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PubMed2003

Neuropsychological outcome in long-term survivors of a childhood extracranial solid tumor who have undergone autologous bone marrow transplantation.

The purpose of this study was to evaluate neuropsychological and adaptive functioning of children who have undergone bone marrow transplantation (BMT) without previous cranial irradiation. In total, 76 children treated for an extracranial tumor with BMT without total body irradiation (TBI) were evaluated at least 5 years after the end of the treatment.Overall, their performance and skills were in the normal range and their professional and academic outcomes were satisfactory. Nevertheless, we observed a deleterious effect of deafness on verbal IQ associated with the previous administration of cisplatin during conventional chemotherapy. In addition, reading difficulties had arisen. This could be related to absence from kindergarten or primary school during hospitalization. Finally, in the younger subgroup, visual-perceptual skills were found to be more fragile.

Adolescent↗

PubMed1994

Detection of numerical and structural chromosome abnormalities in pediatric germ cell tumors by means of interphase cytogenetics.

In contrast to the cytogenetically well characterized testicular germ cell tumors (GCT) in adults, reports on cytogenetic studies in pediatric GCT are scarce. The presence of an i(12p) and numerical abnormalities involving chromosome 12 are the most frequent cytogenetic changes in GCT of adults. We have performed in situ hybridization (ISH) studies on paraffin sections and on isolated nuclei of 13 pediatric GCT with particular emphasis on those chromosome abnormalities that are common in adult GCT. These include numerical and structural abnormalities of chromosomes 1 and 12 as well as numerical deviations of chromosomes 8, 10, X, and Y. The histological subsets of the tumors investigated included two dysgerminomas (DGE), one seminoma (SE), two embryonal carcinomas (EC), four mixed and two pure yolk sac tumors (YST), and one undifferentiated (IT) and one differentiated teratoma (TD). Similar to the GCT in adults, additional copies of chromosome 12 were the most frequently observed numerical abnormalities. In contrast to the findings in adult GCT, changes in the size of the pericentromeric hybridization signals of chromosome 12, suggesting the presence of i(12p) chromosomes, were found in only two cases. No chromosome abnormalities were found in the pure TD or in the TD cells of mixed tumors containing a YST component. In the YST portion, however, Ip deletions and/or numerical chromosome changes were present. Surprisingly, deletions of the short arm of chromosome I, del(I)(p36.3), were frequent in pediatric GCT and were the sole abnormality detected in two cases. The Ip36 deletions were present in all stage-IV EC and YST investigated and were absent in the relatively benign TD and in one YST stage-I. Therefore, Ip36 deletions may have value as a prognostic marker in pediatric GCT.

Adolescent↗

PubMed1999

Is radiosensitive cell line cross-sensitive to heat?: Effect of heat on two rat yolk sac tumor cell lines with different radiosensitivity.

The differences between two rat yolk sac tumor cell lines, which are of the same origin but differ in their response to irradiation, in thermal sensitivity and development of thermotolerance were investigated. A radiosensitive cell line NMT-1 is consistently less heat sensitive than the radioresistant cell line NMT-1R. The thermotolerances in NMT-1 and in NMT-1R preheated at 43 degrees C for 30 min, respectively, reached peaks at 6 h and at 12 h, but did not completely disappear at 48 h. Thermotolerance with a good correlation between both cell lines with HSP70 accumulation was observed in a different time course after a primary heating.

Animals↗

PubMedDate not supplied

Pregnancy outcome after prenatal exposure to bleomycin, etoposide and cisplatin for malignant ovarian germ cell tumors: report of 2 cases.

Bleomycin plus etoposide and cisplatin seem to be a promising alternative for women with ovarian cancer. We are reporting two cases with favorable pregnancy outcome after exposure to these chemotherapeutic agents at the second and third trimesters of pregnancy. A pregnant woman with a stage Ic yolk-sac tumor underwent a right oophorectomy with omentectomy, and received five cycles of bleomycin, etoposide and cisplatin from the 22nd week of pregnancy until delivery. The second case was a pregnant woman with a stage Ia immature teratoma who underwent right salpingo-oophorectomy and received two cycles of bleomycin, etoposide and cisplatin starting at 30th week of pregnancy. The two patients did not have any evidence of recurrence of ovarian cancer for 6 and 2 years, respectively. Their babies did not have any evidence of minor or major malformations, and showed normal neurological development at 6 and 2 years of follow-up, respectively.

