Urinary gonadotropins in management and prognosis of testicular tumor

Suprasellar germinoma. Unresolved problems in diagnosis, pathogenesis, and management

A suprasellar germinoma, initially thought to be granulomatous diencephalitis of uncertain cause, responded following chloramphenicol and methicillin treatment both by clinical and radiographic criteria and was not diagnosed until a third biopsy was performed. Analysis of this case and review of the literature lead to the conclusion that adequate diagnostic workup of such lesions requires that biopsy be extensive enough to include the central core as well as the granulomatous reaction that surrounds such tumors. Furthermore, since the degree of inflammation may fluctuate, regression does not mean that the lesion is not neoplastic in origin. In the present instance, the correct diagnosis could have been made earlier if the beta-chain of human chorionic gonadotropin had been measured in spinal fluid.

Urinary hexosaminidase in patients with lung carcinoma

The specific activity of urinary hexosaminidase was determined in 58 patients with various histological types of lung carcinoma. Compared to an apparently healthy control population, 32/35 patients with widely disseminated disease showed elevated values and 18/23 patients with disease confined to the chest had normal hexosaminidase values. Detailed studies of 18 patients indicated that declining hexosaminidase values were associated with effective therapy, rising values generally accompanied progressive disease.

Current dilemmas in the management of non-seminomatous germ cell tumors of the testis

Testicular tumors are the second most common neoplasm in young adult males. Improved techniques of staging, surgery, radiation therapy and chemotherapy have markedly improved the survival of these patients during the past twenty years. However, the treatment of non-seminomatous germ cell tumors remains controversial. This paper reviews the current literature and suggests that methods of performing controlled clinical trials must be found if we are to learn the best methods of treating these patients.