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Successful treatment of a high-risk nonseminomatous germ cell tumor using etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine: A case report

Authors
Yun, JinaLee, Sang W.Lim, Sung H.Kim, Se H.Kim, Chan K.Park, Seong K.
Issue Date
Nov-2020
Publisher
Baishideng Publishing Group Co. Limited
Keywords
Antineoplastic combined chemotherapy protocols; Choriocarcinoma; Testicular neoplasms; Cyclophosphamide; Methotrexate; Case report
Citation
World Journal of Clinical Cases, v.8, no.21, pp 5334 - 5340
Pages
7
Journal Title
World Journal of Clinical Cases
Volume
8
Number
21
Start Page
5334
End Page
5340
URI
https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/2322
DOI
10.12998/wjcc.v8.i21.5334
ISSN
2307-8960
Abstract
BACKGROUND Choriocarcinoma is an infrequent entity and the most aggressive subtype of germ-cell tumors. Because of early metastatic spread and rapid disease progression, choriocarcinoma patients display poor prognosis. Although etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine (EMA-CO) regimen is widely used to treat gestational trophoblastic tumors in females, its role in treating male choriocarcinoma is seldom reported. CASE SUMMARY A 32-year-old man was diagnosed with burned-out primary germ cell tumors (GCT) with retroperitoneum, liver and lung metastases. Biopsy of the liver revealed pure choriocarcinoma. The patient received bleomycin, etoposide, and cisplatin chemotherapy. After two cycles of treatment, response evaluation revealed the mixed response. EMA-CO regimen was used in the second-line therapy. After eight cycles, the patient showed a potentially resectable state and thus, all residual masses were surgically removed. The patient was completely cured, and 10 years later, he is leading a healthy life without complications. CONCLUSION This paper is the first case of high-risk nonseminomatous GCT in a male patient to be successfully treated with the EMA-CO regimen. The EMA-CO regimen can be used actively in patients with high-risk nonseminomatous GCT.
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