Adult↗

PubMed1998

[Gastrocystoplasty for severely contracted bladder following high dose pelvic irradiation: a case report].

A 24-year-old female who had received hysterectomy and adnexectomy of bilateral appendages for yolk sac tumor at the age of 12 years, followed by repeated surgery and pelvic irradiation over a total of 100 Gy for relapse of tumor, suffered from a severely contracted bladder and renal dysfunction of serum creatinine level over 2.0 mg/dl. The diagnosis was radiation-induced contracted bladder with renal dysfunction due to vesicoureteral reflux. Since the small intestine was not considered suitable after high dose irradiation, the stomach was used to reconstruct the bladder. The vesical pressure, which was 70 cmH2O at the capacity of 30 ml, was decreased to 22 cmH2O at the capacity of 100 ml, 5 weeks after surgery. The renal function was stable with a serum creatinine level below 1.4 mg/dl and the bladder capacity was 200 ml, 15 months after surgery. This method using the stomach was considered valuable for bladder reconstruction after large dose pelvic irradiation.

Adult↗

PubMed2004

Epidemiologic analysis of 1,442 children and adolescents registered in the German germ cell tumor protocols.

BACKGROUND: Germ cell tumors (GCTs) constitute a heterogeneous group of tumors that significantly vary with respect to their clinical presentation and biology. The objective of this analysis was to analyze a large population-based pediatric cohort of GCTs and to evaluate the parameters age, sex, site of the tumor, histology, and potential correlations between these parameters. PROCEDURE: Between 1981 and 2000, 1,442 patients were prospectively enrolled onto the German protocols for testicular and non-testicular GCTs. Tumors were histologically classified according to the WHO. RESULTS: We observed a bimodal age distribution with a first peak during infancy and a second after the onset of puberty. At birth, almost all tumors were teratomas, sometimes with microfoci of yolk sac tumor, which on the other hand, was the predominant histology during childhood. After the onset of puberty, germinomatous GCTs represented the most frequent histological subtype, and malignant non-germinomatous GCTs often presented as mixed tumors with choriocarcinoma and embryonal carcinoma components. During infancy, non-gonadal GCTs accounted for the majority of GCTs, while after the onset of puberty, gonadal GCTs predominated. Notably, among non-gonadal GCTs, there was a female predominance during childhood and a strong male predominance during adolescence. CONCLUSIONS: Two separate groups of GCTs with distinct clinical features relevant for differential diagnosis and the diagnostic assessment can be distinguished. This observation correlates with genetic studies that reveal different genetic changes in childhood and adolescence GCTs. Further studies are needed to elucidate the molecular mechanisms of germ cell and GCT development that account for the age- and sex-dependent clinical manifestation.

Adolescent↗

PubMed1996

Cytological distinction between clear cell carcinoma and yolk sac tumor of the ovary.

Cytological characteristics of clear cell carcinoma (CCC) and yolk sac tumor (YST) of the ovary were examined and compared. Indices for differential diagnosis of these two histologically similar but biologically different tumors were analyzed based on cytological features of the tumor cells. The main results obtained were from three cases of CCC and one case of YST who underwent imprint smear or similar examinations. Seventeen cases of CCC and two of YST with positive cytology results, mainly obtained from ascites samples, were also examined. Cytological characteristics of CCC compared to those of YST were: more marked cohesiveness of tumor cells with less-marked pleomorphism, well-preserved cell borders, fine vesicular cytoplasm, evenly thickened nuclear membrane, and fewer nucleoli and multinucleated giant cells in number. Cells with large cytoplasmic vacuolation were infrequent, and hobnail-shaped tumor cells were rather few in number in CCC cases examined. On the other hand, in the case of YST, cells were more dyscohesive, with marked cellular pleomorphism, usually faint cell borders, no thickening of nuclear membrane and occasional presence of nuclear grooves. The "naked" cells were commonly observed. Further, nucleoli were frequently numerous in number, and multinucleated giant cells were frequently found which showed marked cellular and nuclear atypism. These characteristics found mainly in imprint smears were also relatively well preserved in specimens obtained from ascites or other metastatic sites. These findings indicate that detailed cytological examination can provide a means for differential diagnosis of CCC and YST, supplementing other clinical information.

Adenocarcinoma, Clear Cell↗

PubMed2003

Mitochondrial creatine kinase with atypical pI values detected in serum of a patient with ovarian hepatoid yolk sac tumor.

