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At least 145 records · Page 8Linked to original sources
PubMed1981

Chemotherapy for primary retroperitoneal yolk sac tumor: report of a case.

A case of primary extragonadal yolk sac tumor occurring in the retroperitoneum of a young adult male was studied. The chemotherapy of this tumor has not previously been described for cases of extragonadal origin. A combination of cyclophosphamide, vinblastine, bleomycin, cis-diamminedichloroplatinum, actinomycin-D, and chlorambucil was used. A partial response and dramatic prolongation of survival was achieved, compared with previously reported cases.

Adult↗
PubMed1981

Ultrastructural study of intracranial yolk sac tumor: with special reference to the oncologic phylogeny of germ cell tumors.

Ultrastructural studies of yolk sac tumors (YST) have generally demonstrated the resemblance of this neoplasm to the primitive human yolk sac. However, these studies have failed to explain the common occurrence of mixed germ cell tumors with yolk sac elements. This report describes the ultrastructural features of a suprasellar YST. This tumor resembled those previously described. Also demonstrated, however, was the presence of primitive germ cells admixed within the neoplasm. A new schema is proposed based on these observations for the interrelationship of germ cell tumors, which may explain the common occurrence of mixed germ cell tumors.

Adult↗
PubMed1981

Successful treatment of metastatic extragonadal endodermal sinus (yolk sac) tumor in childhood.

Two children with metastatic extragonadal endodermal sinus tumor who had failed VAC chemotherapy were treated with combination chemotherapy consisting of cis-platinum, vinblastine, doxorubicin HCl (Adriamycin) and bleomycin (cis-VAB). There was a complete response in both patients with one child remaining tumor-free 3 1/2 years after metastasis and 2 1/2 years after stopping therapy. The main toxic reactions encountered were associated with the use of cis-platinum, but these were manageable and resolved upon completion of therapy. Cis-VAB appears to be a safe and effective regimen for the treatment of metastatic endodermal sinus tumor. A study of the efficacy of cis-VAB in a larger group of children with endodermal sinus tumor of poor prognosis seems indicated.

Adolescent↗
PubMed1981

AFP in yolk sac tumor and solid teratoma of the ovary: significance of postoperative serum AFP.

Serial serum alpha-fetoprotein (AFP) was examined postoperatively in five patients with yolk sac tumor and in three with solid teratoma of the ovary. Serial estimation of AFP was also done in sera from postpartum patients to compare the decreasing ratio between the two groups. Serum AFP in these postpartum women decreased according to the exponential function curve as AFP = be-mx (x = days after delivery) with a mean m value of 0.1652 and a mean correlation coefficient of -0.9911. Half-time of serum AFP in postpartum subjects was 4.33 days. Exponential decrease of serum AFP was also found in postoperative patients with yolk sac tumor and solid teratoma of the ovary. However, in those in whom there was an incomplete removal of the tumors, the values of either m or coefficient of correlation were significantly lower as compared to those in patients with complete extirpation of lesions or those in postpartum subjects. Elevation of serum AFP was noted postoperatively in two patients with recurrences; however, significant decreases in AFP following chemotherapy were apparent in one patient with immature solid teratoma. These findings suggest that the decreasing ratio of postoperative serum AFP is an effective indicator to determine whether or not the lesions were completely extirpated, although a normal value may not always imply the absence of microscopic metastasis of tumor cells. Serial estimation of serum AFP was of value in assessing the presence of recurrences and evaluating the efficacy of chemotherapy.

Adolescent↗
PubMed1982

Endodermal sinus tumor of the mediastinum.

Endodermal sinus tumor (EST) of the mediastinum is a rare germ-cell neoplasm affecting mainly young adult males. Ten patients with EST were treated with a multimodality approach that included surgery, chemotherapy, and radiotherapy. All patients had relapses after achieving a transient response except one who is still in complete remission more than five years following the diagnosis of the disease. Optimal therapy for this neoplasm has yet to be discovered. The disease is a subset of extragonadal germ cell tumors which appears to be lethal in most cases, particularly when the primary tumor is unresectable. The first case of five-year disease-free survival is described.

Adolescent↗
PubMed1982

Tumor classification and size in germ-cell testicular cancer: influence on the occurrence of metastases.

