Modified BEP regimen leads to abatement of choriocarcinoma syndrome in a patient with extra gonadal germ cell tumor : a case report

• Published in: Hinyokika kiyo. Acta urologica Japonica Vol. 60; no. 4; pp. 183 - 187
• Main Authors: Oshima, Jumpei, Uemura, Motohide, Kato, Taigo, Nagahara, Akira, Kiuchi, Hiroshi, Tsujimura, Akira, Nonomura, Norio
• Format: Journal Article
• Language: Japanese
• Published: Japan 01.04.2014
• Subjects: Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Bleomycin - therapeutic use; Choriocarcinoma, Non-gestational - drug therapy; Cisplatin - therapeutic use; Etoposide - therapeutic use; Humans; Lung Neoplasms - secondary; Male; Middle Aged; Neoplasms, Germ Cell and Embryonal - drug therapy; Respiratory Distress Syndrome, Adult - etiology; Syndrome
• ISSN: 0018-1994

We present a case study of a 46-year-old man with extra gonadal germ cell tumor with multiple lung metastases and very high levels (324,100 mIU/ml) of the tumor marker human chorionic gonadotropin (hCG). He underwent chemotherapy with VP-16, ifosfamide and cisplatinum regimen, but on day 2, he noticed strong dyspnea. A chest X-ray showed bilateral infiltration of the lungs, and he was diagnosed with acute respiratory distress syndrome (ARDS) from choriocarcinoma syndrome. After ARDS improved, he underwent modified bleomycin, VP-16 and cisplatinum for induction therapy again. After salvage chemotherapies, levels of the tumor marker hCG decreased to normal levels, and retroperitoneal lymph node dissection and left lung wedge resection were performed to confirm pathological complete remission. No obvious recurrence, as shown by tumor markers and imaging studies, has been observed for 17 months after the treatments.