Claire F. Verschraegen, MD

In this month’s Clinical Quandaries case report, a 49-year-old man was diagnosed with an extragonadal seminoma. The diagnosis was made on a fine-needle aspiration of a 7-cm supraclavicular mass. Beta–human chorionic gonadotropin and alpha-fetoprotein levels were normal. The only cancer history for this patient was a basal cell carcinoma of the nose. The patient complaints were fatigue; sensory and motor dysfunction in the hands, legs, and abdomen; unsteady gait; and blurry vision.

Topoisomerase inhibitors have been widely studied for the treatment of refractory or recurrent cervical cancer. Various schedules have been used, with response rates ranging from 13% to 20%. The combination of cisplatin and irinotecan (CPT-11, Camptosar) is being studied in cervical cancer.

Several studies have evaluated the use of irinotecan (CPT-11 [Camptosar]), a topoisomerase inhibitor, in the treatment of refractory or recurrent cervical cancer. Various schedules have been used. Response rates have