The influence of local tumor spread (T-classification) and of tumor size on the occurrence of metastases was studied in 241 patients with testicular germ-cell neoplasms. All patients underwent thorough clinical or pathologic staging, or both, and were treated at the University of Minnesota Hospitals. Spread of tumor through the tunica vaginalis (T2) was associated with abdominal lymph node or distant metastases in eight of nine patients. Local tumor extension to the spermatic cord (T4a) was associated with metastatic spread in 29 of 31 men. Tumor size did not appear to correlate with metastatic rate. These findings are an important aid in designing adjuvant therapy trials and in establishing a "no treatment" approach after orchiectomy.

Adolescent↗
PubMed1982

Hepatoid yolk sac tumor of the ovary (endodermal sinus tumor with hepatoid differentiation): a light microscopic, ultrastructural and immunohistochemical study of seven cases.

Seven cases of ovarian yolk sac tumor (endodermal sinus tumor) with patterns resembling those of hepatocellular carcinoma were encountered in patients 7-43 years of age. Two of the patients had gonadal dysgenesis with a 46XY karyotype. At operation three tumors were confined to the ovary and four were associated with intra-abdominal metastases. Two of the Stage I tumors recurred within one year. The hepatoid pattern was a prominent feature of all the tumors and was exclusive in four of them. In one specimen it merged almost imperceptibly with a polyvesicular vitelline pattern. The hepatoid component of the tumors was characterized by discrete masses, nests and/or broad bands of large polyhedral cells with central nuclei and prominent nucleoli; gland-like spaces, some of which contained mucin, were occasionally evident. Each tumor contained numerous PAS-positive, diastase-resistant intracytoplasmic and extracytoplasmic hyaline bodies. Alpha-fetoprotein and alpha-1-antitrypsin were identified by immunoperoxidase and immunofluorescence techniques in four tumors and albumin in two. Immunoperoxidase stains for chorionic gonadotropin were negative in four cases. Ultrastructural analysis of two specimens disclosed features similar to those of hepatocellular carcinoma.

Adolescent↗
PubMed1982

Histologic pattern and growth in two human testis cancers before and after transplantation to nude mice.

A yolk sac tumor of the testis and a testicular germ cell tumor with a mixed pattern were serially transplanted to athymic mice. The morphologic pattern in light microscope of each of the transplanted tumours were similar to that of the donor tumor, and both the donor and the transplanted tumors revealed alphafetoprotein reactivity by immunohistochemical staining. The observed growth of the mixed tumor in the donor and in the transplants fitted well with an estimation by the Gompertz equation. The ultrastructure of the transplanted tumors were similar to those previously described for testicular tumors with similar histologic patterns.

Adult↗
PubMed1983

Sequential bilateral nephroblastic tumors of different cell types in an infant. Possible effect of chemotherapy versus de novo origin.

A 14-month-old infant had a classical Wilms' tumor of the left kidney and subsequently developed a tumor showing predominantly mature mesenchymal elements and lack of cellular atypia in the right kidney. His father had classical Wilms' tumor of the left kidney. The various possibilities regarding the precise nature and mechanism of the development of the tumor in the right kidney are discussed. The similarities and the differences between this tumor and congenital mesoblastic nephroma are noted. The possible relation of chemotherapy to mesenchymal differentiation and maturation in Wilms' tumor is considered. The possibility of an unusual, histologically benign, mesenchymal variant in the spectrum of infantile nephroblastic neoplasia is also suggested.

Age Factors↗
PubMed1983

Human chorionic gonadotropin and alpha-fetoprotein in testicular germ cell tumors. An immunohistochemical study in comparison with tissue concentrations.

The relation between immunohistochemical demonstration and tissue concentration of humanchorionic gonadotropin (hCG) and alpha-fetoprotein (AFP) was examined in 17 testicular germ cell tumors. There was a good correlation between their results; e.g., a tumor with high hCG concentration contained numerous hCG positive cells, and vice versa. The immunoperoxidase localization of hCG and AFP was investigated in 57 tumors including above 17. HCG was revealed in syncytiotrophoblastic giant cells of seminoma or embryonal carcinoma as well as syncytial cells of choriocarcinoma, and on rare occasion in mononuclear cells. AFP was localized in tumor cells of yolk sac tumor or embryonal carcinoma and occasionally hyaline globules. No cell was stained concomitantly with hCG and AFP. Pathogenetical significance of cells positively stained was discussed.

