Tumors Of Other Histologic Types Research Articles

Oral pathology following treatment of brain tumors in childhood

Relevance. The limited selectivity of antitumor therapy for central nervous system neoplasms entails the risk of dental morbidity in patients.The aim of the study is to assess the severity of damage to the dental hard tissues in patients with tumors of the posterior cranial fossa (medulloblastoma, astrocytoma) and other tumors of the central nervous system.Materials and methods. Three comparison groups were established based on the toxicity profiles of antitumor therapy among 251 patients at the "Russian Field" treatment and rehabilitation scientific center, to assess the characteristics of oral health status. The assessment of oral health status included diagnosing the carious process and calculating the DMFT index. The degree of damage to the dental hard tissues was evaluated on a four-point scale. The clinical manifestations of oral cavity pathology were compared using the Z-criterion for multiple pairwise comparisons of data, with adjustments for multiple testing (Multiple pairwise comparison Z-test for proportions with multiple testing correction) using the free R software version 3.5.2. The null hypothesis of equal indicators in the compared groups was rejected with a 95% confidence probability when comparing groups of patients.Results. Dental hard tissue pathology was significantly more prevalent in patients with medulloblastoma compared to those diagnosed with astrocytomas and other central nervous system tumors. Additionally, the prevalence of dental hard tissue pathology progressively decreased as the observation period following the completion of antitumor remission was extended.Conclusion. The most severe damage to dental hard tissues is observed in patients with medulloblastoma, who undergo more intensive antitumor therapy compared to those with CNS tumors of other histological types.

Follow-Up and Treatment of Patients with Coexisting Brain Tumor and Intracranial Aneurysm

The association of primary brain tumors with coexisting unruptured intracranial aneurysms (UIAs) has been debated, and treatment strategies have not yet been established. We evaluated the flow association between brain tumors and coexisting UIAs and the outcomes of patients with brain tumor who did not receive treatment of coexisting UIAs. The medical records of patients with coexisting UIAs and brain tumors who had undergone surgical tumor resection were retrospectively analyzed to evaluate the incidence of UIAs according to tumor type, association of arterial feeder vessels and coexisting UIAs, and the occurrence of subarachnoid hemorrhage during the follow-up period for patients who had not receive treatment for the UIAs. Of the 55 patients, 21 (38.9%) had undergone treatment of UIAs and 33 (61.1%) had received regular follow-up examinations without UIA treatment. Two patients (6.1%) developed subarachnoid hemorrhage. Of the 33 patients with astrocytic or oligodendroglial tumors who had not undergone treatment of UIAs, 2 had experienced an interval increase. Flow-related UIAs were found to be significantly more common in patients with astrocytic or oligodendroglial tumors than in those with tumors of other histological types (P= 0.01). The incidence of UIAs among patients with primary brain tumors appears to be greater than that in the general population. An interval increase in aneurysm size and aneurysmal rupture was observed in 2 patients with astrocytic or oligodendroglial tumors. We would recommend perioperative treatment of flow-related UIAs in patients with astrocytic or oligodendroglial tumors and noninvasive evaluations such as magnetic resonance angiography if coexisting UIAs remain untreated.

Abstract 872: DNA methylation patterns distinguish histologic subtypes of pediatric germ cell tumors