Atypical mitochondrial creatine kinase (creatine N-phosphotransferase, CK, EC 2.7.3.2) was detected in the serum of a patient with carcinoma of germ cell origin, probably hepatoid yolk sac tumor. The pI of the oligomeric atypical mitochondrial CK (Mi-CK) was found at the acidic side compared to that of the typical ubiquitous Mi-CK (uMi-CK), while the molecular size of the atypical Mi-CK was similar to that of the typical uMi-CK. The pIs of the oligomeric and the dimeric atypical Mi-CKs became the same as those of the typical uMi-CK upon treatment with 2-mercaptoethanol. Therefore, the atypical Mi-CK was suggested to be an oxidized form of uMi-CK, and the oxidation might have occurred in the mitochondria because the oligomeric atypical Mi-CK had atypical pIs. The physicochemical characteristics of the oxidized uMi-CK were similar to those of the typical uMi-CK.

Creatine Kinase↗

PubMed2005

Identification of recurrent chromosomal aberrations in germ cell tumors of neonates and infants using genomewide array-based comparative genomic hybridization.

Human germ cell tumors (GCTs) of neonates and infants comprise a heterogeneous group of neoplasms, including teratomas and yolk sac tumors with distinct clinical and epidemiologic features. As yet, little is known about the cytogenetic constitution of these tumors. We applied the recently developed genomewide array-based comparative genomic hybridization (array CGH) technology to 24 GCTs derived from patients under the age of 5 years. In addition, we included seven tumors derived from children and adolescents older than 5 years. In the series from those under the age of 5 years, most teratomas displayed normal profiles, except for some minor recurrent aberrations. In contrast, the yolk sac tumors displayed recurrent losses of 1p35-pter and gains of 3p21-pter and of 20q13. In the GCTs of patients older than 5 years, the main recurrent anomalies included gains of 12p and of whole chromosomes 7 and 8. In addition, gains of the 1q32-qter region and losses of the 6q24-qter and 18q21-qter regions were frequent in GCTs of varied histology, independent of age. We concluded that array CGH is a highly suitable method for identifying recurrent chromosomal anomalies in GCTs of neonates and infants. The recurrent anomalies observed point to chromosomal regions that may harbor novel diagnostic/prognostic identifiers and genes relevant to the development of these neoplasms.

Adolescent↗

PubMed1994

Demonstration of fibrils in the hyaline globules of yolk sac tumor with parietal differentiation in fine-needle aspiration smears.

Hyaline globules of the yolk sac tumor (YST) have been described as homogeneous pink intracellular globules and intercellular basement membrane material [Akhtar et al.: Diagn Cytopathol 1990:6:184-192]. In Diff-Quik-stained air-dried smears of a lung fine-needle aspiration (FNA) of YST metastatic from anterior mediastinum, short curvilinear nonbranching fibrils are demonstrated in the metachromatic hyaline substance. The fibril-containing hyaline substance, which presents as intracellular globules as well as extracellular matrix deposits, is a diagnostic clue for YST with parietal differentiation [Ulbright et al.: Am J Surg Pathol 1986; 10:151-164]. The fibrils are not observed in the translucent homogeneous golden yellow hyaline substance in the Papanicolaou preparation. The fibrils are speculated to be the core protein of proteoglycans. To the best of the author's knowledge, this is the first demonstration of fibrils in the hyaline substance of YST with parietal differentiation.

Adult↗

PubMed2000

Caffeine enhanced radiosensitivity of rat tumor cells with a mutant-type p53 by inducing apoptosis in a p53-independent manner.

The radiosensitizing effects of caffeine on two rat yolk sac tumor cell lines with a different p53 status were investigated. A reduction of radiation-induced G(2) arrest was caused by caffeine at a concentration of 2 mM in both cell lines. The reduction of survival was observed in a combination of radiation and 2 mM caffeine only in a lower radiation dose range, but not in a higher dose range in NMT-1 with a wild type p53. Radiosensitization of caffeine was recognized even in a higher dose range for cells with a mutant-type p53. Apoptosis, which was not prominent after irradiation alone or caffeine treatment alone, was induced by irradiation in combination with caffeine in cells with a mutant-type p53 through a p53-independent pathway.

Animals↗

PubMed1993

Increased serum levels of monosialo-alpha-fetoprotein in hepatocellular carcinoma and other malignancies.

