Triple drug immunochemotherapy resulted in a significant clinical effect comparable to an aggressive intravenous interleukin-2 treatment regimen but without significant toxicity.

Triple drug immunochemotherapy resulted in a significant clinical effect comparable to an aggressive intravenous interleukin-2 treatment regimen but without significant toxicity.

No abstract

The association of clear cell adenocarcinoma of the vagina and vaginal adenosis with prenatal exposure to diethylstilbestrol (DES) is well-documented in the United States. In Europe, however, DES was never used in the therapy of threatened abortion and, therefore, clear cell adenocarcinoma and vaginal adenosis remained rare diseases. We report on the clinical and pathological features of a case of clear cell adenocarcinoma of the upper vagina in a 17-year-old German girl, who had a history of hypoplasia of the left kidney with an ectopic termination of the ureter in the upper vagina, removed surgically 2 years before. No previous report of a similar coincidence of vaginal clear cell carcinoma and a congenital disorder of the genitourinary tract exists. Congenital anomaly of the ureter interfering with the development and the differentiation of the distal Müllerian tract and its epithelium might have provided a similar histological basis for carcinogenesis in our patient to that in those provided exposed to DES.

Between 1979 and 1992, 79 patients with seminoma were treated at our institution. Nineteen of these patients with advanced seminoma were treated with cisplatin-based chemotherapy (stage IIA, n = 2; stage IIB, n = 6; stage IIC, n = 2; stage III, n = 5 [2 with primary extragonadal tumor site]; relapse, n = 5 [1 with previously stage III seminoma]). One patient died of progressive disease 3 months after treatment with chemotherapy and retroperitoneal lymph node dissection (RPLND) which had led initially to a complete clinical response. Another patient (62 years old) died of an acute heart failure due to a sepsis caused by chemotherapy. Treatment of the other 17 patients was successful. Ten patients with a residual retroperitoneal mass after inductive chemotherapy underwent a RPLND. In 1 case viable seminoma (diameter of the residual mass 5 cm), in 4 cases necrotic tumor tissue, and in 5 cases fibrosis was diagnosed histopathologically. The 2 patients with extragonadal seminoma showed complete responses after surgery and chemotherapy. In conclusion, in patients with advanced seminoma, inductive cytostatic therapy seems to be the best treatment regimen. Residual retroperitoneal masses after chemotherapy with a diameter of > 3 cm should be treated with RPLND.