Abstract Introduction Pediatric malignant germ cell tumors (GCTs) represent approximately 3% of childhood cancers. GCTs are heterogeneous and grouped together due to the presumed common cell of origin, the primordial germ cell (PGC). Generally, GCTs are grouped into two broad classes based on degree of differentiation: the germinomas, comprised of testicular seminomas and ovarian dysgerminomas, and the nonseminomas, comprised of yolk sac tumors, embryonal carcinomas, choriocarcinomas and teratomas. Aberrant DNA methylation has been implicated in cancer etiology, and may be especially relevant in GCTs due to the extensive epigenetic reprogramming that occurs in the germ line and early embryo during normal development. Methods We evaluated DNA methylation in 52 pediatric GCTs, including 10 yolk sac tumors, 7 dysgerminomas, 28 teratomas, and 8 tumors with mixed tumor histology, obtained from the Cooperative Human Tissue Network (CHTN). DNA methylation was evaluated using the Illumina GoldenGate Cancer Methylation Panel (Illumina, Inc.), which includes 1,505 CpG loci selected from 807 genes with cancer-related potential. Methylation differences in the three main histologic subtypes (yolk sac tumors, dysgerminomas, and teratomas) were evaluated using unsupervised hierarchical clustering with the Manhattan metric and average linkage. We then used a locus by locus approach to identify genes that were differentially methylated by tumor histology using a generalized linear model and accounted for multiple testing by controlling the false-discovery rate (FDR). Ingenuity Pathway Analysis (IPA; Ingenuity Systems) was used to identify pathways that were enriched in this dataset. Results Methylation patterns differed by tumor histology, with all yolk sac tumors forming a distinct cluster. In comparisons of yolk sac tumors with other histologic types, we identified 639 CpG sites with statistically significant differences in methylation (q value < 0.05). Twenty-two CpG loci with the most significant q values also had an adjusted fold change in β > 3, indicating that yolk sac tumors had methylation levels > 3 times higher than tumors of other histologic types at these loci. Three pathways showed significant enrichment in a comparison of yolk sac tumors with other histologic types, with the most significant pathway including genes involved in human embryonic stem cell pluripotency. Conclusion These results support data from a previous study showing that yolk sac tumors exhibit abnormal epigenetic reprogramming (1). Understanding methylation patterns in pediatric GCTs, overall and by histologic type, may identify the developmental stage at which the tumor arose. This knowledge in turn may identify the at-risk period when environmental exposures are most harmful. 1. S. Furukawa et al., Cancer Sci 100, 698 (Apr, 2009). Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 872. doi:10.1158/1538-7445.AM2011-872

EGFR mutation in kidney carcinoma confers sensitivity to gefitinib treatment: A case report

Mutations of the epidermal growth factor receptor (EGFR) gene are known to be associated with the pronounced tumor response to EGFR tyrosine kinase inhibitors (TKI). Unfortunately, these TKI-sensitizing alterations have been detected almost exclusively in lung adenocarcinomas; indeed, their occurrence in tumors of other histologic types or other organs is exceptionally rare. Here we report a case of intragenic EGFR microdeletion in renal cell carcinoma (RCC) associated with the effect of treatment by gefitinib. Patient G., 60 years old, underwent radical surgery for clear cell RCC, however local relapse and metastatic lesions in the lungs were revealed 33 months later. The patient was successfully treated by interleukin-2 (first line therapy), tamoxifen (second line), and interferon-α (third line). After disease progression, EGFR mutation test was performed as a compassionate attempt. It revealed “classical” 15 base pair deletion, so gefitinib was administered. This treatment led to a dramatic symptomatic response within the first week of therapy; reduction of dyspnea was so evident that it allowed the patient to return to work. Clinical examination demonstrated significant improvement with respect to pleuritis and pericarditis. The duration of tumor response, which was classified as disease stabilization, was equal to 4 months. This case report suggests that kidney tumors have to be investigated more closely with respect to the occurrence of TKI-sensitizing EGFR mutations.

Clinicopathologic significance of an immunohistochemical expression of p27 in scirrhous carcinoma of the breast

Scirrhous carcinoma has been known to have more aggressive biological behavior than other histologic subtypes of invasive ductal carcinoma of the breast. The significance of expression of p27kip1, which is thought to be a tumor suppressor gene, in breast carcinoma remains controversial. The aim of the current study was to clarify clinicopathologic significance of scirrhous carcinoma of the breast with special reference to p27 expression. Clinicopathologic features including immunohistochemical expression of p27 were compared between scirrhous carcinoma (n=42) and non-scirrhous invasive ductal carcinoma (papillotubular and solid-tubular carcinoma, n=63) of the breast. The proportion of pathologic lymph node metastasis among scirrhous carcinomas was significantly higher than that among carcinomas of other histologic types (papillotubular or solid-tubular carcinomas, p=0.029). The proportion of strong expression of p27 among scirrhous carcinomas was significantly lower than that among tumors of other histologic types (p<0.0001). Biological behavior of scirrhous carcinoma was found to be aggressive. The aggressiveness and poor cellular differentiation of scirrhous carcinoma of the breast might be related to low p27 expression.

