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[A case of germ-cell tumor of the mediastinum]
Yasushi Horimasu1, Soichi Kitaguchi, Miki Ohe
1Department of Molecular and Internal Medicine, Graduate School of Biomedical Science, Hiroshima University.
Abstract:
An 18-year-old man complaining of chest pain was admitted to our hospital. Contrast-enhanced chest computed tomography (CT) showed an anterior mediastinal tumor with patchy enhanced lesions in the peripheral and poorly-enhanced central areas. His serum alpha fetoprotein (AFP) level was high. FDG-PET imaging indicated intense FDG uptake in the mediastinal tumor (SUVmax was 11.2), but no other abnormal FDG uptake, including in his testes, was detected. CT-guided needle biopsy revealed necrotizing tissue, including immature cartilage-like tissue. Based on these clinical features, we diagnosed mixed-type germ cell tumor originating from the mediastinum. Bleomycin, etoposide and cisplatin combination chemotherapy was administered every 3 weeks, for 4 cycles. His serum AFP level declined during the treatment course, and the mediastinal tumor decreased in size. After 4 cycles of chemotherapy, the residual tumor was resected completely and no viable cells were detected in the resected tumor. Tumor recurrence has not been detected for more than 9 months after surgery without adjuvant chemotherapy at the time of writing.
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