Intensive chemotherapy followed by autologous bone marrow transplantation for a patient having wide-spread embryonal carcinoma in the central nervous system.

A patient with an intracranial embryonal carcinoma, which was resistant to cisplatin-based combined chemotherapy and radiotherapy, developed spinal seeding. Alpha fetoprotein (AFP), human chorionic gonadotropin (HCG) and the beta chain of HCG (NCG beta) in serum or cerebrospinal fluid immediately returned to elevated levels despite sequential chemotherapy and resection. Accordingly, we treated this patient with spinal irradiation and intensive combination chemotherapy (cisplatin etoposide, vinblastine, cyclophosphamide and actinomycin D) followed by autologous bone marrow transplantation. With this treatment, the clinical manifestations showed a tendency to improve and, furthermore, the serum levels of AFP and HCG returned to normal. These findings suggest autologous bone marrow transplantation to be a potential approach to the treatment of patients with embryonal carcinomas.