Serum alpha-fetoprotein (AFP) from cord blood and from patients with hepatitis, cirrhosis, hepatocellular carcinoma, gastrointestinal tumors and yolk sac tumor was analyzed by extended agarose gel electrophoresis coupled with our sensitive detection method of antibody-affinity blotting. AFP was separated into AFP-A, AFP-B and AFP-C from the anode to the cathode, corresponding to disialo-, monosialo- and asialo-AFP, respectively, as revealed by the results of neuraminidase digestion of serum AFP. AFP-Af, which migrated ahead of AFP-A as band or leading smear and varied widely in intensity, was eliminated in calculating the proportions of other band intensities. Disialo-AFP was the major component and monosialo-AFP the minor one in benign conditions, the latter being 4.2 +/- 6.0% in chronic hepatitis and 9.0 +/- 8.9% in cirrhosis. Monosialo-AFP in hepatocellular carcinoma was increased significantly, the proportion being 29.9 +/- 11.2%. AFP in other malignancies was further characterized by the appearance of asialo-AFP.

Carcinoma, Hepatocellular↗

PubMed1992

Intratubular germ cell neoplasia in infantile yolk sac tumor. Verification by tandem repeat sequence in situ hybridization.

The strong association of intratubular germ cell neoplasia (ITGCN) with adult germ cell testicular tumors is well known, but studies noting the absence of ITGCN in certain germ cell neoplasms such as spermatocytic seminoma, childhood teratoma, and infantile yolk sac tumor (YST) have raised the issue of whether these latter neoplasms follow a different path of tumorigenesis, accounting for their more benign behavior. A case study illustrating the association of ITGCN with infantile YST is presented to challenge this hypothesis. In addition to the usual characteristic features that included strong cytoplasmic glycogen deposits, and focal placental alkaline phosphatase immunoreactivity, the atypical intratubular germ cells manifested triploidy by in situ hybridization using as probe a telomeric tandem repeat sequence, p1-79, specific to chromosome 1. The invasive YST cells, in contrast, showed evidence of tetraploidy by both in situ hybridization and flow and image cytometric studies, excluding the possibility that the atypical intratubular germ cells represented intratubular invasion by adjacent YST. These findings challenge the belief that the infantile YST follows a different path of tumorigenesis than its adult germ cell counterpart and suggest other hypotheses that might better explain its more benign behavior.

Blotting, Southern↗

PubMedDate not supplied

Usefulness of endometrial aspiration cytology for the preoperative diagnosis of ovarian carcinoma.

OBJECTIVE: To evaluate the usefulness of endometrial aspiration cytology for the preoperative diagnosis of ovarian carcinoma. STUDY DESIGN: A total of 210 patients with ovarian carcinoma were investigated by endometrial aspiration cytology. RESULTS: Fifty-five of 210 patients (26.2%) had positive endometrial aspiration cytology. The positive rates of endometrial cytology were 3.9% in stage I, 23.8% in stage II, 36.5% in stage III and 53.3% in stage IV. When classified by histologic type, the positive rates of endometrial cytology in patients with serous adenocarcinoma, mucinous adenocarcinoma, clear cell adenocarcinoma, undifferentiated carcinoma and yolk sac tumor were 38.9%, 11.8%, 21.1%, 16.7% and 16.7%, respectively. One hundred twenty-eight of 210 patients (61.0%) were positive on peritoneal cytology, and 54 of these 128 cases (42.2%) were also positive on endometrial cytology. The positive rates of endometrial cytology were especially high in patients with serous adenocarcinoma (51.2%) and those with clear cell adenocarcinoma (40.0%) among those who were positive on peritoneal cytology. Of 74 patients who were negative on peritoneal cytology, only one (1.4%) with mucinous adenocarcinoma had positive endometrial cytology. Hysterectomy was performed on 130 patients, and the positive rate of endometrial cytology was 100% in 4 patients with endometrial invasion and 15.9% in 126 cases without invasion. CONCLUSION: Endometrial aspiration cytology can detect ovarian carcinoma cells not only in patients with endometrial involvement but also in patients with positive peritoneal cytology. Endometrial aspiration cytology appears to be useful for the preoperative diagnosis of ovarian carcinoma.

Adenocarcinoma, Clear Cell↗

PubMed2002

Metastatic spinal cord compression of testicular yolk sac tumor.

