Testicular non-seminomatous germ cell tumour presenting as a neck lump: a diagnostic and therapeutic challenge

2020 ◽  
Vol 1 (1) ◽  
pp. 19-23
Author(s):  
Mohammad Hasan ◽  
◽  
Leanne Duff ◽  
Sara Katharine Drever ◽  
Andrea Chapman ◽  
...  
Keyword(s):  
Germ Cell ◽  
Mature Teratoma ◽  
Germ Cell Tumour ◽  
Needle Aspiration ◽  
Good Prognosis ◽  
Cell Tumour ◽  
Retroperitoneal Lymphadenectomy ◽  
Young Males ◽  
Left Neck ◽  
Neck Lump

Testicular tumours are one of the most prevalent cancers in young males. Teratoma is one type of testicular tumour, which carries a good prognosis if treated appropriately. We describe a case of a 37 year old man, diagnosed with testicular non-seminomatous germ cell tumour in 2005. He underwent left orchidectomy and radical chemotherapy with Bleomycin, Etoposide and Cisplatin. He had involved retroperitoneal lymph nodes at the time of diagnosis and underwent retroperitoneal lymphadenectomy in 2007. He made a good recovery but presented with a left neck lump in 2009, the appearance of which suggested differentiated teratoma on fine needle aspiration cytology. The neck lump was excised without any complications and histology confirmed the mass to be mature teratoma with no undifferentiated elements. He has remained disease free since then and remains under oncological surveillance, in keeping with current protocols.

scholarly journals Giant adrenal germ cell tumour in a 59-year-old woman

2016 ◽  
Vol 10 (5-6) ◽  
pp. 201
Author(s):  
Lei Chen ◽  
Lu Fang ◽  
Zhiqi Liu ◽  
Dexin Yu ◽  
Daming Wang ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Lymph Nodes ◽  
Germ Cell ◽  
Germ Cell Tumour ◽  
Malignant Tumour ◽  
Large Mass ◽  
Needle Aspiration ◽  
Cell Tumour ◽  
Supraclavicular Lymph Nodes ◽  
The Right

Adrenal germ cell tumour is very rare. We report a case of a 59-year-old woman who presented with right flank discomfort. The laboratory examinations were normal and the chest computed tomography (CT) showed right pleural effusion. The abdominal CT scan revealed a large mass on the right adrenal gland. The patient underwent an adrenalectomy. Histopathologic examination and immunohistochemical findings were consistent with mixed germ cell tumour. Three months later following the operation, the patient was admitted to our hospital again with chest tightness and shortness of breath. The chest CT showed right pleural effusion recurrence and enlargement of mediastinal lymph nodes and right hilar lymph nodes. The patient had right supraclavicular lymphadenectasis on physical examination. Fine needle aspiration cytology from the supraclavicular lymph nodes showed groups of malignant tumour cells. The patient died within 6 months postoperatively. In this case, the lymph node pathway played an important role in the metastatic procedure.

Liver metastases in germ cell tumors.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 403-403
Author(s):  
Suliman Boulos ◽  
Jonathan Shamash ◽  
Han Hsi Wong ◽  
Sarah Maria Rudman ◽  
Gary Doherty ◽  
...  
Keyword(s):  
Liver Resection ◽  
Germ Cell ◽  
Mature Teratoma ◽  
Germ Cell Tumour ◽  
Germ Cell Tumors ◽  
Adverse Outcomes ◽  
Cell Tumour ◽  
Retroperitoneal Lymph Node Dissection ◽  
High Dose ◽  
Response To Chemotherapy

403 Background: Metastatic germ cell tumour (GCT) to the liver is considered rare and usually caries adverse outcomes. We aimed to determine the outcome of patients with metastatic GCT to the liver. Methods: We identified retrospectively 36 patients with metastatic germ cell tumour to the liver between the years 2001 and 2015, from which 34 were non-seminomatous germ cell tumours (NSGCT) and two seminomas. 35 patients had other sites of metastases including lungs, bones and brain. Elevated tumour markers were seen in the vast majority of patients (97.2%). 15 patients received treatment with dose intense regime including actinomycin-D, high-dose methotrexate, etoposide and cisplatin (GAMEC) every 14 days, 20 patients received the standard protocol of bleomycin, etoposide and cisplatin (BEP) every 21 days and one patient received POMB/ACE chemotherapy. 20 patients had an induction cycle of cisplatin, vincristine and bleomycin (Baby-BOP) prior to initial treatment. Results: 12 patients had radiological complete response (CR) and 19 patients had radiological partial response (PR) in the liver, with five patients having a CR in all sites with negative markers. Five patients underwent liver resection with no viable tumour seen. Three patients that underwent liver resection also had retroperitoneal lymph node dissection (RPLND) the histology from which was viable seminoma in one case, mature teratoma in one case and necrosis in the final patient.16 patients had marker negative PR, 10 patients had marker positive PR and 5 patients had a marker negative CR. 15 patients eventually relapsed and 10 died with only one liver relapse. Median Overall survival for patients that received BEP was 35.38 months (not reached for GAMEC) (p = 0.0147). The median progression free survival (PFS) for the BEP group was 24.45 months (not reached for GAMEC) (p = 0.22) and the 2-years PFS for the GAMEC and BEP groups were 73% and 55% respectively. Conclusions: Within this cohort, liver metastasis from germ-cell tumour had a good response to chemotherapy, with progression occurring mainly in extra-hepatic sites. There was also a suggestion that dose dense GAMEC regime may offer superior efficacy compared with BEP.These results also question the role of liver metastectomy after initial response to chemotherapy.

