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Article: Paradoxical response of a pineal immature teratoma to combination chemotherapy

TitleParadoxical response of a pineal immature teratoma to combination chemotherapy
Authors
Keywordschildren
germ cell tumour
intracranial
teratoma
Issue Date1995
PublisherJohn Wiley & Sons, Inc.
Citation
Medical And Pediatric Oncology, 1995, v. 24 n. 1, p. 53-57 How to Cite?
AbstractA case of primary intracranial germ cell tumour is reported in a 5-year- old Chinese boy who presented with symptoms and signs of increased intracranial pressure. Computed tomography (CT) scan of the brain revealed a multicystic tumour over the pineal region. Stereotactic biopsy yielded enteric epithelium and isolated cells with hyperchromatic nuclei and high nuclear-to-cytoplasmic ratio, suggesting the diagnosis of an immature teratoma. Grossly elevated serum and cerebrospinal fluid (CSF) levels of α- fetoprotein and mildly elevated levels of β human chorionic gonadotrophin suggested the simultaneous presence of embryonal tissues. Combination chemotherapy with cisplatin, etoposide, and bleomycin resulted in a gradual but complete normalisation of the serum and CSF tumour markers. Paradoxically, the patient's consciousness deteriorated and repeat CT scan after 3 months of treatment showed that the tumour was actually increasing in size. Complete surgical removal was attempted and histologic sections of the specimen revealed only mature teratomatous tissues. The child is now well and remains disease-free with minimal left hemiparesis 12 months after completion of treatment. This case illustrates the importance of combined neoadjuvant chemotherapy and surgery in the management of intracranial non-germinomatous germ cell tumour harbouring both germ cell and teratomatous components, while monitoring of both biochemical and radiological parameters are necessary in assessing the clinical behaviour of mixed germ cell tumours.
Persistent Identifierhttp://hdl.handle.net/10722/80172
ISSN
2005 Impact Factor: 1.649
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLee, ACWen_HK
dc.contributor.authorChan, GCFen_HK
dc.contributor.authorFung, CFen_HK
dc.contributor.authorLeung, SYen_HK
dc.contributor.authorLau, YLen_HK
dc.date.accessioned2010-09-06T08:03:14Z-
dc.date.available2010-09-06T08:03:14Z-
dc.date.issued1995en_HK
dc.identifier.citationMedical And Pediatric Oncology, 1995, v. 24 n. 1, p. 53-57en_HK
dc.identifier.issn0098-1532en_HK
dc.identifier.urihttp://hdl.handle.net/10722/80172-
dc.description.abstractA case of primary intracranial germ cell tumour is reported in a 5-year- old Chinese boy who presented with symptoms and signs of increased intracranial pressure. Computed tomography (CT) scan of the brain revealed a multicystic tumour over the pineal region. Stereotactic biopsy yielded enteric epithelium and isolated cells with hyperchromatic nuclei and high nuclear-to-cytoplasmic ratio, suggesting the diagnosis of an immature teratoma. Grossly elevated serum and cerebrospinal fluid (CSF) levels of α- fetoprotein and mildly elevated levels of β human chorionic gonadotrophin suggested the simultaneous presence of embryonal tissues. Combination chemotherapy with cisplatin, etoposide, and bleomycin resulted in a gradual but complete normalisation of the serum and CSF tumour markers. Paradoxically, the patient's consciousness deteriorated and repeat CT scan after 3 months of treatment showed that the tumour was actually increasing in size. Complete surgical removal was attempted and histologic sections of the specimen revealed only mature teratomatous tissues. The child is now well and remains disease-free with minimal left hemiparesis 12 months after completion of treatment. This case illustrates the importance of combined neoadjuvant chemotherapy and surgery in the management of intracranial non-germinomatous germ cell tumour harbouring both germ cell and teratomatous components, while monitoring of both biochemical and radiological parameters are necessary in assessing the clinical behaviour of mixed germ cell tumours.en_HK
dc.languageengen_HK
dc.publisherJohn Wiley & Sons, Inc.en_HK
dc.relation.ispartofMedical and Pediatric Oncologyen_HK
dc.rightsMedical and Pediatric Oncology. Copyright © John Wiley & Sons, Inc.en_HK
dc.subjectchildrenen_HK
dc.subjectgerm cell tumouren_HK
dc.subjectintracranialen_HK
dc.subjectteratomaen_HK
dc.subject.meshAntineoplastic Combined Chemotherapy Protocols - therapeutic useen_HK
dc.subject.meshBrain Neoplasms - drug therapy - pathologyen_HK
dc.subject.meshChild, Preschoolen_HK
dc.subject.meshHumansen_HK
dc.subject.meshMaleen_HK
dc.subject.meshPineal Glanden_HK
dc.subject.meshTeratoma - drug therapy - pathologyen_HK
dc.titleParadoxical response of a pineal immature teratoma to combination chemotherapyen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0098-1532&volume=24&spage=53&epage=57&date=1995&atitle=Paradoxical+response+of+a+pineal+immature+teratoma+to+combination+chemotherapyen_HK
dc.identifier.emailChan, GCF:gcfchan@hkucc.hku.hken_HK
dc.identifier.emailLeung, SY:suetyi@hkucc.hku.hken_HK
dc.identifier.emailLau, YL:lauylung@hkucc.hku.hken_HK
dc.identifier.authorityChan, GCF=rp00431en_HK
dc.identifier.authorityLeung, SY=rp00359en_HK
dc.identifier.authorityLau, YL=rp00361en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1002/mpo.2950240112en_HK
dc.identifier.pmid7968794-
dc.identifier.scopuseid_2-s2.0-0028917776en_HK
dc.identifier.hkuros2505en_HK
dc.identifier.volume24en_HK
dc.identifier.issue1en_HK
dc.identifier.spage53en_HK
dc.identifier.epage57en_HK
dc.identifier.isiWOS:A1995QH46800011-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLee, ACW=7405631431en_HK
dc.identifier.scopusauthoridChan, GCF=16160154400en_HK
dc.identifier.scopusauthoridFung, CF=7102443754en_HK
dc.identifier.scopusauthoridLeung, SY=7202044886en_HK
dc.identifier.scopusauthoridLau, YL=7201403380en_HK

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