SUCCESSFUL TREATMENT OF RECURRENT MALIGNANT GERM-CELL TUMORS - REPORTOF 2 CASES

WE REPORT TWO patients with recurrent malignant germ cell tumors who w ere successfully treated with radiation therapy and cisplatin combinat ion chemotherapy. Patient 1, who had a suprasellar mixed yolk sac tumo r, had been free of tumor for 3.5 years after cisplatin/vinblastine/bl eomycin combination chemotherapy alone but showed a recurrent tumor in the pineal region. In Patient 2, who had a pineal a-fetoprotein-produ cing tumor, recurrent tumors appeared in the lateral ventricle 3 years after the tumor was controlled by radiation and cisplatin/vinblastine /bleomycin therapy. They were treated successfully again by radiation therapy, followed by cisplatin and etoposide combination therapy, and they have been free of tumor for 5.5 and 7 years after recurrence, res pectively. The total dose of cisplatin in both patients exceeded 1,000 mg/m2, which would have contributed to the control of the recurrent t umors. Anterior pituitary dysfunction observed in Patient 1 did not im prove, even after tumor disappearance by chemotherapy, suggesting seve re damage to the neurohypophysis by direct invasion of the tumor.