Conventional Cisplatin-Based Combination Chemotherapy Is Effective in the Treatment of Metastatic Spermatocytic Seminoma with Extensive Rhabdomyosarcomatous Transformation

Abstract

A 52-year-old man was presented with a huge left testicular mass and palpable cervical lymphadenopathy with retroperitoneal lymph node enlargement on an abdominal computed tomography. A left radical orchiectomy and an ultrasound-guided neck node biopsy were performed. A pathological examination revealed spermatocytic seminoma with extensive rhabdomyosarcomatous transformation, a condition known to be highly resistant to platinum-based chemotherapy. The patient received four cycles of etoposide, ifosfamide and cisplatin (VIP) chemotherapy. A repeat computed tomography revealed a substantial regression consistent with a partial response. Retroperitoneal lymph node dissection was attempted, which revealed rhabdomyosarcoma; however, complete microscopic resection was not achieved. After surgery, the residual abdominal lymph node progressed and salvage paclitaxel, ifosfamide and cisplatin (TIP) chemotherapy was employed, which again achieved a partial response. Here, we present a first case report of a spermatocytic seminoma with extensive rhabdomyosarcomatous transformation and multiple metastatic lymphadenopathies that showed a favorable response to platinum-based systemic chemotherapy.

Propolis from the Stingless Bee Trigona incisa from East Kalimantan, Indonesia, Induces In Vitro Cytotoxicity and Apoptosis in Cancer Cell lines

“…Although the mode of action of these drugs is to affect the synthesis of nucleic acids and/or proteins, drug resistant cancers have been found. For example, rhabdomyosarcoma was reported to be resistant to platinum-based chemotherapy, where neurotoxicity is the main dose-limiting side effect that prevents higher systemic doses being administered (Donzelli et al, 2004;Jeong et al, 2014). In addition, the extremely rare metastatic spermatocytic seminoma with sarcomatous transformation has been reported to be highly resistant to cytotoxic chemotherapy (Wetherell et al, 2013).…”

Spermatocytic seminoma of testis associated with undifferentiated sarcoma revealed in metastatic disease: A review and case report analysis

“…SS with sarcoma is an extremely rare diagnosis with only 20 cases previously reported in the literature ( Table 1 ). 2 , 3 , 4 This sarcomatous transformation, which occurs in approximately 6% of cases, induces a sudden rapid growth in the size of the tumor and is associated with aggressive behavior, presence of metastasis, and poor prognosis. The SS with a sarcomatous component has the same age incidence as the pure SS, the mean age of 51 years (range 29–68).…”

“…The SS with a sarcomatous component has the same age incidence as the pure SS, the mean age of 51 years (range 29–68). 2 , 3 …”

“…Eight cases of metastatic SS with sarcoma are documented in the literature and are highly resistant to cytotoxic chemotherapy with a median survival of 5 months. 3 …”

Additive Interaction of Cisplatin and Histone Deacetylase Inhibitors Combined Treatment in Rhabdomyosarcoma Cells – Αn Isobolographic Analysis

“…Introduction of other treatment systems like IVA (ifosfamide, vincristine and dactinomycin) or CEV (carboplatin, etoposide and vincristine), as well as IVE (ifosfamide, vincristine and etoposide) did not improve survival or reduce the intensity of local therapy, but was associated with increased toxicity (38). Recent data suggest favorable response to platinum-based systemic chemotherapy for RMS treatment at different localizations in the body (39)(40)(41)(42).…”