Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Serum AFP was determined serially by radioimmunoassay in 13 patients with ovarian germ cell tumors and in one patient with bilateral pure gonadoblastoma. There were 4 patients with pure dysgerminoma, one with pure endodermal sinus tumor (EST) and 8 with mixed germ cell tumors, all containing EST. The patients with dysgerminoma and gonadoblastoma had normal serum AFP at all times. All patients with tumors containing EST had raised serum AFP, although in most cases it was first determined between 1 and 3 weeks after operation and there was no evidence of metastases. Serum AFP became normal 5 to 7 weeks after operation and began to rise when disease recurred. Serum AFP determinations detected presence of recurrent disease long before it became detectable by other methods. Serum CEA was determined serially by radioimmunoassay in 8 of these patients, including 2 who dies with metastases, and was normal on all occasions.
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PMID:Serum alphafetoprotein (AFP) in diagnosis and management of endodermal sinus (yolk sac) tumor and mixed germ cell tumor of the ovary. 7 54

A review of the histology, clinical findings and results of therapy in 9 females with endodermal sinus tumor (EST) is presented. Five patients had histologically pure EST; 4 had EST mixed with other germ cell components. The site of primary tumor was the ovary in 8 of the 9 females; the remaining patient with an extraovarian primary represents the first reported case of EST arising in the vulva. The addition of combination chemotherapy has prolonged survival over historical controls treated with surgery or surgery plus irradiation. Adjuvant chemotherapy appears warranted as treatment for occult metastatic disease; postoperative radiation therapy appears useful in providing local control of primary disease. There is a suggestion of increased sensitivity of EST to combination chemotherapy as compared to other germ cell histologies with which it is commonly admixed.
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PMID:Endodermal sinus tumor: the Stanford experience and the first reported case arising in the vulva. 63 17

Germ cell tumours form an important group of gonadal neoplasms and are also found in a number of extragonadal sites like the mediastinum, para-pineal and sacrococcygeal regions and retroperitoneum. Although there are considerable differences between germ cell tumours occurring in different anatomical locations they exhibit a remarkable homology, and are considered as a group. In this review germ cell tumours are discussed as a group emphasizing some of the recent developments in this field. In the testis germ cell tumours form the most common group of neoplasms comprising 90% of all testicular tumours and 99% of them are malignant. In the ovary germ cell tumours comprise approximately 20% of ovarian neoplasms, and more than 90% are mature cystic teratomas and are benign. Malignant testicular neoplasms are 10 times more common than their ovarian and 20 times more common than their extragonadal counterparts. Malignant germ cell tumours have a specific age incidence and occur mainly in children and young adults. Due to this they represent one of the most important groups of neoplasms in this age group. Testicular germ cell tumours show marked racial and geographical differences occurring much more frequently in Western Europe, especially in Scandinavia, as compared with Southern and Eastern Europe. They are rare in Africa and are very uncommon in Blacks as compared to Whites. These remarkable differences are not observed in ovarian or extragonadal germ cell tumours. It is now accepted that histogenetically all the tumours in this group are of germ cell origin, and that germ cell tumours are capable of somatic (embryonal) and extra-embryonal differentiation (fig. 1). The occurrence of extragonadal germ cell tumours in anatomical locations in the midline of the body is explained on the basis of migration of the primitive germ cells during embryonic life from the wall of the yolk sac to the primitive gonad. An all embracing classification of germ cell neoplasms based on the WHO classifications of ovarian and testicular tumours is presented. The importance of careful and thorough examination of germ cell tumours is emphasized, especially in view of the recent advances in the therapy of malignant germ cell neoplasms. The value of tumour markers like alphafoetoprotein (AFP) and human chorionic gonadotropin (HCG) produced by endodermal sinus tumour (EST) and some embryonal carcinomas and choriocarcinoma and syncytiotrophoblastic giant cells respectively in diagnosis, monitoring the progress of the disease, and the efficacy of therapy, as well, as for early detection of metastases and recurrences, is strongly emphasized.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Germ cell tumours. 300 Mar 96

In the first five-year period of the Danish Testicular Carcinoma Study (DATECA) 1058 consecutive testicular germ cell tumours were examined. Of these, 554 were seminomas comprising 515 of typical type, 26 anaplastic and 13 spermatocytic; 497 were non-seminomas comprising 145 pure tumours and 352 mixed tumours of various types. Among the various subtypes of non-seminomas embryonal carcinoma (EC) was recorded in 87 per cent, endodermal sinus tumour (yolk sac tumour; EST) in 22 per cent, teratoma (T) in 55 per cent and choriocarcinoma (CC) in 17 per cent. Only very few tumours were pure EST or pure CC. Five tumours were recorded as 'others or uncertain'. The tumours were graded with regard to various histologic features. Moderate and severe necrosis, bleeding, and a large number of mitoses were significantly more frequent in non-seminomas. The presence of tumour tissue at the resection margin was also more frequent in non-seminomas. Tumours with a largest diameter of less than 2.5 cm had already caused metastases in 16 per cent of the seminomas and 29 per cent of the non-seminomas. Increasing size of the tumours was associated with increasing frequency of metastatic disease but this association was not directly proportional. Distribution of the various histologic types according to the stage of disease varied. Thus, 78 per cent of the seminomas presented in stage I while 54 per cent of the non-seminomas had localized disease. Anaplastic seminomas were distributed similarly to the non-seminomas while all spermatocytic seminomas, with one exception, were recorded as stage I. Of non-seminomatous subtypes pure EC was associated with the highest frequency of stage III, followed by mixed tumours containing CC components. Although the present series is large the heterogeneity of germ cell tumours demands further investigation of larger numbers to confirm some of the findings.
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PMID:Testicular germ cell tumours in Denmark 1976-1980. Pathology of 1058 consecutive cases. 609 40

