Scientific Research

Embryonal Carcinoma with Immature Teratoma: A Homeopathic Case Report

A 3-year-old girl diagnosed with embryonal carcinoma with immature teratoma (after surgery), was treated on the basis of the principles of classical homeopathy and has stayed free of cancer for 6 years now.

Centre for Classical Homeopathy, Vijayanagar, Bangalore, India;
University of the Aegean, International Academy of Classical Homeopathy, Alonissos, Northern Sporades, Greece
Complement Med Res 2017;24:117–121 Published online: October 30, 2017 DOI: 10.1159/000481819

Keywords
Embryonal carcinoma · Immature teratoma ·
Homeopathic management of cancer

Summary
Background: Embryonal carcinoma with immature teratoma is a cancer with poor prognosis if the expression levels of biological markers are very high. In such a case, after surgical removal of the tumor, homeopathic treatment resulted in maintenance of the cancer-free state for over 6 years.

Case Report: This is the case of a 3-year-old Indian girl diagnosed with embryonal carcinoma with immature teratoma (after surgery), treated and followed up for over 6 years. She was treated on the basis of the principles of classical homeopathy and has stayed free of cancer for 6 years now.

Discussion: The cancer marker expression levels dropped while the girl developed severe skin eruptions, which is in accordance with the laws of classical homeopathic treatment. Although other examples of successful homeopathic treatment in severe pathologies exist, further confirmatory studies are needed on a large scale.
© 2017 The Author(s). Published by S. Karger GmbH, Freiburg

Schlüsselwörter
Embryonales Karzinom · Unreifes Teratom ·
Homöopathische Krebsbehandlung

Zusammenfassung
Hintergrund: Ein embryonales Karzinom mit einem unreifen Teratom ist eine Krebsart mit einer schlechten Prognose, wenn sehr hohe Expressionslevel der biologischen Marker vorliegen. In solch einem Fall führte eine homöopathische Behandlung nach der chirurgischen Entfernung des Tumors zur Aufrechterhaltung des krebsfreien Zustands für mehr als 6 Jahre. Fallbericht: Dies ist der Fall eines 3-jährigen indischen Mädchens, das (nach Operation) die Diagnose eines embryonalen Karzinoms mit einem unreifen Teratom erhielt und das mehr als 6 Jahre lang behandelt und nachbeobachtet wurde. Sie wurde gemäß den Prinzipien der klassischen Homöopathie behandelt und ist jetzt seit 6 Jahren frei von Krebs geblieben. Diskussion: Die Expressionslevel der Krebsmarker fielen, während das Mädchen schwere Hautausschläge entwickelte, was mit den Gesetzen der klassischen homöopathischen Behandlung in Einklang steht. Obwohl es noch andere Beispiele für eine erfolgreiche homöopathische Behandlung bei schwerwiegenden Pathologien gibt, sind weitere, groß angelegte Studien, die dies untermauern, notwendig.

Introduction

Germ cell tumors consist of primitive cell types in different stages of differentiation. Embryonal carcinoma (EC) consists of poorly differentiated cells [1] with a tendency to spread fast. When coupled with other benign types (e.g. mature teratoma), mutation into malignancy is regularly found [2]. Immature teratoma is rare among germ cell tumors and has the tendency to spread aggressively [3]. ECs exhibit a predominantly maternal genetic imprinting [4, 5] and recurrence is as high as 33% after surgery and chemotherapy [6]. Germ cell tumors secrete biological markers that serve to monitor the treatment results and to detect subclinical recurrences.

