Teratoma with malignant transformation in germ cell tumors in men

Ahmed, Tauseef; Bosl, George J.; Hajdu, Steven I.

doi:10.1002/1097-0142(19850815)56:4<860::aid-cncr2820560426>3.0.co;2-3

Cited by 212 publications

(146 citation statements)

References 16 publications

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“…Moreover, it will be difficult to detect mature teratoma by FDG-PET as it is a benign condition with a (near) normal metabolism. However, mature teratomas must be resected because of their potential for malignant transformation [21]. In the present series, FDG-PET had no additional value over CT in clinical staging of NSGCT I and IIA.…”

Section: -Fdg Pet For Staging Germ Cell Tumours After Chemotherapy 553contrasting

confidence: 58%

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The role of ¹⁸fluoro‐2‐deoxyglucose positron emission tomography in initial staging and re‐staging after chemotherapy for testicular germ cell tumours

Spermon¹,

et al. 2002

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Objective To investigate the role of 18 fluoro-2-deoxyglucose positron emission tomography (FDG-PET) tumorous residual mass the FDG-PET scan was clearly positive; in four of 12 with mature teratoma and inflammation components retroperitoneally, the FDG-PET was also positive. In contrast, eight patients with solitary mature teratoma had a negative PET result. In four of five patients with necrosis after chemotherapy the PET result was correctly negative. All eight patients on surveillance had a negative PET scan and were free of disease at median (range) of 14 (8-18) months. Interestingly, of the 12 patients with a correct negative PET result, 11 had no mature teratoma in their primary tumour. Nine of 10 patients with SGCT were correctly staged. Two FDG-PET studies showed increased uptake; in one, a viable seminomatous mass was found and in the other there was inflammation in the residual mass. In all other patients the FDG-PET scan correctly predicted absence of viability in the residual mass. Conclusions In primary staging, FDG-PET has no benefit over CT. In re-staging, a negative FDG-PET result predicts fibrotic residual mass in seminomatous GCT. Moreover, it could be useful to predict fibrotic residual mass in NSGCT in those patients with no teratoma component in their primary tumour.

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Section: -Fdg Pet For Staging Germ Cell Tumours After Chemotherapy 553contrasting

confidence: 58%

“…In most patients with NSGCT mature teratoma was found in the residual mass (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27). In five of them (16)(17)(18)(19)(20) FDG uptake was found (SUV 1.7-3.7).…”

Section: Resultsmentioning

confidence: 99%

The role of ¹⁸fluoro‐2‐deoxyglucose positron emission tomography in initial staging and re‐staging after chemotherapy for testicular germ cell tumours

Spermon¹,

et al. 2002

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“…[1][2][3] The median OS in one retrospective study was 23 months. 4 Complete surgical resection of residual or recurrent disease is recommended when feasible.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] A derivation from preexistent mesenchymal elements of the teratomatous tissue is assumed. 4 Alternatively, the nongerm tissue may arise from the malignant transformation of totipotential germ cell subpopulations showing partial differentiation into somatic mesenchymal tissue.…”

mentioning

confidence: 99%

Testicular germ cell tumor with rhabdomyosarcoma successfully treated by disease-adapted chemotherapy including high-dose chemotherapy: case report and review of the literature