Late Relapse of a Non-Seminomatous Germ Cell Tumour from Residual Mature Teratoma

1998 ◽  
Vol 53 (3) ◽  
pp. 193-197
Author(s):  
J. Van den Brande ◽  
D. Schrijvers ◽  
Ph. Vroman ◽  
A. Prove ◽  
P. Van Schi1 ◽  
...  
Keyword(s):  
Germ Cell ◽  
Mature Teratoma ◽  
Germ Cell Tumour ◽  
Cell Tumour ◽  
Late Relapse

A suprasellar germ cell tumour presenting with cranial diabetes insipidus

2019 ◽  
Author(s):  
Suhaniya Samarasinghe ◽  
Rebecca Scott ◽  
Michael J Seckl ◽  
Mike Gonzalez ◽  
Richard Harvey ◽  
...  
Keyword(s):  
Germ Cell ◽  
Diabetes Insipidus ◽  
Germ Cell Tumour ◽  
Cell Tumour ◽  
Cranial Diabetes Insipidus

scholarly journals COVD-01. VINBLASTINE MONOTHERAPY INDUCTION FOR LOCALISED CNS GERMINOMA DURING THE COVID-19 PANDEMIC

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii282-iii282
Author(s):  
Rafael Moleron ◽  
Sara Stoneham ◽  
Thankamma Ajithkumar ◽  
Justin Cross ◽  
James Nicholson ◽  
...  
Keyword(s):  
Germ Cell ◽  
Treatment Options ◽  
Single Agent ◽  
Germ Cell Tumour ◽  
Research Priorities ◽  
Tumour Volume ◽  
Cell Tumour ◽  
Low Grade ◽  
Testicular Seminoma

Abstract INTRODUCTION Patients with localised CNS-germinoma have excellent survival. More recently, intensive inpatient chemotherapy (carboPEI=carboplatin/etoposide/ifosfamide in Europe) has been effectively employed to reduce radiotherapy fields and/or dose. Current research priorities focus on reducing treatment burden and long-term sequelae. Of note, outpatient-based single-agent carboplatin chemotherapy is associated with excellent outcomes in metastatic testicular seminoma (an identical pathology) [Alifrangis,EJC,2020]. Recently, successful vinblastine monotherapy was reported in localised CNS-germinoma [Murray,Neurooncol-Adv,2020]. METHODS Due to the COVID-19 pandemic, adapted UK guidelines for germ-cell-tumour management were distributed, including potential non-standard treatment options that would reduce hospital visits/admissions. A 30-year-old patient presented with a 32mmx30mmx35mm diameter solid+multi-cystic localised pineal CNS lesion, consistent radiologically with a germ-cell-tumour with prominent teratoma component. Investigation revealed negative AFP/HCG markers and biopsy-proven pure germinoma. After appropriate consent, the patient commenced 12-week induction with weekly vinblastine monotherapy (low-grade-glioma dosing [Lassaletta,JCO,2016]), with wk6&12 MRI re-assessment prior to definitive radiotherapy. RESULTS Vinblastine was well-tolerated. After initial 4mg/m2 test-dosing (wk1), standard 6mg/m2 was delivered for wk2, but resulted in asymptomatic neutropenia (nadir 0.3x10^9/l) and missed dosing at wk3. Subsequent doses were 4mg/m2, with no further neutropenia. As expected, MRI showed moderate 40% tumour volume reduction by wk12. Surgical resection of the residual presumed teratoma component was undertaken prior to radiotherapy. CONCLUSION Patients with CNS-germinoma have excellent outcomes and reduction of treatment-effects remains a priority. The exquisite chemosensitivity of germinoma, excellent results from monotherapy for metastatic testicular disease, and early promise of vinblastine monotherapy lend itself to further exploration for CNS-germinoma.

scholarly journals Germ cell tumour chemotherapy

1989 ◽  
Vol 59 (2) ◽  
pp. 156-159 ◽  
Author(s):  
A Horwich
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumour ◽  
Cell Tumour
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