SULM – Schweizerische Union für Labormedizin | Union Suisse de Médecine de Laboratoire | Swiss Union of Laboratory Medicine

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J. Lenicek Krleza1 , J. Stepan2 , M. Nakic2 , V. Zizic1

1Children's Hospital Zagreb, Dep. for laboratory diagnostics, Klaiceva 16, Zagreb, Croatia, 2Children's Hospital Zagreb, Dep. for hematology and oncology, Klaiceva 16, Zagreb, Croatia

Aim of report: stress importance of value of serum alpha fetoprotein (AFP) in child with germ cell tumor.
Patient: eight months old girl was performmed routine ultrasound due to congenital abnormalities in urogenital system - ureterocoela. During this procedure in pelvis was find heteroechogenic tumor mass which probably make problems with urine derivation. We find also the high value of alpha-fetoprotein (> 16000 ng/ml). Tumor was at this time inoperable, surgeon performmed only punction biopsy and cytology was confirmed diagnosis of germ cell tumor. After confirmation of diagnosis we started with neoadjuvant chemotherapy- after three of VIP (vincristin- iphosphamide-cis-platinum) protocol (reduction protocol - 80% therapeutic dose) we had reduction of tumor size and infiltration of neighbourh tissues. The value of serum alpha-feto protein was measured before cycle, at the end of cycle and one time per week during treatment. At the end of third cycle we had normal value of alpha-fetoprotein (9,71 ng/ml). After imiging – ultrasound with color Doppler and computed tomography surgeon confirmed the necessity of tumor removal. Patohistology confirmed germ cell orgin of tumor. Postoperativly we have still normal value of alpha-fetoprotein (7,47 ng/ml). We will continue with three cycle of chemotherapy.
Conclusion: measurment of alpha-fetoprotein in our patient is important for confirmation of diagnosis, observation of treatment success and definition of time when tumor will be remove. We have to continue the measurment during postoperative chemotherapy and control period due to sensitivity of that tumor marker.


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