An operative case of malignant mediastinal germ cell tumor (seminoma) markedly responsive to induction chemotherapy
An 18-year-old boy was admitted to our hospital with anterior chest pain. Chest X-ray and CT scan showed a huge mass on the anterior mediastinum. Laboratory examination revealed high levels of serum human chorionic gonadotropin (HCG). The diagnosis of primary anterior mediastinal germ cell tumor was...
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| Published in | Nihon Kokyuki Geka Gakkai zasshi (Kyoto, 1992) Vol. 14; no. 5; pp. 612 - 617 |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | English |
| Published |
The Japanese Association for Chest Surgery
2000
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0919-0945 1881-4158 1881-4158 |
| DOI | 10.2995/jacsurg.14.612 |
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| Abstract | An 18-year-old boy was admitted to our hospital with anterior chest pain. Chest X-ray and CT scan showed a huge mass on the anterior mediastinum. Laboratory examination revealed high levels of serum human chorionic gonadotropin (HCG). The diagnosis of primary anterior mediastinal germ cell tumor was made by preoperative percutaneous needle biopsy. Preoperative two courses of cisplatin-based combination chemotherapy were administered. The serum HCG level decreased rapidly to a normal level and tumor size was extremely reduced. Combined resection of the tumor and adjacent pulmonary and pericardial tissue was carried out through a median sternotomy. One course of the combination chemotherapy was added postoperatively. Seven years after the surgery, he has no signs of recurrence. In conclusion, preoperative cisplatin-based combination chemotherapy is effective, and aggressive surgical procedure is indicated for the treatment of mediastinal germ cell tumor. |
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| AbstractList | An 18-year-old boy was admitted to our hospital with anterior chest pain. Chest X-ray and CT scan showed a huge mass on the anterior mediastinum. Laboratory examination revealed high levels of serum human chorionic gonadotropin (HCG). The diagnosis of primary anterior mediastinal germ cell tumor was made by preoperative percutaneous needle biopsy. Preoperative two courses of cisplatin-based combination chemotherapy were administered. The serum HCG level decreased rapidly to a normal level and tumor size was extremely reduced. Combined resection of the tumor and adjacent pulmonary and pericardial tissue was carried out through a median sternotomy. One course of the combination chemotherapy was added postoperatively. Seven years after the surgery, he has no signs of recurrence. In conclusion, preoperative cisplatin-based combination chemotherapy is effective, and aggressive surgical procedure is indicated for the treatment of mediastinal germ cell tumor. |
| Author | Genka, Keiichiro Kuniyoshi, Masayuki Ohta, Morio Ishikawa, Kiyoshi Kawabata, Tsutomu |
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| References | 19) Luna MA, Valenzuala-Tamariz J: Germ cell tumors of the mediastinum. Postmortem findings. Am J Clin Pathol 65: 450-454, 1976. 14) Vugrin D, Whitmore WF Jr, Golbey RB: VAB-6 combination chemotherapy without maintenance in treatment of disseminated cancer of the testis. Cancer 51: 211-215, 1983. 8) Clamon GH: Management of primary mediastinal seminoma. Chest 83: 263-267, 1983. 15) Pizzocaro G, Piva L, Salvioni R, et al: Cisplatin, etoposide, bleomycin first-line therapy and early resection of residual tumor in far-advanced germinal testis cancer. Cancer 56: 2411-2415, 1985. 18) 平泰彦, 長田博昭, 横手薫美夫, 他: 縦隔セミノーマの3例. 胸部外科40: 455. 461, 1987. 2) 水渡哲史, 他: 縦隔に発生したセミノーマの2例. 肺癌20: 322, 1980. 4) 伊藤元彦, 三宅正幸, 光岡明夫: 縦隔奇形群腫瘍の診断と治療. 癌と化学療法12: 1361-1370, 1985. 10) Vogelzang NJ, Raghavan D, Anderson RW, et al: Madiastinal nonseminomatous germ cell tumors. The role of combined modality therapy. Ann Thorac Surg 33: 333-339, 1982. 11) Knapp RH, Hurt RD, Payne WS, et al: Malignant germ cell tumors of the mediastinum. J Thorac Cardiovasc Surg 89: 82-89, 1985. 