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Successful treatment of a primary endodermal sinus tumor of the liver
Author(s) -
Whelan J. S.,
Stebbings W.,
Owen R. A.,
Calne R.,
Clark P. I.
Publication year - 1992
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19921101)70:9<2260::aid-cncr2820700908>3.0.co;2-y
Subject(s) - medicine , endodermal sinus tumor , primary (astronomy) , sinus (botany) , general surgery , chemotherapy , germ cell tumors , physics , botany , astronomy , biology , genus
A 27‐year‐old woman had a large hepatic tumor and a markedly increased serum alpha‐fetoprotein (AFP) level. A diagnosis of endodermal sinus tumor was made after a needle biopsy was performed on the liver. Clinical and radiologic examinations did not show an alternative primary site. Treatment with cisplatin, etoposide, and bleo‐mycin was started, but, after three cycles, was changed to cisplatin, vincristine, methotrexate, bleomycin, dactino‐mycin, cyclophosphamide, and etoposide because the serum AFP level was decreasing too slowly. After additional chemotherapy was given, the patient was well but had an increased AFP level and a large residual mass in the liver. A right hemihepatectomy was performed, but no viable tumor was present. The patient is alive and disease‐free 5 years later. Thus, AFP levels may be misleading in the presence of large necrotic tumors. The authors stress the need to make a diagnosis of these rare tumors early because aggressive treatment with combination chemotherapy may result in cure. Cancer 1992; 70:2260‐2262.