Brain metastasis as the site of relapse in germ cell tumor of testis

Raina, Vinod; Singh, Supriya; Kamble, Nitin; Tanwar, Rajendra Kumar; Rao, K. Narayan; Dawar, Ramesh; Rath, G. K.

doi:10.1002/1097-0142(19931001)72:7<2182::aid-cncr2820720719>3.0.co;2-p

Cited by 35 publications

(10 citation statements)

References 6 publications

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“…The International Germ Cell Cancer Collaborative Group reported that the incidence of initial brain metastasis was about 10-15% of advanced TGCT and 1-2% of all TGCT. [5][6][7][8] These rates are consistent with other reports. [8][9][10] According to the IGCCC, almost all patients with non-pulmonary metastases, such as those of the brain, belong in the poor prognosis group.…”

Section: Introductionsupporting

confidence: 92%

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Brain metastases from testicular germ cell tumors: A retrospective analysis

et al. 2009

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Objectives: To review our series of testicular germ cell tumors with brain metastases and to establish an optimal treatment strategy for them. Methods: Twenty-seven cases of testicular germ cell tumors from three institutions were retrospectively reviewed. Results: Twenty-six were non-seminomatous tumors and only one was a seminoma. Based on the International Germ Cell Consensus Classification, two cases were classified as good prognosis, seven as intermediate prognosis and 18 as poor prognosis. Chemotherapy was carried out in all patients. Additionally, whole-brain radiotherapy was performed in 10 cases, stereotactic radiosurgery in six, whole-brain radiotherapy combined with stereotactic radiosurgery in three and complete surgical resection in five. Three patients received chemotherapy only. Cancer-specific 5-and 10-year survival rates were both 35.9%. The prognosis of those with brain metastases at the time of diagnosis tended to be better than those developing brain metastases during treatment. Those with a single brain metastasis showed significantly better survival than those with multiple brain metastases. No other significant prognostic factor was found at multivariate analysis. Conclusion: Testicular germ cell tumors with brain metastases can be managed with the combination of whole-brain radiotherapy, stereotactic radiotherapy, and/or surgical resection in combination with chemotherapy.

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Section: Introductionsupporting

confidence: 92%

“…Brain metastasis from a TGCT is a relatively rare event. The International Germ Cell Cancer Collaborative Group reported that the incidence of initial brain metastasis was about 10–15% of advanced TGCT and 1–2% of all TGCT 5–8 . These rates are consistent with other reports 8–10 .…”

Section: Introductionsupporting

confidence: 89%

Brain metastases from testicular germ cell tumors: A retrospective analysis

et al. 2009

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“…A small proportion of patients, usually with predisposing factors, relapse in the inguinal nodes. Uncommon sites of isolated metastases such as brain and tonsil have been noted in case reports 36,37 . Chemotherapy is the treatment of choice for supra‐diaphragmatic relapse and gives close to a 100% cure rate.…”

Section: Adjuvant Radiotherapymentioning

confidence: 99%

“…Uncommon sites of isolated metastases such as brain and tonsil have been noted in case reports. 36,37 Chemotherapy is the treatment of choice for supra-diaphragmatic relapse and gives close to a 100% cure rate. Inguinal relapse can often be treated successfully with radiotherapy to the involved area.…”

Section: Adjuvant Radiotherapymentioning

confidence: 99%

Stage I seminoma: What should a practicing uro‐oncologist do in 2009?

Skliarenko¹,

Vesprini²,

Warde³

2009

Int J of Urology

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Testicular tumors are uncommon, but they continue to represent an important group of malignancies in young men. It is the most common solid malignancy in males between the ages of 20 and 35, and primary germ cell tumors are the most common histological type. In the United States in 2008, approximately 4800 cases of seminoma, approximately 4100 of which were stage I disease were projected after the completion of staging investigations.Remarkable progress has been made in the treatment of testicular seminoma over the past 25 years. Management options of stage I seminoma include radiotherapy, surveillance, or adjuvant chemotherapy. Standard management until recent years has been adjuvant retroperitoneal radiotherapy. Although providing excellent long term results, this approach has been associated with increased risk of gonadal toxicity, development of secondary malignancies and an increased risk of cardiovascular disease. The use of surveillance in management of patients with stage I seminoma is therefore becoming more frequent as it minimizes the burden of treatment and maintains the cure rate at virtually 100%. Adjuvant chemotherapy using Carboplatin has been investigated as an alternative management approach. However, the long term outcomes of patients managed with Carboplatin are not yet clear and this strategy should only be used in a study setting. It has been suggested that more patients with stage I seminoma will die of their treatment than of their cancer; therefore, the thrust of modern management should be to maintain 100% cure while minimizing the burden of treatment.

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“…Similarly, in a report by [6], no indication of the sites of metastatic disease are reported in the 305 patients reviewed. Raina et al [17] reported on three adult patients with isolated brain metastasis as a site of relapse of testicular germ cell tumor and made reference to 10 other adult patients. Two of their patients were alive greater than 15 months from the recurrent disease after surgery and radiation therapy.…”

Section: Case Reportmentioning

confidence: 99%

Isolated CNS metastasis as the first site of recurrence in a child with germ cell tumor of the mediastinum

Berkow

Kelly

1995

Med. Pediatr. Oncol.

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We describe a 2-year-old black female who was previously in complete remission from a stage 4 mediastinal germ cell tumor (stage 4 because of a single pulmonary parenchymal lesion). She presented with headaches, obtundation, and brain herniation, and suffered sudden death 12 months after completing high-dose chemotherapy. Autopsy revealed a large intraventricular lesion with mixed germ cell tumor elements, but no other evidence of malignancy was found. This case represents the first report of isolated CNS metastasis of malignant germ cell tumor in a child in apparent remission without evidence of advanced or recurrent disease in other sites. It is possible that the aggressive chemotherapy used resulted in a change in the natural history of this disorder.

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Brain metastasis as the site of relapse in germ cell tumor of testis

Cited by 35 publications

References 6 publications

Brain metastases from testicular germ cell tumors: A retrospective analysis

Brain metastases from testicular germ cell tumors: A retrospective analysis

Stage I seminoma: What should a practicing uro‐oncologist do in 2009?

Isolated CNS metastasis as the first site of recurrence in a child with germ cell tumor of the mediastinum

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