Expression of the organic cation transporter SLC22A16 can be a feature of human epithelial ovarian cancers with different histological type

5131 Background: SLC22A16 is an organic cation transporter that is expressed on the plasma membrane of living cells and transports adriamycin into the cytoplasm. In this study, we examined SLC22A16 expression and evaluated its clinical significance in epithelial ovarian cancer. Methods: To evaluate the expression of SLC22A16 gene and protein, 12 ovarian cancer cell lines and 116 human tissues, including 94 ovarian cancers, 5 normal ovaries, 12 ovarian adenomas, and 5 borderline tumors were examined using immunohistochemistry, quantitative reverse transcription -PCR, and western blotting. Results: Positive immunoreactivity for SLC22A16 was detected on the plasma membrane of epithelial tumor cells. Positive immunoreactivity occurred in 15 of 94 (16%) ovarian cancer tissues, 2 of 5 (40%) borderline tumors, and 1 of 12 (8.3%) benign adenomas. Normal ovaries were all negative. The positive ovarian cancer tissues included 2 of 38 (5%) serous adenocarcinomas, 1 of 15 (6.7%) endometrioid adenocarcinomas, and 12 of 26 (20.4%) clear cell adenocarcinomas. SLC22A16 mRNA was significantly more expressed in clear cell adenocarcinomas than in tumors of other histological types (P<0.0001). Western blotting found immunoreactive bands corresponding to SLC22A16 in 10 out of 12 ovarian cancer cell lines. Conclusions: Our results suggest that adriamycin and related anthracyclines taken up through SLC22A16 have the potential to be effective treatment for clear cell adenocarcinoma. No significant financial relationships to disclose.

¿Es el adenocarcinoma colorrectal mucinoso una entidad diferente?

Several publications have demonstrated that mucinous carcinomas of the colon and rectum are associated with certain clinicopathological and genetic peculiarities that distinguish them from non-mucinous carcinomas. The principal aim of this study was to evaluate whether the biological behavior of mucinous carcinomas differs from that of intestinal carcinomas in patients undergoing surgery for colorectal cancer. Between January 1993 and December 2000, 215 patients. underwent surgery in our hospital for colorectal cancer. The patients were divided into two groups according to histological type: tumors were intestinal in 169 patients (82%) and mucinous in 36 (17.6%). Patients undergoing non-resective surgery and those with tumors of other histological types (n = 10) were excluded. The percentage of patients aged less than 50 years in the group with mucinous carcinoma was 19% (7/36) compared with 4% (7/169) in the non-mucinous group (p = 0.001). Regarding presenting symptoms, anemia was more frequent in patients with mucinous carcinoma (18.2% [n = 6] vs 5.7% [n = 8]) and a change in bowel habits was less frequent (15% [n = 5] vs 34.3% [n = 48]; p < 0.05). A total of 63.9% of mucinous carcinomas (n = 23) were located in the proximal colon (cecum, ascending and transverse colon) compared with 21.3% (n = 36) of non-mucinous carcinomas (p < 0.001). Surgical intention was palliative in 41.7% (n = 23.7) of mucinous carcinomas and in 23.7% (n = 40) of non-mucinous carcinomas (p < 0.05). The mean tumoral size was 6.2 2.5 cm in mucinous carcinomas and 4.7 2 in non-mucinous carcinomas (p = 0.001). Patients with mucinous carcinoma presented a higher percentage of nodal and distant metastases and a lower percentage of early stage tumors (p < 0.05). However, no differences were found in survival between the two histological types. Mucinous tumors were more frequently located in the right colon and in patients less than 50 years old and were more likely to be in more advanced stages than non-mucinous tumors but no differences were found in survival according to tumor type.

Von Hippel-Lindau gene mutations in N-nitrosodimethylamine-induced rat renal epithelial tumors.

Mutations in the von Hippel-Lindau (VHL) gene are common in human clear cell kidney cancers. Carcinogens in cigarette smoke, especially nitrosamines, are known to induce kidney tumors of a variety of histologic types in rodents--but with no evidence of VHL mutations; however, none of these tumors resembled human clear cell carcinomas. We examined N-nitrosodimethylamine-induced kidney tumors of the clear or mixed clear/granular cell type in Wistar rats to assess the presence of VHL mutations. Sections of eight clear or mixed clear/granular cell kidney tumors that had been formalin fixed and paraffin embedded were microdissected. DNA was extracted from the microdissected tissue, and exons 1-3 of the rat VHL gene were examined by use of polymerase chain reaction and cycle sequencing techniques. Four VHL gene mutations (three G:C to A:T and one A:T to G:C) were detected in three of the tumors in contrast to no mutations in 40 previously reported rat kidney tumors of other histologic types (three of eight tumors versus none of 40; two-sided Fisher's exact test; P=.003). Only tumors showing prominent swollen clear cell cytology with a signet-ring appearance had VHL mutations. To our knowledge, this is the first report of VHL mutations in kidney tumors after direct chemical exposure and provides a possible molecular pathway linking tobacco smoking to kidney cancer.

