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Postchemotherapy retroperitoneal residual mass in infantile yolk sac tumor
1Division of Urology, Veterans General Hospital-Taipei, Taiwan, Republic of China. juku.@vghtpe.gov.tw
Insights
Complete necrosis of residual yolk sac tumor after chemotherapy is rare in children. This case highlights successful treatment of recurrent yolk sac tumor with cisplatin-based chemotherapy and complete surgical resection, achieving long-term remission.
Area of Science:
- Pediatric Oncology
- Surgical Oncology
- Medical Chemotherapy
Background:
- Infantile yolk sac tumors (YS) can present with persistent retroperitoneal residual masses post-chemotherapy, even with normalized alpha-fetoprotein (AFP) levels.
- Recurrent YS tumors pose significant treatment challenges, necessitating effective therapeutic strategies to achieve durable remission.
Observation:
- A 38-month-old boy with recurrent YS tumor received cisplatin-based combination chemotherapy.
- Post-chemotherapy imaging revealed significant reduction of the retroperitoneal lymph node metastasis from 7 x 6 cm to 2 x 2 cm.
- Serum AFP levels normalized, and surgical resection of the residual mass showed complete necrosis without viable tumor cells.
Findings:
- Cisplatin-based chemotherapy effectively reduced tumor burden in a recurrent infantile yolk sac tumor.
- Complete pathological necrosis of the residual mass was achieved post-chemotherapy.
- Surgical resection of the necrotic residual mass led to a disease-free state.
Implications:
- This case suggests that aggressive chemotherapy followed by surgical resection can be a viable strategy for managing persistent retroperitoneal residual masses in recurrent infantile yolk sac tumors.
- Achieving complete pathological necrosis is a critical indicator of successful treatment response.
- Long-term disease-free survival is achievable in select cases of recurrent yolk sac tumors.
Background:
Persistent postchemotherapy retroperitoneal residual mass with normalization of alpha-fetoprotein (AFP) in infantile yolk sac tumor is rare.
Methods/Results:
A 38-month-old boy with recurrent yolk sac tumor was treated with cisplatin-based combination chemotherapy. After chemotherapy, the retroperitoneal lymph node metastasis, 7 x 6 cm in size, decreased to 2 x 2 cm. Serum AFP levels returned to normal. The retroperitoneal residual mass was resected and histologically showed complete necrosis without viable cancer cells.
Conclusion:
The patient has remained free of disease for 36 months after operation.