Prolonged survival in a patient with disseminated malignant teratoma in the presence of a persistently elevated serum alpha-fetoprotein level
✍ Scribed by Clive Stewart Lawson; Janine Lucia Mansi; Eve Wiltshaw
- Publisher
- John Wiley and Sons
- Year
- 1989
- Tongue
- English
- Weight
- 222 KB
- Volume
- 63
- Category
- Article
- ISSN
- 0008-543X
No coin nor oath required. For personal study only.
✦ Synopsis
The authors report a patient with disseminated malignant teratoma who has survived for 3.5 years after discontinuation of treatment despite a persistent and nonprogressive elevation of his serum alpha-fetoprotein level. Potential sources of the marker in his case are discussed and the possibility of a chemotherapeutically induced evolution of his tumor considered.
Cancer 63:804-806, 1989.
HE VALUE OF MEASURING Serum markers, especially
T alpha-fetoprotein (AFP) and beta human chorionic gonadotrophin (HCG) in the management of patients with tumors of germ cell origin is well established. These measurements not only reduce errors in staging, indicate possible histologic findings, and provide prognostic information but also act as objective indicators of response to therapy and of disease relapse. However, we report a patient with a persistently elevated serum AFP level who has survived for over 4 years after cessation of treatment for disseminated malignant teratoma and more than 6 years after diagnosis.
Case Report
A 23-year-old man presented in June 1981 with a 3-month history of pain in the left chest and left upper abdomen. Physical examination revealed a 5 X 10 cm mass in the left hypochondrium and a left hydrocele. He had multiple bilateral metastases on his chest radiograph and elevated serum markers with an AFP of 2400 kU/1 (NR < 10) and an HCG of 42 IU/I (normal value [NR] < 4). Abdominal computerized tomography (CT) scan showed a retroperitoneal soft tissue mass on the left from LI to L4 with an associated hydronephrosis. Fine-needle biopsy of a pulmonary deposit was suggestive of adenocarcinoma. Histologic examination of the left testis after inguinal orchidectomy revealed no evidence of tumor.