Perspectives for immunization of HLA-A1 patients carrying a malignant melanoma expressing gene MAGE-1.

Many human melanoma tumors express antigens that are recognized in vitro by cytolytic T lymphocytes derived from the tumor-bearing patient. A gene has been identified that directs the expression of antigen MZ2-E on a human melanoma cell line. This gene, which has been named MAGE-1, shows no similarity to known sequences and belongs to a family of at least 3 closely related genes. Gene MAGE-1 is expressed in approximately 40% of melanoma tumor samples and by some tumors of other histological types. No expression has been observed in a panel of normal tissues. Antigen MZ2-E appears to be presented by HLA-A1, a HLA type found in approximately 25% of the population. Thus, precisely targeted experimental immunotherapy directed against antigen MZ2-E could be provided to individuals identified as HLA-A1 and MAGE-1 positive by HLA typing and analysis of the RNA of a small tumor sample.

Increased iofetamine I 123 brain uptake in metastatic melanoma.

Four of five patients with brain metastases from melanoma had increased lofetamine I 123 uptake in the region of the tumor deposits. A comparison group of five patients with melanoma with no clinical or radiologic evidence of brain involvement and 46 of 47 patients without malignant melanoma but with known brain tumors of other histologic types had normal or decreased iofetamine I 123 brain uptake in the region of the tumor. An exception was one patient whose metastatic small cell lung cancer to the brain showed focally increased uptake. These findings suggest that certain brain tumors such as melanoma are capable of selectively binding iofetamine I 123 because of specific chemical properties of the radiopharmaceutical. Increased uptake of iofetamine I 123 in brain lesions in a patient at risk for metastatic melanoma may be a useful aid to differential diagnosis.

Computed tomography of malignant tumors of the nasal cavity and paranasal sinuses.

Staging of malignant tumors of the nasal cavity and paranasal sinuses by computed tomography (CT) was studied in a total of 49 patients, 33 with squamous cell carcinoma and 16 with tumors of other histologic types. Involved sites by the tumor were studied, and clinical staging was made using CT findings alone according to AJC classification for maxillary sinus tumors. Surgical findings for comparison were available for most cases. Of 33 squamous cell carcinomas and of 16 tumors with other histologic types, the maxillary sinus was the site of origin in 29 and eight, respectively. Of these 37 maxillary sinus tumors, 11 were staged T3, 26, T4, and none was staged T1 or T2. None of these tumors were down staged, and one T3 was upstaged after surgical procedures, although all sinuses were not explored in some cases. Sinusitis due to obstruction was indistinguishable from the tumor without bone destruction. And the determination of the site of origin was difficult in some cases. Despite these, CT should be used for pretreatment evaluation of the tumors of these sites.

Computed tomography of benign supratentorial astrocytomas of infancy and childhood

The CT findings of 15 benign supratentorial astrocytomas in children less than 15 years of age are compared with the CT findings of 19 supratentorial tumors of other histological types in the same age group. Astrocytomas were more often hypodense, lacked calcification and showed greater contrast enhancement than other tumors. Seven of the 15 astrocytomas were hypodense, without calcification and showed contrast enhancement of more than 10 Hounsfield units, whereas this coexistence was not present in any of the 19 tumors of the other histological types.

Extraction and preliminary characterization of tumor antigens in human bronchogenic adenocarcinoma and squamous cell carcinoma

Guinea pigs were immunized with extracts (Pfr) prepared from the insoluble fractions of either human bronchogenic adenocarcinoma (BAC), or squamous cell carcinoma (BSC). After suitable absorption, the anti-BAC-Pfr serum reacted with 6 of 6 BAC-Pfr by immunodiffusion and the anti-BSC-Pfr serum with 7 of 7 BSC-Pfr. These absorbed antisera failed to react with adult organ extracts, fetal organ homogenates, or extracts from tumors of other histologic types. The possibility that the reaction could be related to previously known antigens was ruled out. These antigens were detected in sera from patients with the corresponding tumor, but not in sera from post-operative patients or in control sera. Initial characterization of the antigens showed them to be cell membrane-associated proteins with β-electrophoretic mobility and to be insoluble in 50% saturated ammonium sulfate. Further purification of the antigens by reverse immunoabsorption has been successfully undertaken. Both purified antigens were estimated to have mol. wts close to 63,000.