Date     Symptoms                   Prescription         Remarks
08/09/2009 AFP: 3.57 mg/ml (normal: < 10);      Tuberculinum 14C     obvious good result as the cancer  HCG: < 2.0 mIU/ml (normal: < 1);           continued    markers remain low; therefore,

ESR: 12 mm/h                         no change in  remedy was required

12/09/2009 relapse of cold and cough,        Tuberculinum 16C     onset of an acute inflammation;  persisting for 1 week now   1 dose a day for 1 month          therefore, the potency was increased

29/10/2009 tonsils enlarged on both sides,            Tuberculinum 18C     the acute inflammation gets stronger; cough persists        1 dose a day for 1 month      thus, the potency was further increased

12/11/2009 AFP: 2.5 mg/ml;

HCG: < 2.0 mIU/ml; ESR: 6 mm/h

23/11/2009 fever and cough relapsed increased dosage to  the number of doses was increased as a

3 times a day       potency change was not indicated

15/12/2009 cough persisting  Tuberculinum 20C  the acute condition was progressing and

1 dose a day for 1 month  therefore the potency was increased

22/01/2010 rattling in the chest during sleep;     Tuberculinum 22C  occasional pain in the abdomen        1 dose a day for 1 month

> stools

18/02/2010 no acute conditions since 1 month     Tuberculinum 24C        in a chronic case, when the case is in  1 dose a day for 1 month      status quo, a potency increase after a  certain period allows for further progress

AFP = α-Fetoprotein; HCG = human chorionic gonadotropin; ESR = erythrocyte sedimentation rate.

Table 1. Evolution of the case after the first remedy

Sl. no. Symptom Qualification
1 face – eruptions – crusty, scabby – around mouth 1
2 generals – touch – egg – in children 1
3 generals – touch – egg – slight 2
4 generals – touching – anything – egg 2
5 generals – lying – on back – unable to turn from back 1
6 sleep – position – on back 2
7 sleep – position – on back – feet drawn up 2
8 mind – complaining – pitiful – in children 2
9 generals – uncovering – desire for 2
Sl. no. = serial number.

Table 2.

[3]. ECs exhibit high levels of human chorionic gonadotropin (HCG) in the blood and also α-fetoprotein (AFP). The presence of high levels of AFP and a bigger size of the tumor in the case of a germ cell tumor herald a very bad prognosis. Even with the latest, better prognosis reports, the initial surgery needs to be followed up with adjuvant chemotherapy to ensure complete clearance of the cancerous cells [3, 7].

Case Report

A 3-year-old girl child with EC and immature teratoma underwent surgical removal of the tumor in the ovary, after which the family, when given chemotherapy as the next option of treatment, refused and opted for homeopathic treatment. The initial anamnesis of the case took place on August 13, 2009.

The mother had detected a large swelling in the abdomen of the child, which was revealed on the ultrasound scan to be a large ovarian tumor of suspected ovarian neoplasm, measuring 7.1 × 1.3 × 2.4 cm (dated June 22, 2009).

This tumor was excised and biopsied. The biopsy showed a malignant mixed-germ cell tumor consisting of immature teratoma and EC (70% and 5%, respectively) (dated July 29, 2009). The laboratory findings, dated July 23, 2009, prior to removal of the tumor were:

  • hemoglobin (Hb): 9.7 g%
  • erythrocyte sedimentation rate (ESR): 38 mm/h
  • total HCG: 956.3 mIU/ml (normal: <1 mIU/ml) – AFP: 1,336 mg/ml (normal: <10 mg/ml)
  • lactose dehydrogenase (LDH): 281 U/l (normal) Past history: She suffered from recurrent colds and adenoids.

Family history: On the father’s side of the family there were many genetic disorders and

congenital disorders. The mother reported that she had had tremendous stress during the  pregnancy as she had to separate from her husband during that time, which ultimately ended in divorce. Further, the mother has recently been diagnosed with breast cancer (in 2015).

Presenting symptoms available for homeopathic repertorization were: The girl ground her teeth in her sleep, she had increased perspiration during sleep, and her tongue was furrowed in the center; her thirst was very much decreased. She craved cold milk and bananas and had an aversion to eggs.


Fig. 1. Repertorization results during skin eruptions.


Fig. 2. Progression of the skin eruptions from the face down to the body (fig. 2–4).


Fig. 3. Progression of the skin eruptions from the face down to the body (fig. 2–4).


