23/04/2026
Relapsed Pituitary Germ Cell Tumor in a 14-Year-Old: AFP Tumor Marker Decline and Improved Recovery Condition After Integrating ECCT Supportive Therapy
A clinical observation of a Pituitary Germ Cell Tumor patient from Singapore showing improved energy levels, faster blood count recovery, and significant AFP reduction during treatment.
Name: Nur Syakira
Age: 14 years old
Country: Singapore
Diagnosis: Relapsed Pituitary Germ Cell Tumor (GCT)
Nur Syakira, a 14-year-old girl from Singapore, was first diagnosed with a pituitary germ cell tumor involving the suprasellar region during childhood. The tumor was located near the pituitary stalk and optic chiasm, an anatomically sensitive region responsible for endocrine regulation and visual pathways.
As a result of the tumor and its initial treatment, the patient experienced significant impairment of pituitary gland function, resulting in long-term endocrine deficiencies. Since then she has required continuous hormone replacement therapy, including:
- Levothyroxine for thyroid hormone support
- Hydrocortisone for adrenal insufficiency
- Desmopressin for diabetes insipidus
- Estradiol replacement therapy
- Insulin therapy for treatment-related hyperglycemia
Despite these long-term medical challenges, Nur Syakira responded well to treatment and remained in clinical remission for approximately six years. During this period she continued regular surveillance through MRI imaging and tumor marker monitoring.
*Gradual Changes Prior to Relapse*
Approximately two years before relapse, routine follow-up blood tests began showing a gradual increase in tumor markers, particularly alpha-fetoprotein (AFP).
Around the same time, she also developed metabolic complications, including hyperglycemia requiring insulin therapy and imaging evidence of fatty liver changes.
In December 2025, follow-up MRI imaging confirmed that the previously stable lesion had increased in size, indicating tumor relapse.
MRI performed on 13 January 2026 demonstrated a residual enhancing suprasellar lesion measuring approximately *1.5 × 0.6 × 0.9 cm* , located along the posterior pituitary stalk and inferior optic chiasm.
Imaging findings confirmed:
- No new intracranial lesions
- No extension into the sella
- No evidence of spinal metastasis or leptomeningeal spread
- Additional imaging findings included fatty liver and mild splenomegaly, which were not associated with tumor spread.
At the time relapse was confirmed, the patient’s AFP tumor marker had risen significantly to above 500, reflecting active tumor activity.
Following confirmation of relapse, Nur Syakira began systemic chemotherapy using the GEMPOX regimen, consisting of:
- Gemcitabine
- Paclitaxel
- Oxaliplatin
A Hickman line was inserted to facilitate treatment administration.
The patient continued to undergo routine blood monitoring and clinical follow-up throughout this period.
*Introduction of ECCT Supportive Therapy for Pituitary Germ Cell Tumor*
In early February 2026, Nur Syakira’s family began the ECCT supportive therapy programme alongside her ongoing chemotherapy treatment and medical follow-up.
A personalized configuration was introduced using ECCT for her condition. Because of the patient’s young age and current medical condition, therapy was introduced cautiously with a short adaptation phase, allowing the body to gradually adjust. The programme was conducted at home, with regular monitoring and guidance from the ECCT medical team.
*Early Clinical Response After ECCT Initiation*
Nur Syakira tolerated the ECCT therapy well during the adaptation phase. No significant adverse effects were reported. The only sensation occasionally noted was mild warmth during treatment sessions, which is commonly observed in early ECCT exposure. Within weeks of starting the programme, the patient’s family began noticing visible improvements in her overall condition.
One of the earliest changes was in her daily energy levels. Despite undergoing chemotherapy, Nur Syakira appeared more active, energetic, and physically engaged in daily life. She could play around with her brother. Her sleep quality also improved, contributing to more stable daytime activity and mood.
*Significant Improvement in AFP Tumor Marker*
One of the most encouraging developments during this period was the rapid decline in Nur Syakira’s AFP tumor marker levels.
Prior to this, AFP levels had risen to above 500, indicating active tumor activity during relapse.
Following her most recent chemotherapy cycle and the initiation of the ECCT programme, her father reported that AFP levels began decreasing drastically, representing a significant reversal of the previous upward trend.
Although AFP levels require continued monitoring and ideally need to normalize fully, the significant downward trend was considered a positive development during this stage of treatment.
*Improved Blood Count Recovery*
Another important observation reported by the family was related to the patient’s Full Blood Count (FBC). According to her father, Nur Syakira’s blood counts appeared to recover much faster after treatment cycles compared to earlier periods.
This suggested that her body was demonstrating improved resilience and recovery capacity, particularly during the period following the start of ECCT therapy.
In an update shared on 17 April, Nur Syakira’s father described the changes he had observed since beginning the ECCT programme. He noted that his daughter had recently become “very active and energetic,” appearing physically stronger than before.
The family also noticed that her Full Blood Count was improving faster, and that her overall health seemed to be recovering more steadily.
Encouraged by these improvements, the family decided to continue focusing strongly on the ECCT programme while maintaining the current chemo regime and regular hospital follow-ups.
The father expressed that their goal as parents is to ensure that every reasonable option is explored for their daughter, so that whatever the future outcome, they will have no regrets about the decisions made for her care.
At the time of this report, Nur Syakira remains under regular monitoring and follow-up.
Since the integration of ECCT therapy, the most notable improvements observed by caregivers include:
- Significant reduction in AFP tumor marker levels
- Increased daily energy and physical activity
- Improved sleep quality
- Faster recovery of blood counts following treatment
- Improved overall vitality and resilience
- Positive emotional well-being within the home environment
- She remains neurologically stable, with no reports of headaches, seizures, or new neurological symptoms.
Nur Syakira’s case illustrates the challenges of managing relapsed pediatric brain tumors while maintaining quality of life during treatment. Following the introduction of ECCT therapy, caregivers observed clear improvements in clinical markers and daily functioning, particularly the decline in AFP levels, improved blood count recovery, and increased overall vitality. These improvements have provided encouragement to the family as they continue navigating her treatment journey and the family hope this story of her fighting bring hopes to another family in need of options.
https://www.ecct-asia.com/post/relapsed-pituitary-germ-cell-tumor-in-a-14-year-old-afp-tumor-marker-decline-and-improved-recovery
Disclaimer: This case summary reflects observations reported by caregivers and available clinical records. Individual responses may vary. Supportive therapies should always be used alongside appropriate medical supervision and are not intended to replace conventional medical care.
