Chemotherapeutic complete remission in patients with metastatic ovarian dysgerminoma: Potential for cure and preservation of reproductive capacity

Two patients with metastatic dysgerminoma of the ovary were treated with a combination of etoposide, bleomycin, and cisplatin at The University of Texas M. D. Anderson Hospital and Tumor Institute at Houston. Both patients achieved a complete remission. Patient 1 developed a massive recurrence in the para‐aortic lymph nodes 21 months after diagnosis and treatment with right salpingo‐oophorectomy alone. She received four cycles of chemotherapy and is free of disease 21 months from the start of chemotherapy. Patient 2 had Stage III dysgerminoma and a lymphangiogram positive for tumor in the para‐aortic lymph nodes. After surgery she received three cycles of chemotherapy and is free of disease 20 months from the start of chemotherapy. Both complete remissions were documented with second‐look laparotomy. Chemotherapy may be an alternative to radiotherapy for the treatment of metastatic dysgerminoma and should also be considered for selected patients with Stage I disease. A literature review further supports the conclusion that additional clinical trials might expand the indications for chemotherapy in patients with this disease.