Fig. 4. Progression of the skin eruptions from the face down to the body (fig. 2–4).

In the homeopathic Materia Medica, these symptoms very clearly constitute the picture of a single remedy [8].  The assessment regarding her health was that, although she had the diagnosis of cancer and her cancer marker levels were very high to begin with, she exhibited frequent acute infections and the immune system was strong enough to put up a clear picture of a homeopathic remedy, implying that she was on a better level [9].

Fig. 5. Latest picture of the girl.

At this level, the prescription strategy is based on the totality of symptoms, which includes the sum of all the individualistic symptoms of the patient. Vithoulkas’ [10] expert system of the radar software was used for repertorization.  The remedy given was Tuberculinum 14C, 1 dose per day for 1 month. Follow-up consultations of the first part of the treatment are listed in table 1.

The girl received only homeopathic treatment.

During 5 months of treatment with Tuberculinum in rising C potencies, the child underwent several acute infections of the upper respiratory tract, which stopped when she developed skin eruptions around the mouth. The eruptions were cracked, crusty, and painful.

Placebo 3 times a day for 5 days was prescribed, as we saw a stable situation in cancer markers. The beginning of a skin eruption in cases with deep affections is always a good sign according to the theory and the idea of a hierarchical organization of the human organism [9, 11]. One day later, though, the eruptions took a dangerous shape and were threatening to spread. Thus, they needed to be treated. The symptoms on February 24, 2010, considered for repertorization were as given in table 2.

The repertorization showed Pulsatilla as the remedy (fig. 1): Pulsatilla 30C was given. Follow-up of the skin treatment and its process are summarized in table 3 and in figures 2–4.  The child has now been observed for 6 years, with periodical scans and blood tests as surveillance for relapse of cancer. There has been no evidence, so far, of any cancerous activity in the body, and the girl has stayed well.

She required occasional treatment for acute infections, which over time have become rarer. The reports of the 6 years are given in table 4. The latest photograph of the girl is provided as figure 5.

Embryonal Carcinoma with Immature Teratoma    Complement Med Res 2017;24:117–121          119 Table 3. Evolution of the case after the second remedy

Date Symptoms Prescription Remarks
25/02/2010 immediately after application of the remedy, the swelling of the eyelid and mouth became less; the child could open the mouth; the dangerous areas are clearing up while the lower parts are becoming affected Pulsatilla 30C  2 doses a day clearly the case is better (downward movement of the lesions as they clear up from above),  but it is still severe, thus needing repetition
26/02/2010 skin lesions shifting to neck and downwards; itching all over the body, more in the genital area; fever of 101.8 F; appetite improved; asks for food; thirst for ½ a glass in a day; sleepless; no stools since last day Pulsatilla 200C,  every 4 h fever onset indicates active immune system,  but care needs to be taken as the skin lesions are extensive and chances of septicemia must be ruled out; this state requires frequent repetition to assist in recovery
27/02/2010 temperature 100.2 F; skin peeling on abdomen and back; appetite good; asks for oranges Pulastilla 200C  3 doses a day reduced fever and healing skin: very good development, so dosage reduced
28/02/2010 shivering and startling observed in the child; food intake a little reduced; thirst remains the same; she asks for fruits; skin peeled on genitals; she cries while passing stools Pulsatilla 200C only  if fever rises at this stage, we must observe if the immune system can take care of itself, by observing fever; therefore, remedy repeated only if required
02/03/2010 sleep was good; normal skin appearing in some parts; lesions descended to feet; fever had risen to 102 F in the night (upon giving the Pulsatilla dose); now temperature 98 F; reddish gums; stools still hard; trembling when standing placebo remedy repeated only when required
04/03/2010 new skin appearing further placebo healing skin and better immune status warrants no remedy
06/03/2010 skin peeling off gradually and new skin appearing; swelling in right eye; generally well placebo
08/03/2010 skin peeling better; generally better placebo
13/03/2010 drastic changes in the whole body; scar marks are disappearing as well; appetite improved placebo
19/03/2010 swelling of tonsils; mild cough Pulsatilla 200C