Adolescent↗
PubMed1984

The prognostic significance of endodermal sinus tumor histology among patients treated for stage III nonseminomatous germ cell tumors of the testes.

A retrospective study was undertaken to determine the prognostic significance of endodermal sinus tumor (EST) elements in 56 patients with Stage III nonseminatous germ cell tumors of the testes (NSGCTT). The study patients were treated with conventional vinblastine, bleomycin and cisplatinum chemotherapy prior to our recognition of EST as a distinct entity. Twenty-one (37.5%) of the patients had EST elements in their tumors. Nineteen patients had EST in their primary testis tumor, whereas two had EST in metastatic sites only. Prognostic criteria (tumor volume, Dixon-Moore classification and chemotherapy vinblastin and bleomycin [VB] and VB plus cisplatin [VB + P] ) were similar in EST and non-EST patients. Long-term disease-free survival was significantly poorer for patients with Stage III NSGCTT containing EST (38%) compared with those not containing EST (71%) (P = 0.04). All 12 patients with small volume disease (III-B1-III-B2), independent of the presence of EST, are alive and free of disease for more than 2 years. Only 6 of 18 patients (33%) with advanced disease and EST are alive and free of disease, whereas 17 of 26 (65%) of patients with advanced disease not containing EST are alive and free of disease (P = 0.074). The addition of single agent bolus cisplatin to the treatment of patients with advanced disease achieved no improvement in survival. Endodermal sinus tumor must be included in future studies of advanced Stage III NSGCTT as an important prognostic variable.

Abdominal Neoplasms↗
PubMed1984

Transformation of an AFP-positive yolk sac carcinoma into an AFP-negative neoplasm. Evidence for in vivo cloning of the human parietal yolk sac carcinoma.

An alpha-fetoprotein (AFP)-positive ovarian yolk sac carcinoma of typical histologic appearance was surgically removed from a 19-year-old woman. The AFP-positive tumor recurred and was treated with x-rays and cytotoxic drugs to full remission, i.e., until no clinical or biochemical signs of tumor were evident. The second recurrence, which proved to be fatal, was noticed approximately 1 year after the initial diagnosis, but was not associated with elevated levels of serum AFP. At autopsy, the widespread tumor had the histologic appearance reminiscent of murine parietal yolk sac (PYS) carcinoma. The tumor cells did not form the characteristic histologic features of the classical human yolk sac carcinoma, did not secrete AFP, and were surrounded by extensive hyalinous extracellular matrix rich in laminin and collagen. It is thus shown that recurrent human yolk sac carcinomas could change their histologic morphology due to selective outgrowth and cloning of the parietal yolk sac component. Clinical recognition of this cloning is important because the PYS carcinoma cells do not secrete AFP, and the tumor growth cannot be biochemically monitored with this classical tumor marker.

Adult↗
PubMed1984

Antikeratin antibodies in tumor diagnosis. Distinction between seminoma and embryonal carcinoma.

The authors investigated the presence and distribution of keratin in germ cell tumors using a rabbit-anti-keratin antiserum and a monoclonal antikeratin antibody--which is specific for keratin classes of 40, 50, and 56.5 kdaltons--by various immunohistochemical methods on frozen sections, alcohol-fixed, and formalin-fixed paraffin-embedded tissues. Thirty-four germ cell tumors were studied. These were the following: 18 seminomas, 10 embryonal carcinomas, 2 teratocarcinomas, 3 yolk sac tumors and 1 choriocarcinoma. All seminomas, including four poorly differentiated (so-called anaplastic seminomas), gave negative results, regardless of the method employed. Embryonal carcinoma, the epithelial component of the teratocarcinoma, the yolk sac tumors, and choriocarcinoma were at least focally positive for keratin. The monoclonal antibody provided a cleaner background and stronger staining than the rabbit-anti-total-human-epidermal-keratin antibody. Best results were obtained from fresh-frozen sections or alcohol-fixed, paraffin-embedded materials. Formalin-fixed, nonseminomatous tumors, when predigested with trypsin and incubated overnight with primary antibody, gave no false-negative results but staining was often focal. The authors' results agree with the reported absence of detectable keratin in primordial germ cells of the normal testis, and with prevailing concepts of the histogenesis of germ cell tumors. These results indicate that the presence or absence of keratin by immunocytochemical methods can be helpful in distinguishing seminoma from embryonal carcinoma.