Antibody Responses of Tumor-Bearing Mice to Their Own Tumors Captured and Perpetuated As Hybridomas

Abstract Experiments were performed to determine whether antibody-producing hybridomas could be derived by fusion of BALB/c P3X63Ag8 myeloma cells and spleen cells from C57BL/6 mice either immune to or bearing a syngeneic methylcholanthrene (MCA)-induced fibrosarcoma (M3). Mice were immunized by tumor amputation followed by injections of tumor cells, purified tumor cell membranes, or murine leukemia virus isolated from M3 cells (M3-MuLV). Tumor-bearer spleens were obtained at weekly intervals over a 6-week course of tumor bearing. Hybridoma cultures showing the best growth in selective HAT medium were screened by radioimmunoassay for antibody production against a) viable and glutaraldehyde-fixed cultured M3 cells, b) glutaraldehyde-fixed in vivo-passaged M3 cells, c) purified M3 cell membranes, and d) M3-MuLV. Stable antibody-producing cloned hybridomas were obtained only from fusions involving tumor-bearer spleen cells. One clone (2C2-A1) secretes an IgM antibody that binds well to purified M3-MuLV and M3 membranes, but only weakly to intact M3 cells. Another cloned line (3A5-L1) secretes an IgG1 antibody that binds to M3 cells but not to M3-MuLV. Further analysis of specificity by binding and absorption studies involving more than 30 other normal and transformed murine cell types indicates that 3A5-L1 antibody binds to some, but not all, MCA-induced murine fibrosarcomas. 3A5-L1 antibody demonstrates little, if any, binding to murine tumors of other histologic types or to normal tissues. The results demonstrate that it is possible to capture and perpetuate part of the tumor-bearing host's antibody repertoire in the form of hybridomas secreting monoclonal antibodies specific for tumor-associated antigens.

Relationship between the Epstein‐Barr virus and undifferentiated nasopharyngeal carcinoma: Correlated nucleic acid hybridization and histopathological examination

In order to examine critically the closeness of association between Epstein-Barr virus (EBV) DNA and nasopharyngeal carcinoma (NPC) a correlated histopathological and nucleic acid hybridization study was performed on 51 undifferentiated NPC, 4 NPC with some signs of squamous differentiation, 7 nasophayngeal tumors of other histological types and 14 head and neck carcinomas located outside the nasopharynx. All 51 undifferentiated NPCs contained significant numbers of EBV-genome copies per cell. Two of the somewhat differentiated NPCs were also EBV-DNA-positive, whereas 2 were negative. Of the 7 other nasopharyngeal tumors, 1 was EBV-DNA-positive. Histological examination, however, showed that this was a typical Burkitt lymphoma. The other 6 tumors were all EBV-DNA-negative lymphoproliferative malignancies. All 14 had head and neck carcinomas located outside the nasopharynx were EBV-DNA-negative. The sera of undifferentiated NPC patients had elevated antibody titers against the EBV-determined antigens, the EA (D) componet in particular. These findings confirm that there is a regular association between EBV-DNA and undifferentiated NPC.

Human lung organ-specific antigens on normal lung, lung tumors, and a lung tumor cell line.

An antiserum raised in rabbits against a lung tumor cell line (2563) was selected from a library of antisera against normal and malignant human lung, lung tumor cell lines, and fetal tissues and was found by complement fixation, immunofluorescence, and saturation binding assays to contain antibodies for antigens characteristic of those found in normal lung. Studies with the adsorbed antiserum (A49) revealed: 1) An antigen was shared by normal lung and normal kidney (NLK-1) 2) lung tissue-specific antigen(s) were present on normal lung tissue (NL-1); 3) NL-1 was found on both external and internal cell membranes; and 4) NL-1, in addition to being present on normal lung and the adenocarcinoma-derived cell line 2563, was present on 1 of 2 metastatic lung adenocarcinomas but on none of 4 metastatic lung tumors of other histologic types.