2 doses a day for 2 days

now the child is out of danger and is showing signs of a common cold; as a rule, the previous remedy must be repeated
27/03/2010 swelling better; mild cough Pulsatilla 200C 2 doses per day for 3 days
10/04/2010 skin is better; tonsils are still swollen Pulsatilla 200C 2 doses a day for 10 days
25/04/2010 generally well; occasionally complains of pain in abdomen placebo from here on, the case was treated as and when required for the onset of common colds alone
Date            Report
06/02/2012  CT scan shows bilateral lymphadenopathy, but otherwise normal condition

11/02/2012 AFP: 1.78 mIU/ml

01/04/2013 CT scan shows normal condition; AFP: 1.03 mIU/ml

26/07/2014 ultrasound scan shows normal condition

28/07/2015 ultrasound scan shows normal condition

CT = Computed tomography, AFP = α-fetoprotein.

 Table 4. Imagery and blood tests follow-up after homeopathic treatment

Discussion: Although it may be difficult to achieve such a response in all  cases with such a poor prognosis, this case report still demonstrates the potential that homeopathy has as a treatment modality for serious pathologies. There have been other case reports where the pathological state was very advanced and yet homeopathic treatment was successful [12]. This is probably because the patients, despite their advanced pathologies, were still in a better condition of health. In such cases, homeopathic medicines can elicit favorable reactions from the immune system [9, 11].

The follow-up has lasted for over 6 years, during which time the dramatic skin eruptions also responded well to homeopathy, leaving the girl in an overall healthier state. Table 3. Evolution of the case after the second remedy

Date Symptoms Prescription Remarks

25/02/2010 immediately after application of the remedy, the swelling of the eyelid and mouth became less; the child could open the mouth; the dangerous areas are clearing up while the lower parts are becoming affected Pulsatilla 30C 2 doses a day clearly the case is better (downward movement of the lesions as they clear up from above), but it is still severe, thus needing repetition

26/02/2010 skin lesions shifting to neck and downwards; itching all over the body, more in the genital area; fever of 101.8 F; appetite improved; asks for food;  thirst for ½ a glass in a day; sleepless; no stools since last day Pulsatilla 200C, every 4 h fever onset indicates active immune system, but care needs to be taken as the skin lesions are extensive and chances of septicemia must be ruled out; this state requires frequent repetition to assist in recovery 27/02/2010 temperature 100.2 F; skin peeling on abdomen and  back; appetite good; asks for oranges

Pulastilla 200C  3 doses a day reduced fever and healing skin: very good development, so dosage reduced

28/02/2010 shivering and startling observed in the child; food  intake a little reduced; thirst remains the same; she  asks for fruits; skin peeled on genitals; she cries while passing stools Pulsatilla 200C only if fever rises at this stage, we must observe if the immune system can take care of itself, by observing fever;

therefore, remedy repeated only if required 02/03/2010 sleep was good; normal skin appearing in some parts; lesions descended to feet; fever had risen to 102 F in the night (upon giving the Pulsatilla dose); now temperature 98 F; reddish gums; stools still hard; trembling when standing placebo remedy repeated only when required 04/03/2010 new skin appearing further placebo healing skin and better immune status warrants no remedy

06/03/2010 skin peeling off gradually and new skin appearing; swelling in right eye; generally well placebo

08/03/2010 skin peeling better; generally better placebo

13/03/2010 drastic changes in the whole body; scar marks are disappearing as well; appetite improved placebo

19/03/2010 swelling of tonsils; mild cough Pulsatilla 200C 2 doses a day for 2 days now the child is out of danger and is showing signs of a common cold; as a rule, the previous remedy must be repeated

27/03/2010 swelling better; mild cough Pulsatilla 200C 2 doses per day for 3 days

10/04/2010 skin is better; tonsils are still swollen Pulsatilla 200C 2 doses a day for 10 days

25/04/2010 generally well; occasionally complains of pain in abdomen placebo from here on, the case was treated as and when required for the onset of common colds alone

Date Report

06/02/2012 CT scan shows bilateral lymphadenopathy, but otherwise normal condition

11/02/2012 AFP: 1.78 mIU/ml

01/04/2013 CT scan shows normal condition; AFP: 1.03 mIU/ml

26/07/2014 ultrasound scan shows normal condition

28/07/2015 ultrasound scan shows normal condition

CT = Computed tomography, AFP = α-fetoprotein.

