Table 1. Reported Cases of ‘Burned Out’ TGCT.
n = number of cases
aFP = alpha-fetoprotein
BhCG = beta-human chorionic gonadotropin
LDH = lactate dehydrogenase
N = normal level
+ = elevated level
BEP = bleomycin, etoposide, cisplatin
RPLND = retroperitoneal lymph node dissection
NR = not reported
NOS = not otherwise specified
| First Author/Citation | Year of Study | Presenting/Metastatic Site | Age of Patient | Tumor Markers | Histology | Treatment | Outcome | ||||||
| Balalaa N [17] | 2011 | Retroperitoneal (n=1) | 31 | aFP | N | NR | BEP | Treatment response | |||||
| BhCG | N | ||||||||||||
| LDH | + | ||||||||||||
| Balzer BL [18] | 2006 | Retroperitoneal (n=20) | 17-67 (mean 32) | BhCG | + (n=2) | Seminoma (n=26) | NR | NR | |||||
| Widely disseminated tumor (n=2) | |||||||||||||
| Lung and Liver (n=1) | |||||||||||||
| Mediastinum (n=1) | |||||||||||||
| Other (thyroid, neck thoracic cavity) (n=1) | |||||||||||||
| Testicular mass (n=7) | |||||||||||||
| Castillo C [19] | 2003 | Retroperitoneal (n=1) | 25 | aFP | + | Mature teratoma | BEP | Initial clinical response | |||||
| BhCG | + | ||||||||||||
| Comiter CV [20] | 1995 | Retroperitoneal (n=1) | 22-36 | NR | NR | NR | NR | ||||||
| Supraclavicular (n=1) | |||||||||||||
| Curigliano G [21] | 2006 | Retroperitoneal (n=1) | 42 | aFP | N | Seminoma | Orchiectomy, BEP, and RPLND | NR | |||||
| BhCG | + | ||||||||||||
| LDH | N | ||||||||||||
| Fabre E [5] | 2004 | Testicular (n=1) | 32 | aFP | N | Seminoma | Orchiectomy and Radiotherapy (30Gy) | Free of disease 16 years after the diagnosis | |||||
| BhCG | N | ||||||||||||
| LDH | N | ||||||||||||
| Retroperitoneal (n=1) | 35 | aFP | + | Mature teratoma | Orchiectomy, BEP plus vincristine, and RPLND | Free of disease 6 years after the diagnosis | |||||||
| BhCG | + | ||||||||||||
| Retroperitoneal (n=1) | 50 | aFP | N | Seminoma | Orchiectomy, RPLND, and EP | Total remission 3 years after the diagnosis | |||||||
| BhCG | N | ||||||||||||
| LDH | + | ||||||||||||
| Retroperitoneal (n=1) | 17 | aFP | N | Mature teratoma | BEP, retroperitoneal mass resection, and orchiectomy | Free of disease 4 years after the diagnosis | |||||||
| BhCG | N | ||||||||||||
| LDH | N | ||||||||||||
| Supraclavicular (n=1) | 39 | aFP | N | Seminoma | BEP followed by salvage chemo (vinblastine, etoposide, ifosfamide, and cisplatin) | Total remission 3 years after the diagnosis | |||||||
| BhCG | N | ||||||||||||
| LDH | N | ||||||||||||
| George SA [22] | 2015 | GIST (n=1) | 24 | aFP | N | Mixed GCT | Orchiectomy | NR | |||||
| BhCG | N | ||||||||||||
| LDH | N | ||||||||||||
| Gurioli A [23] | 2013 | Retroperitoneal (n=1) | 35 | aFP | N | Seminoma | BEP and orchiectomy | Free of disease 2 years after the diagnosis | |||||
| BhCG | N | ||||||||||||
| LDH | + | ||||||||||||
| Retroperitoneal (n=1) | 50 | aF | N | Seminoma | Orchiectomy, vincristine, ifosfamide, bleomycin, and surgical debulking of mass | Free of disease 4 years after the diagnosis | |||||||
| BhCG | + | ||||||||||||
| Hu B [24] | 2015 | Retroperitoneal (n=1) | 37 | aFP | N | Seminoma | NR | NR | |||||
| BhCG | N | ||||||||||||
| LDH | N | ||||||||||||
| Jaber S [25] | 2010 | Retroperitoneal (n=1) | 32 | aFP | N | Seminoma | Orchiectomy and surgical removal of the retroperitoneal mass | NR | |||||
| BhCG | N | ||||||||||||
| Kebapci M [26] | 2001 | Supraclavicular (n=1) | 22 | aFP | N | GCT having choriocarcinoma and probable embryonal cell carcinoma components | Orchiectomy and BEP | NR | |||||
| BhCG | + | ||||||||||||
| Leleu O [27] | 2000 | Pulmonary (n=1) | 30 | aFP | + | Malignant germ cell tumor | Orchiectomy and BEP | Stable 3 years after the diagnosis | |||||
