Posts Tagged ‘leukemia’ - Part 2

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 […]

Mediastinal Germ Cell Tumors (15)Ten patients required postchemotherapy surgery with findings of teratoma (four patients), teratoma plus non-germ cell elements (two patients), necrosis (two patients), residual viable cancer (one patient), and incomplete resection of residual germ cell cancer (one patient). Of the 18 patients obtaining disease free status, ten have remained continuously disease free. Two patients […]

Mediastinal Nonseminomatous Germ Cell Tumors: Whereas treatment of mediastinal seminoma remains controversial, nearly all experienced investigators view chemotherapy as the principal mode of therapy in mediastinal nonseminomatous germ cell tumors. Most investigators recommend that, after histologic or serologic confirmation of the presence of a mediastinal nonseminomatous germ cell tumor, the patient receive modern cisplatin-based chemotherapy. If the patients serum tumor marker levels normalize, complete resection of persistent roentgenographic abnormalities by […]

Mediastinal Germ Cell Tumors (13)Patients with bulky seminoma at any site frequently have residua] roentgenographic abnormalities after chemotherapy. Management of such patients with residual mass after primary chemotherapy treatment of seminoma remains controversial. Previous experience at Indiana University and the Southeastern Cancer Study Group as well as […]

This is in contrast to four of eight patients (50 percent) from the same institution obtaining long-term disease-free survival with local/regional radiotherapy and/or surgery. Loehrer and colleagues at Indiana University and the Southeastern Cancer Study Group report seven of nine patients (78 percent) with mediastinal seminoma obtaining complete remission with cispla-tin, bleomycin, and either etoposide or vinblastine. Seven of these patients had received prior radiotherapy to the chest alone. These […]

Mediastinal Germ Cell Tumors (11)Management of Mediastinal Seminoma: Mediastinal seminoma is histologically identical to its gonadal counterpart and these tumors share the unique radiosensitivity of testicular seminoma. For many years, primary therapy consisted of a megavoltage irradiation to the mediastinum. Such an approach results in a 60 […]

Management of Malignant Mediastinal Germ Cell Tumors: The initial problem in the management of patients with suspected malignant mediastinal germ cell tumors is establishing the diagnosis. Elevation of serum tumor markers (AFP, HCG) in a young man with a mediastinal mass is very suggestive of a mediastinal germ cell tumor. Whenever possible, a tissue diagnosis should be obtained to determine histologic subtype, the presence of nongerm cell elements within the […]

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