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Large mediastinal germ cell tumor with disease progression during systemic therapy
Diana S Hsu1, Sawley A Wilde1, Kian C Banks1
1Department of Surgery, Highland Hospital, University of California, San Francisco - East Bay, Oakland, CA 94602, USA.
Journal of Surgical Case Reports
|October 6, 2021
Summary
A young man with a large anterior mediastinal mass, diagnosed as immature teratoma and mixed germ cell tumor, required hospitalization for chemotherapy and surgery. Despite initial chemotherapy, the tumor grew, necessitating urgent surgical resection.
Area of Science:
- Oncology
- Thoracic Surgery
- Pathology
Background:
- Mediastinal masses can present with severe symptoms requiring prompt diagnosis and treatment.
- Germ cell tumors, though rare in the mediastinum, necessitate a multidisciplinary approach.
Observation:
- A 29-year-old male presented with acute shortness of breath and fevers.
- Imaging revealed a 17 cm anterior mediastinal mass.
- Initial biopsy suggested immature teratoma with possible mixed germ cell tumor.
Findings:
- The patient received neoadjuvant cisplatin-based chemotherapy due to compressive symptoms and neutropenic fevers.
- Despite chemotherapy, the tumor showed mild growth.
- Urgent en bloc resection was performed via a right hemi-clamshell incision.
Implications:
- Final pathology confirmed a mixed germ cell tumor.
- The patient had an uncomplicated postoperative recovery and was discharged within a week.
- This case highlights the complex management of anterior mediastinal germ cell tumors.
