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New perspectives on therapy for vaginal endodermal sinus tumors

2002; Lippincott Williams & Wilkins; Volume: 168; Issue: 2 Linguagem: Inglês

10.1016/s0022-5347(05)64724-6

1527-3792

Liann N. Handel, Stephen Scott, Roger Giller, Brian Greffe, Mark A. Lovell, Martin A. Koyle,

Urologic and reproductive health conditions

No AccessJournal of UrologyPEDIATRIC UROLOGY: Classic Article in Pediatric Urology1 Aug 2002New perspectives on therapy for vaginal endodermal sinus tumors Liann N. Handel, Stephen M. Scott, Roger H. Giller, Brian S. Greffe, Mark A. Lovell, and Martin A. Koyle Liann N. HandelLiann N. Handel More articles by this author , Stephen M. ScottStephen M. Scott More articles by this author , Roger H. GillerRoger H. Giller More articles by this author , Brian S. GreffeBrian S. Greffe More articles by this author , Mark A. LovellMark A. Lovell More articles by this author , and Martin A. KoyleMartin A. Koyle More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)64724-6AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Malignant germ cell tumors account for 3% of childhood cancers. Endodermal sinus tumor, the most common malignant germ cell tumor, requires treatment primarily with chemotherapy and surgery is reserved as a last resort. It is rare for the vagina to be the primary site of endodermal sinus tumor, and we report on our experiences with this phenomenon at a single institution. Materials and Methods: We retrospectively reviewed the clinical features, treatment and outcomes of 3 children with vaginal endodermal sinus tumor. Results: Initial treatment was combination chemotherapy, in 2 patients. α-fetoprotein decreased rapidly and returned to normal in both. One patient is disease-free 7 years after chemotherapy and the other patient is currently disease-free with a normal α-fetoprotein 3 months after induction chemotherapy. In the remaining case progressive disease developed following initial chemotherapy and subsequent salvage surgery combined with radiation, chemotherapy and ultimately autologous bone marrow transplant was performed. The patient has remained disease-free for 6.5 years since completing this extensive therapy. Conclusions: Endodermal sinus tumor of the vagina is rare. All of our patients presented with painless bleeding of no obvious source. In such cases one must maintain a high index of suspicion for possible underlying pathological conditions even if ultrasound is negative. Evaluation must include endoscopic examination of the lower genitourinary tract. Bone marrow transplant should be considered as a last therapeutic resort in salvage cases of unresponsive vaginal endodermal sinus tumor. References 1 : Germ cell tumors. I. Tumor biology and classification. In: Neoplastic Diseases of Childhood. Edited by . New York: Harwood Academic Pub.1994: 827. chapt. 43. Google Scholar 2 : Endodermal sinus tumor of the vagina and cervix. Cancer1985; 55: 2558. Google Scholar 3 : Clinical experience with conservative surgery for vaginal endodermal sinus tumor. J Pediatr Surg1996; 31: 219. 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Google Scholar From the Departments of Pediatric Urology, Obstetrics and Gynecology, Hematology/Oncology and Pathology, The Children’s Hospital and The University of Colorado School of Medicine, Denver, Colorado© 2002 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byStriegel A, Myers J, Sorensen M, Furness P and Koyle M (2018) Vaginal Discharge and Bleeding in Girls Younger Than 6 YearsJournal of Urology, VOL. 176, NO. 6, (2632-2635), Online publication date: 1-Dec-2006. Volume 168Issue 2August 2002Page: 687-690 Advertisement Copyright & Permissions© 2002 by American Urological Association, Inc.Keywordsendodermal sinus tumorvaginasalvage therapygerminomaMetricsAuthor Information Liann N. Handel More articles by this author Stephen M. Scott More articles by this author Roger H. Giller More articles by this author Brian S. Greffe More articles by this author Mark A. Lovell More articles by this author Martin A. 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