[A case of unresectable mediastinal carcinoma obtaining clinical complete response after sequential...

A man in his sixties was pointed out a solitary anterior mediastinal tumor 3 cm in diameter by CT scan with a complaint of chest compression, which grew 7 cm in diameter involving right subclavian and common carotic arteries and left innominate vein and superior vena cava 2 months later. FDG-PET/CT showed a high abnormal uptake only in the mediastinal tumor. A histological diagnosis of mediastinal poorly differentiated carcinoma or mediastinal lymph node metastasis of unknown origin was made by medistinoscopic biopsy. After 4 courses of chemotherapy with carboplatin and paclitaxel, the tumor was markedly decreased but was judged as unresectable because of residual involvement of great vessels. Addition of 60 Gy of radiotherapy targeted for the tumor resulted in further decrease in diameter of the tumor in CT scan and disappearance of abnormal uptake of the tumor in FDG-PET/CT thus regarded as clinical complete response. Since then, a disease free status has been maintained for 16 months.