Two patients with advanced
germ cell tumor who entered complete remission following intensive
combination chemotherapy,
radiation therapy and surgical intervention are reported. A 28-year-old businessman presented with
abdominal pain and masses associated with an elevated HCG level for which he underwent exploratory
laparotomy. Large retroperitoneal masses were found and microscopical examination of the masses were revealed
seminoma. Three courses of
combination chemotherapy consisting of CDDP, VLB and PEP were given to the patient followed by
radiation therapy to the parailiac, paraaortic, mediastinal and supraclavicular lymph nodes with boost irradiation to the paraaortic lymph nodes where the large masses were located. The other patient was a 21-year-old student who developed sharp precordial
chest pain which proved to be due to a large mediastinal mass accompanied by an elevated AFP level. He was treated with
radiation therapy to the mediastinum, surgical resection and
combination chemotherapy. However, he showed recurrence in the lungs associated with rising AFP levels, and was given a salvage
chemotherapy consisting of 3 courses of CDDP, ADR, PEP and
Etoposide. Both patients were successfully treated with combined modalities of treatment including intensive
chemotherapy and have been off
therapy without recurrence for over 12 and 4 months, respectively.