61 patients with seminoma and 113 with nonseminomatous germ cell tumors of the testis were treated according to the histology, stage of disease, and serum levels of tumor markers (CEA, AFP, hCG, hPL and SP1). 33 were stage I, 63 stage II, and 78 stage III patients. Most patients with seminoma, mature teratoma, immature teratoma, and 'pure type' embryonal carcinoma, as well as the latter three types with seminomatous admixture, had normal serum levels of the markers. Sometimes, slightly elevated levels of hCG suggested the presence of metastases. But, serial measurements of the markers were seldom useful in monitoring therapy. The 5-year tumor-free survival rates were favorable: 100% for stage I and II disease; and 57 or 44% for, respectively, stage III seminoma or the other tumors amounting to 10% of the nonseminomatous group. The role of the five markers was significant in patients with teratoma with malignant transformation, choriocarcinoma, endodermal sinus tumor (EST), and embryonal carcinoma or teratocarcinoma with an admixture of EST or choriocarcinoma or both. Elevation of a marker was a grave prognostic sign. The 5-year survival rates were 100, 16, and 4% for stages I, II and III disease, respectively. An elevated level of one or more of the markers assayed was always useful for monitoring therapy. Decreasing level indicated regression. However, return of an elevated level to normal did not indicate eradication of all tumor and called for diagnosis by imaging modalities. Constantly elevated or increasing marker levels during treatment indicated resistance to therapy. An increasing level from any nadir during remission indicated recurrence. Elevated levels of any of the five markers tested were as important as imaging modalities, and often more sensitive.
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PMID:Evaluation of five tumor markers (AFP, CEA, hCG, hPL and SP1) in monitoring therapy and follow-up of patients with testicular germ cell tumors. 618 97

Two cases of endodermal sinus tumor (EST) are described in a 19-year-old girl and a 50-year-old menopausal women, respectively. Exstirpation uteri totalis cum adnexis was carried out in both cases. According to the FIGO the tumors were classified as Ic. The histologic diagnosis of EST was based on the presence of elements such as extraembryonic mesoderm, yolk sac mesoderm, vascular structures with Schiller-Duval bodies, PAS-positive globules in Duval sinus spaces. In the first case, where the proposed chemotherapy was refused, the patient died 4 months later with symptoms of abdominal metastases. In the other case, chemotherapy was applied according to the VAC program. At 13 months of the treatment a relaparotomy was made and the lymphatic nodes taken showed no metastases. Three months later, the tumor relapsed and the patient died at 22 months of the therapy. In the light of their observations and literature data the authors recommended a radical surgical intervention combined with intense polychemotherapy as the only effective approach to the problem.
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PMID:[Endodermal sinus tumor--a contribution to the clinical aspects of ovarian tumors]. 654 62

Endodermal sinus tumors (EST) are highly malignant lesions with a tendency to recur locally and with a high incidence of metastatic disease at the time of diagnosis. The clinical and radiographic spectra of 24 patients with extragonadal EST are reported. There were 17 females and seven males and the mean age of presentation was 21 months. The primary lesion occurred in the sacrococcygeal region in 16 patients; in the vagina in two patients; in the anterior mediastinum in two patients; and in the bladder, liver, nasopharynx and posterior cranial fossa in one patient each. Computed tomography (CT) is the most accurate study in delineating the extent of primary lesions particularly in the pelvis and head and neck and also for demonstrating metastatic disease in the lungs. Significant improvement in survival rates is obtained with a combination of surgery, chemotherapy and radiotherapy.
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PMID:Extragonadal endodermal sinus tumors in children: a review of 24 cases. 662 83

This case report concerns an endodermal sinus tumor (EST) arising in the pineal region of a 16-year-old boy who died 3 months after radiation. He developed extensive abdominal metastases through a ventriculoperitoneal shunt, whereas the primary tumor and a suprasellar metastasis could be controlled by radiotherapy, demonstrated by autopsy. The histologic diagnosis was supported by an elevated level of alpha-fetoprotein in serum and the demonstration of this marker in the tumor tissue by immunoperoxidase method. The poor diagnosis of all previously reported cases with pineal EST requires a combined modality of surgical approach, radiotherapy, and concomitant chemotherapy.
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PMID:Endodermal sinus tumor of the pineal region. Metastases through a ventriculoperitoneal shunt. 674 18

Fifteen patients with primary lung cancer or pulmonary metastases were treated with electrostatic therapy (EST). The patients were treated with either low voltage (200 to 1200 V), high voltage (500 to 2500 V), or high voltage together with high magnetic field. At six months after EST, tumour regression was observed in two cases, relief of symptoms, but no change in tumour size, in five cases, and no effect of EST in nine patients. In conclusion, no marked effect of EST for treatment of cancer could be observed.
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PMID:Electrostatic therapy (EST) of lung cancer and pulmonary metastasis: report of 15 cases. 753 Oct 32

Endodermal sinus tumours (EST) of the lower female genital tract are uncommon malignancies. The majority of these involve the vagina and cervix, though there are a few case reports of tumours involving the vulva. These are usually either locally advanced or have metastatic disease present at initial diagnosis, and generally do badly on treatment. This case report discusses primary vulval involvement by EST. It shows that the absence of tumour markers can be misleading, and discusses the role of radiation and chemotherapy in the treatment of this rare disease.
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PMID:Endodermal sinus tumour of the vulva: an interesting clinico-pathological problem. 849 26


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