Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0019209 (hepatomegaly)
 5,798 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Metastatic malignant teratoma of the testis is associated with early death for most afflicted patients. Chemotherapy has limited success with this disease. Medroxyprogesterone acetate (MPA) has been known to exert an antitumor effect in cancers of the endometrium, breast and kidney. This paper documents the objective improvement in 3 of 16 patients with metastatic testicular teratoma treated with MPA. The patients were aged 49, 34 and 28 years. 2 of these patients had multiple lung metastases which were unsuccessfully managed by actinomycin D therapy. The 34-year old patient exhibited well-marked tumor regression for several months following MPA therapy. However, his general condition deteriorated with hepatomegaly until death occured. The 49-year old exhibited no sign of tumor occurence and is alive and well 7 years after beginning MPA therapy. The 28-year old patient is currently clinically tumor-free after 2 years of MPA treatment. Actinomycin D will be stopped but MPA will be continued for another 12 months in gradually decreasing doses. The 3 cases demonstrate good response to treatment with MPA. Evidence suggests that progesterone, including MPA, inhibits the release of pituitary gonadotropins causing impairment of spermatogenesis and accessory gland function associated with pronounced degenerative testicular changes. 9 rare cases of spontaneous regression of testicular tumor were documented by Everson and Cale in a literature review covering the period 1900 and 1965. It is unlikely however that the improvement in the 2 cases presented in this report can be attributed to spontaneous regression. In both patients, metastases continued to progress until shortly after MPA treatment was initiated. Prospective multicenter clinical trials should be done to evaluate the therapeutic value of hormones, alone or in combination with chemotherapy and irradiation in the management of malignant testicular teratoma.
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PMID:Possible role of hormones in treatment of metastatic testicular teratomas: tumour regression with medroxyprogesterone acetate. 472 28