Table 4. Imagery and blood tests follow-up after homeopathic treatment

Conclusion
This case report, as far as the authors’ knowledge goes, is the first of its kind where a severe pathology has been shown to respond and stay clear for over 6 years. The dramatic nature of the case and the response to treatment make it necessary to further investigate the possibilities of homeopathic treatment in such severe pathological conditions.

Author’s Contributions
S.M. wrote the manuscript, M.M. was the homeopathic physician who treated the case and contributed the complete details of analysis and prescription. G.V. was the guide under whose directions and ideas the manuscript was prepared. All authors have read and approved the final manuscript.

References

  • Cotran R, Kumar V, Collins T: Robbins Pathologic Basis of Disease, ed 6. Philadelphia, W.B. Saunders, 1998, pp 1018–1024, 1073–1075.
  • Bass P: Germ Cell Tumors. Online Medical Encyclopedia. Rochester, University of Rochester Medical Center, 2017.
  • Rana S, Kaur Gill M, Satarkar R, Sangwaiya A, Singh P: Immature teratoma with embryonal carcinoma; a rare malignant mixed germ cell tumor in a 13-year-old girl.Iran J Pathol 2016; 11: 66–70.
  • Mutter G: Role of imprinting in abnormal human development. Mutat Res 1997; 396: 141–147. 5 Jirtle R: Genomic imprinting and cancer. Exp Cell Res 1999; 248: 18–24.

About the author

Mallapa Mahesh

Dr. Mahesh M completed his homeopathic medical degree in Bangalore, India. While still studying, he started working at a tribal hospital under the right livelihood awardee Dr Sudarshan (he still continues to practice there once a month). He was inspired to take up classical homeopathy after attending a seminar in India by Prof George Vithoulkas. Since then, he has treated over 20,000 cases both in India and abroad. His work is mainly centred on those cases that have lost hope in the mainstream medicine, ranging from vitiligo, cancer, global retardation to diabetic gangrene and psychiatric disorders. He is presently based in Bangalore and is also the assistant teacher with George Vithoulkas at the International Academy of Classical Homeopathy, Greece. Dr. Mahesh is sought out to teach in his unique practical methods. He is also the moderator for the Vithoulkas E Learning course in Bangalore. His cases are documented and published in many journals including peer reviewed ones.

About the author

Seema Mahesh

Dr Seema Mahesh BHMS, MD (hom), Dip IACH is the Research Head of the International Academy of Classical Homeopathy, Greece and the Director of Centre For Classical Homeopathy, Bangalore. She has been instrumental in consolidating the remarkable cases cured with classical homeopathy by the students of prof George Vithoulkas and publishing them in peer reviewed medical journals of repute. She has also presented the concepts of health and disease as taught by prof Vithoulkas at conventional medical conferences all over the world including the Harvard School of Medicine where her presentation won the Best Abstract Award.

About the author

George Vithoulkas

George Vithoulkas is an Honorary Professor of the Moscow Medical Academy, Professor in the Kiev Medical Academy, Honorary Professor at the University of the Aegean, Greece, Collaborating Professor in Basque Medical University (2001-2004) and Doctor Honoris Causa of "Doctor ViktorBabes" University of Medicine and Pharmacy of Timisoara in Romania. In 1995, he established International Academy of Classical Homeopathy in Alonissos, of which he is the director. In 1996, he was honored with the Right Livelihood Award (also known as Alternative Nobel Prize) "for his outstanding contribution to the revival of homeopathic knowledge and the training of homeopaths to the highest standards".

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