INTRODUCTION: Pediatric testicular tumors are rare. Spinal metastasis of testicular yolk sac tumor (YST) is extremely rare, with only one reported case. CASE REPORT: We report a rare case of metastatic spinal cord compression of testicular YST in a 14-month-old boy who presented with progressive paraparesis and neurological bladder dysfunction. Two months prior to admission, he underwent a left radical orchiectomy for YST of the testis. Magnetic resonance imaging revealed severe spinal cord compression by the ventral epidural mass from T-9 to T-11 and at S-3. Emergency surgical resection was performed for tissue diagnosis and spinal decompression. Histopathological features of the epidural mass indicated metastasis of the testicular YST. CONCLUSION: Although spinal involvement with metastatic YST is rare, it must be considered in children with testicular YST exhibiting evidence of pain or weakness, and surgical decompression followed by adjuvant chemotherapy should not be delayed.

Decompression, Surgical↗

PubMed2000

Treatment of malignant ovarian germ cell tumors with preservation of fertility: reproductive performance after persistent remission.

To describe our experience with malignant ovarian germ cell tumors with special reference to reproductive performance after remission, medical records of 31 patients were reviewed. The mean age at diagnosis was 18.6 years. Tumor by stage was I in 16 cases, II in 5, III in 5, IV in 3, and recurrence in 2. Histology was dysgerminoma in 7 cases, yolk sac tumor in 10, immature teratoma in 7, choriocarcinoma in 1, and mixed-type tumor in 6. Conservative surgery for fertility preservation was performed in 21 cases. Postoperative chemotherapy was given to all cases except two with stage Ia dysgerminoma. Of 31 cases, 4 including one fertility-preserved case died of disease. The other 27 cases including 20 fertility-preserved cases were successfully treated. Twenty-five cases (92.6%) have been followed longer than 60 months and 13 cases (48.1%) longer than 120 months. By the last follow-up, 8 of the 20 fertility-preserved cases delivered a total of 9 normal babies. Of the remaining 12 nonpregnant cases, 3 married, 9 have had regular menses, and 3 have had menstrual problems. Two of the latter three cases have been in hypergonadotropic anovulatory cycles. One patient has been diagnosed with tubal infertility caused by peritubal adhesion. Thus, management of the disease with fertility preservation is safe and the majority of patients can attain or retain normal ovarian function and reproductive potential.

Adolescent↗

PubMedDate not supplied

Interaction of radiation and etoposide on two cell lines with different radiosensitivities in vitro.

PURPOSE: To investigate the differences between two rat yolk sac tumor cell lines with different radiosensitivities in etoposide sensitivity and in the sensitizing effect of etoposide in combination with irradiation. MATERIALS AND METHODS: NMT-1 is a parent radiosensitive cell line and NMT-1R is a variant radioresistant cell line. The effects were assessed by clonogenic assay. Apoptosis was evaluated by DNA fragmentation to investigate the mechanism of cell death. RESULTS: Etoposide potentiation of radiation sensitivity was manifested by elimination of the initial shoulder of the cell survival curve in radioresistant NMT-1R cells. However, there was no enhancement effect in radiosensitive NMT-1 cells. The incidence of apoptosis was elevated in NMT-1R cells treated with etoposide and radiation. CONCLUSION: Etoposide had a supra-additive effect in combination with irradiation for radioresistant NMT-1R cells due to the induction of apoptosis. However, a suppra-additive effect was not seen in radiosensitive NMT-1 cells.

Animals↗

PubMed1994

[Vitelline tumor: a rare tumor of the mediastinum].

A young patient presented with a rare tumour of the mediastinum. The first sign was liquid effusion in the right hemithorax. A major rise in alpha-foeto-protein level to 34,000 ng/ml rapidly led to diagnosis. Histological confirmation was obtained on a surgical biopsy specimen of the lung. Management included primary polychemotherapy followed by complete surgical exeresis. A second post-operative cycle of chemotherapy was given but only led to temporary normalization of alpha-foeto-protein levels and intensive chemotherapy followed by autograft to peripheral stem cells was performed. The vitellin tumour is a primary germ cell tumour usually observed in young men. It originates in extraembryonary primary mesenchymal tissue. Like other germ cell tumours, the diagnosis should be entertained for all tumours of the anterior mediastinum. Tumour markers useful for diagnosis and prognosis are beta-HCG, AFP and CEA. Levels above 500 ng/ml confirm vitellin tumour. Chemotherapy should be instituted rapidly using a BEP protocol (bleomycine, etoposide, cisplatinium) or a PVB protocol (cisplatinium, vinblastin, bleomycine). Using these new drugs and current therapeutic protocols, the rate of complete remission has risen from 13% to 40%.

Adult↗