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Hepatic angiosarcomatous transformation of a mediastinal germinal cell tumor: A care case report
Giuseppe Corrias1, Joanna G Escalon, Laura Tang
1Department of Radiology, Memorial Sloan Kettering Cancer Center, York Avenue, New York, NY, USA Department of Radiology, University of Cagliari, via Università, Cagliari, Italy Department of Radiology, New York-Presbyterian/Weill Cornell Medical Center, New York, NY Department of Radiology, University of Colorado, Aurora, CO Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA IRCCS SDN, Naples, Italy.
Rationale:
Mediastinal nonseminomatous germ cell tumor (NSGCT) is an uncommon entity. Metastatic hepatic sarcomatous transformation is rare.
Patient Concerns:
We report a 24-year-old man with no previous related medical history presented with chest pain and left arm numbness.
Diagnoses:
The x-ray showed an anterior mediastinal mass. The chest computed tomography (CT) confirmed the presence of a mildly enhancing mass in the same location, without invasion of any vascular structure. A CT-guided biopsy was performed, revealing a primary mediastinal nonseminomatous germ cell tumor (NSGCT), yolk sac histology, with areas of somatic transformation to malignant nerve sheath tumor. After surgery patient was followed-up with imaging. Two years later a CT scan showed a new hepatic hyper vascular lesion, confirmed by a subsequent magnetic resonance imaging (MRI) and positron emission tomography (PET) scan. A CT-guided biopsy revealed a hepatic metastatic transformation to angiosarcoma of the primitive NSGCT.
Interventions:
The patient went on to received palliative chemotherapy.
Outcomes:
The patient is being followed-up regularly at the outpatient department.
Lessons:
Because of the potential of metastatic sarcoma arising from germ cell tumors, these patients should undergo periodical follow-up, with periodical scans. PET\CT scan might have a role in the follow-up of these patients.
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