Unrecognized Extragonadal Germ Cell Tumor Syndrome: On occasion, patients present with a clinical picture compatible with a mediastinal germ cell tumor, but do not have corroborating serologic or histopathologic evidence of a germ cell tumor. Works from Vanderbilt University and elsewhere suggest that such patients should undergo a very thorough histopathologic evaluation, and in some cases, receive empiric cisplatin-based chemotherapy. buy ventolin inhalers
Greco, Hainsworth, and colleagues at Vanderbilt have described the “unrecognized germ cell tumor syndrome” and recently provided an update of their experience with such patients. The clinical features of this syndrome included patients aged less than 50 years; tumor involving primarily midline structures (mediastinum or retroperitoneum), lungs (in the form of multiple pulmonary nodules) or lymph nodes; elevated B-HCG or AFP, or clinical evidence of rapid tumor growth.
Seventy-one prospectively identified patients with poorly differentiated carcinoma or poorly differentiated adenocarcinoma of unknown primary site with one or more of the above clinical features of extragonadal germ cell tumor syndrome were included in this report. Results of serologic investigations in this patient population revealed normal AFP and HCG in 51 patients (76 percent). Thirteen patients (19 percent) had elevation of one marker and three patients (five percent) had elevation of both markers.
Blog invites submissions of review articles, reports on clinical techniques, case reports, conference summaries, and articles of opinion pertinent to the control of pain and anxiety in dentistry.