Antibodies, Monoclonal↗
PubMed1984

Endodermal sinus tumor of the pineal region. Metastases through a ventriculoperitoneal shunt.

This case report concerns an endodermal sinus tumor (EST) arising in the pineal region of a 16-year-old boy who died 3 months after radiation. He developed extensive abdominal metastases through a ventriculoperitoneal shunt, whereas the primary tumor and a suprasellar metastasis could be controlled by radiotherapy, demonstrated by autopsy. The histologic diagnosis was supported by an elevated level of alpha-fetoprotein in serum and the demonstration of this marker in the tumor tissue by immunoperoxidase method. The poor diagnosis of all previously reported cases with pineal EST requires a combined modality of surgical approach, radiotherapy, and concomitant chemotherapy.

Abdominal Neoplasms↗
PubMed1985

Endodermal sinus tumor of the vagina and cervix.

This report describes six patients with endodermal sinus tumor of the vagina and cervix, a polypoid friable tumor whose clinical presentation in girls younger than age 3 years simulates the presentation of sarcoma botryoides. In four of the six patients, the referring diagnosis was sarcoma botryoides. Five patients were treated with excisional surgery, and all six with chemotherapy. One patient with pulmonary metastases maintained a complete clinical response to vincristine, actinomycin-D, and cyclophosphamide (VAC) for 11 months. This is the first report of such a response. One patient with a vaginal lesion remains clinically free of disease 2 years after local excision and 18 months of VAC chemotherapy. This is the first report of apparently successful therapy that allowed retention of childbearing potential. Four of the six patients have been disease-free from 2 to 23 years. After examining the world literature, it is concluded that a combination of chemotherapy and surgery offers a reasonable prospect of cure with a minimum of serious side effects.

Adolescent↗
PubMed1985

A human embryonal-yolk sac carcinoma model system in athymic mice.

Two new human cell lines (1411H and 1411HRQmet) have been established from a patient with metastatic testicular cancer whose primary and metastatic histology included seminoma, teratoma, embryonal carcinoma (EC), and yolk sac tumor (YST). In vitro, the cells have been maintained for more than 70 passages, produce alpha-fetoprotein (AFP) and human chorionic gonadotropin (hCG), and have a human karyotype. When 2 X 10(7) cells of either line are inoculated into athymic mice, 87.5% of the animals (21/24) develop tumors. Initially 80% to 90% of the mass is EC, whereas the central portion is YST. After 90 to 390 days in vivo, the tumors achieve a large volume (2.13 +/- 0.97 cm3), become cystic, and undergo histologic change. The peripheral rim of the mass remains EC, but the central 80% to 90% becomes YST. The sera of tumor-bearing mice were positive for hCG and AFP in 11% and 38% of animals, respectively. Tumor cyst fluid was positive for hCG and AFP in 87% and 59% of animals, with mean values of 108 mIU/ml and 2,478 ng/ml, respectively. Tumor cyst fluid also contained placental alkaline phosphatase and human fibronectin. These two cell lines are useful for studies on the interrelationship of EC and YST and the differentiation of human germ cell cancer.

Adolescent↗
PubMed1985

Serum lactate dehydrogenase isoenzyme-1 in children with yolk sac tumor.

Although in recent years the evidence of an increase in serum lactate dehydrogenase isoenzyme-1 (LDH-1) in patients with germ cell tumor (GCT) has attracted attention, there have only been a few reports concerning yolk sac tumor (YST), which is a frequent type of GCT in childhood. Serum LDH isoenzymes were determined in eight children with YST, and an increase in LDH-1 was found in seven of them, excluding one in an early stage. On the basis of the findings of serial serum LDH-1 levels during treatment and of LDH isoenzyme pattern in tumor tissues, it is presumed that the increased serum LDH-1 is derived from tumor tissues. LDH-1 seems to be useful as a tumor marker, not specific for YST but associated with the whole spectrum of GCT, for monitoring of YST.

Child, Preschool↗