Some social and medical characteristics of Army men with testicular cancer.

Risk of developing cancer of the testis was related to social and medical characteristics in a case-control study of men on active duty in the US Army, 1950-1970. Service records were obtained for 702 newly-diagnosed patients and 624 members of a systematic sample of unaffected servicemen. Risk ratios were computed for seminomas, tumors of other histologic types, and for all tumors combined. Respectively, these risk ratios were 0.3, 0.1 and 0.2 for blacks compared to whites, 1.5, 1.1 and 1.3 for Protestants compared to Catholics, and 1.5, 1.0 and 1.2 for the ever married compared to the never married. Risk increased regularly with duration of schooling for seminomas but not other types of tumors. Risk appeared relatively low for men from large sibships. Men from the North Central or Western parts of the country were at higher risk than those from the South or Northeast, a trend that was stronger for tumors other than seminomas. Observed changes in risk with respect to history of mumps and ABO blood group were small.

Mediation of immune responses to tumor antigens in vitro by immune RNA.

It was shown that normal nonimmune C3H mouse spleen cells became specifically cytotoxic to chemically-induced syngeneic C3H tumor cells by incubation with xenogeneic I-RNA extracted from the lymphoid organs of specifically immunized guinea pigs. This response was specific for the tumor used to immunize the I-RNA donor. In a totally syngeneic system, we showed that syngeneic I-RNA extracted from the spleens of tumor-bearing rats mediated cytotoxic immune reactions which were directed specifically against the tumor-associated antigens of syngeneic rat tumor target cells. Active antitumor I-RNA synthesis in the lymphoid organs of I-RNA donor animals reached a maximum between days 14 and 21, depending on the route of administration and the nature of the immunizing tumor. Active I-RNA preparations were insensitive to treatment with deoxyribonuclease or pronase, but were inactivated by ribonuclease treatment; thereby indicating that the active moiety was one or more species of RNA. The active fractions of the I-RNA preparations had sedimentation values in sucrose density gradients of 12-16S, and comprised only a small fraction of the total RNA present in the lymphoid cells. Active antitumor I-RNA appeared to be localized in the cytoplasm of sensitized lymphoid cells, rather than in the nucleus. Lymphocytes from normal human donors as well as from cancer patients, when incubated with xenogeneic or allogeneic I-RNA, became specifically cytotoxic for human tumor cells in vitro. Crossreactivity among tumors of the same histologic type was observed, but not crossreactivity with tumors of other histologic types. Xenogeneic I-RNA extracted from the lymphoid organs of donor animals immunized either iwth tumor cells or normal tissues, following incubation with normal allogeneic lymphocytes, mediated cytotoxic immune reactions which were directed both against tumor-associated antigens and normal transplantation antigens. However, when autologous lymphocytes were used as effector cells, only immune reactions directed against tumor-associated antigens were observed. Allogeneic I-RNA extracted from peripheral blood lymphocytes of human cancer patients mediated specific cytotoxic immune reactions that were directed against common tumor-associated antigens shared by human tumors of similar histologic type. I-RNA's directed against "self" normal cell surface antigens appear to be recognized as self by lymphocytes, and immune responses against these self antigens are not elicited. On the other hand, I-RNA's directed against "nonself" tumor-associated antigens induce lymphocytes to effect specific antitumor immune responses. Our data are consistent with the hypothesis that I-RNA is an information-containing ribonucleic acid molecule capable of mediating immune reactions in vitro which are specific for the tumor-associated antigens of the tumor used to immunize the I-RNA donor.

Radiation therapy in the management of children with gynecologic cancers.

SummaryTreatment of most gynecologic malignancies in the young is primarily surgical even in the case of radiosensitive tumors, because radiotherapy of the female pelvis in children presents many problems. The younger the child at the time of treatment, the more prominent some of these problems become. Though “prophylactic” postoperative radiation is not advocated, radiotherapy can play an important role in controlling residual, recurrent or metastatic disease, notably in the case of the dysgerminoma and the granulosa‐theca‐cell tumor. The combination of surgery, irradiation, and chemotherapy is not only palliative in patients who have disseminated tumors of other histologic types, but it also may be curative. Meticulous accuracy is essential to minimize the untoward effects of radiotherapy.