic Impact ◽  
Lymph Node Resection ◽  
Malignant Germ Cell Tumor

Background: Lymphadenectomy has been widely used in the treatment of malignant germ cell tumor of the ovary (OGCT), which is a kind of ovarian cancers occurred mostly in young women and adolescent girls. But the clinical decision mainly depends on the doctor’s experience without a well-defined guideline. This population-based study aimed to evaluate the prognostic impact of lymphadenectomy in different stages of malignant germ cell tumors of the ovary. Methods: Patients with known status of lymphadenectomy in different stages of OGCT were explored from the Surveillance, Epidemiology, and End Results (SEER) program database from 1973 to 2013. We used propensity score matching algorithm to reduce the selection bias between the two study groups. Survival curves, univariate and multivariate Cox proportional hazards model were applied to evaluate the prognostic impact of lymphadenectomy in different stages of OGCT. Results: We included 1,996 OGCT patients in the study, and 818 (41%) of them had lymph node resection. Compared to the LND- group, patients with lymph node resection tended to be at stage II and III, had larger tumor sizes and diagnosed as dysgerminoma. The influence of diagnosis ages, marital status and tumor grades were significantly decreased by applying the propensity score matching. Lymphadenectomy-positive (LND+) group demonstrated significantly worse survival than the lymphadenectomy-negative (LND-) group in later stages (stage III, overall, P=0.027, cancerspecific, P=0.006; stage IV, overall, P=0.034, cancer-specific, P=0.037). While, both the overall and cancer-specific survival showed no significant differences between LND+ and LND- in stage I (overall, P=0.411, cancer-specific, P=0.876) and stage II (overall, P=12, cancer-specific, P=0.061). Univariate (overall, HR=1.497, CI=1.010-2.217, P=0.044; cancer-specific, HR=1.524, CI=1.067- 2.404, P=0.050) and multivariate (overall, HR=1.580, CI=1.046-2.387, P=0.030; cancer-specific, HR=1.661, CI=1.027-2.686, P=0.039) Cox proportional model both verified the association between the lymph node resection and better survival in the whole cohort. Conclusion: Lymphadenectomy significantly increased the survival probability of OGCT patients in stage III and IV, but had no significant influence on early-stage patients (stage I and II), indicating lymphadenectomy should be performed in a stage-dependent manner in clinical utility.

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