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Patient: M.Yu. Lurtsy-Ogly, born October 16, 2004

Admitted to the Pediatric Department of Kiev City Oncology Hospital on June 16, 2006. Complaints: tumor in the gluteal region on the right, pain syndrome.

 

Diagnosis: immature teratoma of small pelvis, lung metastases, stage 4, clinical group 2.

 

Immunohistochemical decision: alterations in favor of immature teratoma (June 29, 2006).

Data of CT examinations (abdomen, small pelvis, chest) handed to the child’s parents.

Four cycles of presurgical polychemotherapy (PEB) in dosage according to age. Good positive effect (reduction of tumor in the small pelvis, regression of lung metastases).

 

October 26, 2006: removal of residual tumor in the presacral region with sacrum resection.

Histological decision of November 2, 2006: teratoblastoma with predominant elements of embryonal cancer and large necroses of tumor tissue after polychemotherapy.

During the surgery, the tumor was found to be disseminating into the sacral canal.

One cycle of polychemotherapy (PEB).

December 6, 2006: thoracotomy on the right, marginal resection of right-lung S8 and S10.

One cycle of polychemotherapy (PEB).

MRI examination of the sacrococcygeal region: residual tumor detected in S1-S2.

One cycle of polychemotherapy (PEB).

Examination:

CT of thorax, abdomen, and retroperitoneum (January 19, 2007): residual “live” tumor tissue of the spinal canal at the level of S1, S2 on the right; new lesions in lungs (on the right, S6 at the apex; on the left, subpleurally S6 and S12)

Course of VAC chemotherapy: Vincristine 1.5 mg/m² on day 1; Cyclophosphanum 1200 mg/m² on days 1, 2; Dactinomycin 0.75 mg/m².

CT examination of thoracic cavity, abdominal cavity, retroperitoneum and small pelvis: continued growth of tumor into the spinal canal extradurally at the level of Th9–S1 on the left. Slight increase in the size of lung lesions.

On the recommendation of the Chief Child Oncologist of Ukrainian Ministry of Public Health, the following polychemotherapy course was started:

Holoxan 2000 mg/m² on days 1 to 3

Adriablastin 60 mg/m² 1 course in 2 days

 

Head of Pediatric Department                                                     /signature/