[A case of alpha-fetoprotein producing mediastinal germ cell tumor treated with preoperative chemotherapy]

A 20-year-old male was treated with 3 courses of cisplatin combined chemotherapy, with a clinical diagnosis of mediastinal germ cell tumor. Although alpha-fetoprotein (AFP), which alone had been high (893 ng/ml on admission) among tumor markers examined, normalized after chemotherapy, the size of the tumor remained unchanged. The patient underwent total resection of the tumor and has been followed with no evidence of recurrence for 18 months. Pathological examination suggested that the tumor was an immature teratoma with extensive proliferation of fibrous element. Neither other elements of germ cell tumor nor AFP producing cells were found. Preoperative chemotherapy is usually effective in treatment of germ cell tumors. However, it is important to recall that measurements of tumor volume occasionally do not provide information on the tumor's response.