| BhCG | + | ||||||||||||
| Lopez JI [28] | 1994 | Retroperitoneal (n=1) | 20 | aFP | N | Choriocarcinoma | Orchiectomy, biopsy of retroperitoneal masses, BEP plus vincristine | Deceased 7 months after initial complaints | |||||
| BhCG | + | ||||||||||||
| LDH | + | ||||||||||||
| Mesa H [29] | 2009 | Gastric ulcers (n=1) | 55 | aFP | N | Poorly differentiated adenocarcinoma- further studies revealed seminoma | Orchiectomy, vincristine, ifosfamide and cisplatin | Free of disease 1 years after the diagnosis | |||||
| BhCG | N | ||||||||||||
| Onishi K [30] | 2014 | Para-neoplastic neurological syndrome (n=1) | 41 | NR | Seminoma | Orchiectomy and chemotherapy | Free of disease 15 months after the diagnosis | ||||||
| Patel MD [8] | 2007 | Testicular (n=1) | 23 | aFP | N | Mixed GCT | Orchiectomy | NR | |||||
| BhCG | N | ||||||||||||
| LDH | N | ||||||||||||
| Perimenis P [31] | 2005 | Retroperitoneal (n=1) | 40 | aFP | N | Seminoma | Orchiectomy, resection of retroperitoneal mass, and radiotherapy to para-aortic nodes | Free of disease 2 years after the diagnosis | |||||
| BhCG | N | ||||||||||||
| LDH | N | ||||||||||||
| Peroux E [32] | 2012 | Retroperitoneal (n=1) | 18 | aFP | + | Non-seminoma NOS | Orchiectomy and chemotherapy | Full remission | |||||
| BhCG | N | ||||||||||||
| Preda O [33] | 2011 | Retroperitoneal (n=1) | 43 | aFP | N | Seminoma | Orchiectomy and chemotherapy | Free of disease 5 months after the diagnosis | |||||
| BhCG | N | ||||||||||||
| LDH | + | ||||||||||||
| Qureshi JM [34] | 2014 | Retroperitoneal and Pulmonary masses (n=1) | 20 | aFP | N | Teratoma GCT | BEP followed by orchiectomy, RPLND, and hepatic mass resection | Free of disease 2 years after the diagnosis | |||||
| BhCG | + | ||||||||||||
| LDH | + | ||||||||||||
| Rzeszutko M [35] | 2015 | Spermatic cord (n=1) | 56 | aFP | N | Non-seminoma NOS | Resection of spermatic cord mass | Free of disease 6 months post operatively | |||||
| BhCG | N | ||||||||||||
| Sahoo PK [36] | 2013 | Retroperitoneal (n=1) | 33 | aFP | N | Seminoma vs poorly differentiated carcinoma (seminoma confirmed on IHC) | Orchiectomy and BEP | Patient under observation at time of publication | |||||
| BhCG | N | ||||||||||||
| LDH | N | ||||||||||||
| Suzuki K [37] | 1998 | Mediastinum (n=1) | 27 | aFP | N | Teratoma GCT and sarcomatous elements | BEP | NR | |||||
| BhCG | N | ||||||||||||
| Tasu J [7] | 2003 | Retroperitoneal (n=1) | 23 | NR | Non-seminoma NOS (n=3) | seminoma (n=2) | Non-seminoma NOS: BEP (n=3) | Metastatic seminoma: radiotherapy and RPLND (n=1) | Seminoma: orchiectomy (n=1) | Complete remission (n=3) | Free of disease after 5 year follow up (n=1) | Free of disease after 7 year follow up (n=1) | |
| Retroperitoneal (n=1) | 35 | ||||||||||||
| Retroperitoneal (n=1) | 50 | ||||||||||||
| Retroperitoneal (n=1) | 17 | ||||||||||||
| Supraclavicular (n=1) | 33 | ||||||||||||
| Yamamoto H [38] | 2007 | Gastric tumor (n=1) | 39 | aFP | N | Seminoma | Orchiectomy and EP | Free of disease 2 years after the diagnosis | |||||
| BhCG | N | ||||||||||||
| LDH | + | ||||||||||||
| Yucel M [39] | 2009 | Retroperitoneal (n=1) | 28 | aFP | N | ‘Burned out’ testicular tumor NOS | Orchiectomy and BEP | Free of disease 5 years after the diagnosis | |||||
| BhCG | N | ||||||||||||
| LDH | + | ||||||||||||
| Yucel M [40] | 2009 | Prostate (n=1) | 49 | aFP | N | Seminoma | Orchiectomy, BEP plus vincristine, and radiotherapy to mediastinum retroperitoneal and pelvic lymph nodes | Free of disease 7 years after the diagnosis | |||||
| BhCG | N | ||||||||||||