13) Einhorn LH: Testicular cancer as a model for a curable neoplasm. The Richard and Hinda Rosenthal Foundation Award Lecture. Cancer Research 41: 3275-3280, 1981. 5) 三宅正幸, 伊藤元彦, 光岡明夫, 他: 縦隔原発のMalignant Germ Cell Tumorの臨床的検討.日外会誌88: 340-348, 1987. 1) Hainsworth JD, Einhorn LH, Williams SD, et al: Advanced Extragonadal Germ Cell Tumors. Ann Intern Med 97: 7-11, 1982. 17) Kay PH, Wells FC, Goldstraw P: A multidisciplinary approach to primary non-seminomatous germ cell tumors of the mediastinum. Ann Thorac Surg 44: 578-582, 1987. 7) Economou JS, Trump DL, Holmes EC, et al: Management of primary germ cell tumors in the mediastinum. J Thorac Cardiovas Surg 83: 643-649, 1982. 3) Teilumn G: Endodermal sinus tumors of the ovary and testis. Comparative morphogenesis of the so-called mesonephroma ovarii (Schiller) and extra embryonic (yolk sac-allantoic) structures of the rat's placeta . Cancer 12: 1092-1105, 1959. 9) 吉竹毅: 縦隔原発胚細胞性腫瘍. 胸部外科43: 582-592, 1990. 16) 高塚雄一, 笹井平, 国府育夫, 他: Cis-platinum (CDDP) を中心とした多剤併用療法にて完全寛解を示した縦隔seminomaの1例. 癌と化学療法12: 951-956, 1985. 20) 和田洋巳, 松延政一, 伊藤元彦, 他: 悪性縦隔腫瘍全国集計. 胸部外科35: 364-371, 1982. 6) Polansky SM, Barwick KW, Ravin CE: Primary mediastinal seminoma. Am J Roentgenol 132: 17-21, 1979. 12) 横井香平, 宮沢直人, 森清志, 他: 化学療法が奏功した縦隔原発seminomaの1例. 肺癌29: 279-285, 1989. |
| References_xml | – reference: 10) Vogelzang NJ, Raghavan D, Anderson RW, et al: Madiastinal nonseminomatous germ cell tumors. The role of combined modality therapy. Ann Thorac Surg 33: 333-339, 1982. – reference: 13) Einhorn LH: Testicular cancer as a model for a curable neoplasm. The Richard and Hinda Rosenthal Foundation Award Lecture. Cancer Research 41: 3275-3280, 1981. – reference: 20) 和田洋巳, 松延政一, 伊藤元彦, 他: 悪性縦隔腫瘍全国集計. 胸部外科35: 364-371, 1982. – reference: 8) Clamon GH: Management of primary mediastinal seminoma. Chest 83: 263-267, 1983. – reference: 14) Vugrin D, Whitmore WF Jr, Golbey RB: VAB-6 combination chemotherapy without maintenance in treatment of disseminated cancer of the testis. Cancer 51: 211-215, 1983. – reference: 4) 伊藤元彦, 三宅正幸, 光岡明夫: 縦隔奇形群腫瘍の診断と治療. 癌と化学療法12: 1361-1370, 1985. – reference: 1) Hainsworth JD, Einhorn LH, Williams SD, et al: Advanced Extragonadal Germ Cell Tumors. Ann Intern Med 97: 7-11, 1982. – reference: 6) Polansky SM, Barwick KW, Ravin CE: Primary mediastinal seminoma. Am J Roentgenol 132: 17-21, 1979. – reference: 12) 横井香平, 宮沢直人, 森清志, 他: 化学療法が奏功した縦隔原発seminomaの1例. 肺癌29: 279-285, 1989. – reference: 3) Teilumn G: Endodermal sinus tumors of the ovary and testis. Comparative morphogenesis of the so-called mesonephroma ovarii (Schiller) and extra embryonic (yolk sac-allantoic) structures of the rat's placeta . Cancer 12: 1092-1105, 1959. – reference: 16) 高塚雄一, 笹井平, 国府育夫, 他: Cis-platinum (CDDP) を中心とした多剤併用療法にて完全寛解を示した縦隔seminomaの1例. 癌と化学療法12: 951-956, 1985. – reference: 19) Luna MA, Valenzuala-Tamariz J: Germ cell tumors of the mediastinum. Postmortem findings. Am J Clin Pathol 65: 450-454, 1976. – reference: 15) Pizzocaro G, Piva L, Salvioni R, et al: Cisplatin, etoposide, bleomycin first-line therapy and early resection of residual tumor in far-advanced germinal testis cancer. Cancer 56: 2411-2415, 1985. – reference: 5) 三宅正幸, 伊藤元彦, 光岡明夫, 他: 縦隔原発のMalignant Germ Cell Tumorの臨床的検討.日外会誌88: 340-348, 1987. – reference: 17) Kay PH, Wells FC, Goldstraw P: A multidisciplinary approach to primary non-seminomatous germ cell tumors of the mediastinum. Ann Thorac Surg 44: 578-582, 1987. – reference: 18) 平泰彦, 長田博昭, 横手薫美夫, 他: 縦隔セミノーマの3例. 胸部外科40: 455. 461, 1987. – reference: 2) 水渡哲史, 他: 縦隔に発生したセミノーマの2例. 肺癌20: 322, 1980. – reference: 9) 吉竹毅: 縦隔原発胚細胞性腫瘍. 胸部外科43: 582-592, 1990. – reference: 7) Economou JS, Trump DL, Holmes EC, et al: Management of primary germ cell tumors in the mediastinum. J Thorac Cardiovas Surg 83: 643-649, 1982. – reference: 11) Knapp RH, Hurt RD, Payne WS, et al: Malignant germ cell tumors of the mediastinum. J Thorac Cardiovasc Surg 89: 82-89, 1985. |
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| Title | An operative case of malignant mediastinal germ cell tumor (seminoma) markedly responsive to induction chemotherapy |
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