Table 1 Summary of endodermal sinus tumor presenting with spinal cord compression found in the literature

Age at presentation

31 years

17 months

7-year old

17 months

13 months

21 months

28 months

Year of study

2006

2000

2018

1989

1988

1997

2003

Primary tumor site

Psoas muscle extending into midline

Paraspinal mass

Right posterior mediastinum

Intramedullary tumor T2-T7

Paravertebral mass

Left suprarenal mass

Retroperitoneal and paravertebral mass

AFP level at time of diagnosis

Not taken at time of admission

41,000 microg/L

< 1.3 ng/mL

Not taken at time of admission

Not taken at time of admission

85660 ng/mL

6285 ng/mL

Presence of distant metastasis

Yes

None

None

None

None

None

Yes

Staging

Stage 4

Stage 3

Not available

Not available

Stage 3

Stage 3

Stage 4

Procedures preformed

Cyst drainage and Biopsy

Biopsy

T6–T10 laminectomy

T1–T9 osteoplastic laminectomy

Thoracotomy with decompressive laminectomy T10–T12

Osteoplastic laminotomy T9-L1

T10–12 laminectomy and epidural mass resection

Chemotherapy protocol and cycles

At 4 week intervals bleomycin 40 mg per day dose for 3 days etoposite 140 mg per day and cisplatin 40 mg per day for 5 days

Post-op:

cisplatin (60 mg/m2)

etoposide (100 mg/m2)

doxorubicin (30 mg/m2)

cyclophosphamide (900 mg/

m2 x2)

additional course:

cisplatin (40 mg/m2 × 3), bleomycin (15 mg/m2).

Subsequent courses: bleomycin (15 mg/m2), etoposide (100 mg/m2×5), cisplatin (40 mg/m2 ×5)

9 cycles post-op:

Ifosfamide 1500 mg/m /day on days 1-5 Carboplatin 150 mg/m /day on days 1-2

Etoposide 100 mg/m /day on days 1-5

and 4 cycles of BEP Bleomycin 15 mg/m /day

on day 1, Etoposide 100 mg/m /day on days 1-5, Cisplatin 20 mg/m /day on days 1-5

21 days post-op PVB: cisplatin, vinblastine and bleomycin

for a total of two courses

Pre-op vincristine (1.5 mg/m2) and

cyclophosphamide (300 mglm2)

Post op:

chemotherapy with vincristine, cyclophosphamide,

actinomycin 0 and adriamycin at recurrence

cis-diamminedichloroplatinum

vinblastin and bleomycin

CCG protocol 8882 “Germ-Cell Tumor” for chemotherapy with bleomycin, VP-16, and cisplatin

4 cycles cisplatin 40 mg/m2 days 1-5 bleomycin 15 mg/m2 day 1 etoposide 100 mg/m2 days 1-5

two more cycles with 50% reduction of the cisplatin dose (total of six cycles of chemotherapy)

Radiotherapy

None

None

None

Low-dose (25 Gy)

Pre-op 8 Gy

Post op: 44 Gy

None

None

Prognosis and outcome

Death due to sepsis

Complete neurologic recovery

Complete neurologic recovery

Mild kyphotic curvature on MRI

Death due to pyelonephritis and uncontrolabe serum electrolyte imbalances

Recurrence at site of laminectomy at 2 years and 10 months. Treated with chemotherapy

Death Day 16 post-op for unknown reason

16 years of complete remission with some mild residual weakness in bilateral lower extremities

Time of follow-up

N/A

N/A

3 years

N/A

At 3 years and 6 months, doing well

N/A

16 years