Korfel

Fischer

Foss

et al. 2001

Bone Marrow Transplant

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A teratoma is associated with malignant nongerm cell tumors in 3 to 6% of patients with metastatic GCT who are treated with platinum-based CHT. 1-3 A derivation from preexistent mesenchymal elements of the teratomatous tissue is assumed. 4 Alternatively, the nongerm tissue may arise from the malignant transformation of totipotential germ cell subpopulations showing partial differentiation into somatic mesenchymal tissue. 5 Up to 80% of patients present with metastases. 4 Most nongerm cell malignancies associated with GCT are sarcomas, rhabdomyosarcoma being the most common subtype. 6 Sarcomas can be present in the primary tumor or appear in metastases. 1,7 Teratomas with rhabdomyosarcomatous differentiation have a poor prognosis. 4 Here, we report a rare case of a combination of seminoma, teratoma and rhabdomyosarcoma. To our knowledge, this is the first report of successful treatment of a metastasized teratoma with rhabdomyosarcomatous differentiation, with HD-CHT and APBSCT. Case reportA 51-year-old man with a left testicular mass underwent inguinal orchidectomy in November 1996. Histologically, the tumor was a combined seminoma, partially immature teratoma and rhabdomyosarcoma. Biopsy of the right testis revealed no malignancy. AFP and ␤HCG serum levels were normal. Retroperitoneal lymph node dissection was performed 3 weeks later due to the unfavorable histology and revealed no evidence of malignant spread.Three months later, the patient was admitted to our hospital because of generalized seizures. There was a 4-week history of back pain, appetite loss, nausea, vomiting, and lethargy. On physical examination, the patient was somnolent but there were no other significant abnormalities. CT scan of the brain and lumbar puncture yielded normal findings. Hematologic and blood chemical tests showed an elevated creatinine (489 mol/l; normal 58-110 mol/l), lactate dehydrogenase (1099 U/l; normal 120-240 U/l), and calcium (4.0 mmol/l; normal 2.24-2.78 mmol/l). A bone scan revealed no radiolabeled technetium uptake. Cytologic and histologic BM examination showed massive rhabdomyosarcoma involvement (Figure 1a), which was confirmed by histochemical stains positive for muscle-specific antigen and desmin (Figure 1b). MRI of the vertebral column revealed multiple spots with low signal intensity in T1-and high signal intensity in T2-weighted images typical of tumor infiltration (Figure 2a). A solitary metastasis was found in the liver.Infusions of normal saline, furosemide, steroids, and pamidronate were given. CHT with 50 mg/m 2 epirubicin for 1 day, etoposide 250 mg/m 2 , 2000 mg/m 2 ifosfamide, and 25 mg/m 2 cisplatin for 2 days each was initiated. The patient regained normal conciousness, and calcium and creatinine levels returned to normal. Four CHT courses were given (total epirubicin dose 200 mg/m 2 ) and 90 mg pami-

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“…On rare occasions, GCT cells undergo somatic malignant transformation (MT). This phenomenon, also known as 'teratoma with MT' according to the World Health Organization (WHO) definition [1], occurs in up to 6% of patients with GCTs [2][3][4]. The prognosis of patients with MT has been reported to be poorer than that of patients with the GCT counterpart [2][3][4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

A case of metastatic testicular germ-cell tumor with rhabdomyosarcoma successfully treated with germ-cell tumor-oriented chemotherapy

et al. 2011

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We report a case of metastatic testicular germcell tumor (GCT) with malignant transformation (MT) successfully treated with a GCT-oriented chemotherapy followed by surgery. A 48-year-old man presented with a right testicular tumor with retroperitoneal lymph node metastases. Pathological examination revealed that the primary tumor was rhabdomyosarcoma with mature teratoma, and the rhabdomyosarcoma element expressed placental alkaline phosphatase (PLAP) which is a marker of primitive germ cells or GCTs. After 4 cycles of GCT-oriented chemotherapy (VIP: etoposide, ifosfamide, and cisplatin), radiological partial response of retroperitoneal metastases was achieved, and subsequent retroperitoneal lymph node dissection revealed no remaining tumor cells. Our report suggests that GCT-oriented chemotherapy may be effective in treatment of patients with metastatic GCT with MT, particularly tumors which express PLAP in the MT element, although this disease entity has traditionally been considered to be chemoresistant.

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Teratoma with malignant transformation in germ cell tumors in men

Cited by 212 publications

References 16 publications

The role of ¹⁸fluoro‐2‐deoxyglucose positron emission tomography in initial staging and re‐staging after chemotherapy for testicular germ cell tumours

The role of ¹⁸fluoro‐2‐deoxyglucose positron emission tomography in initial staging and re‐staging after chemotherapy for testicular germ cell tumours

Testicular germ cell tumor with rhabdomyosarcoma successfully treated by disease-adapted chemotherapy including high-dose chemotherapy: case report and review of the literature

A case of metastatic testicular germ-cell tumor with rhabdomyosarcoma successfully treated with germ-cell tumor-oriented chemotherapy

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Teratoma with malignant transformation in germ cell tumors in men

Cited by 212 publications

References 16 publications

The role of 18fluoro‐2‐deoxyglucose positron emission tomography in initial staging and re‐staging after chemotherapy for testicular germ cell tumours

The role of 18fluoro‐2‐deoxyglucose positron emission tomography in initial staging and re‐staging after chemotherapy for testicular germ cell tumours

Testicular germ cell tumor with rhabdomyosarcoma successfully treated by disease-adapted chemotherapy including high-dose chemotherapy: case report and review of the literature

A case of metastatic testicular germ-cell tumor with rhabdomyosarcoma successfully treated with germ-cell tumor-oriented chemotherapy

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The role of ¹⁸fluoro‐2‐deoxyglucose positron emission tomography in initial staging and re‐staging after chemotherapy for testicular germ cell tumours

The role of ¹⁸fluoro‐2‐deoxyglucose positron emission tomography in initial staging and re‐staging after chemotherapy for testicular germ cell tumours