Development of Acute Megakaryoblastic Leukemia with Isochromosome (12p) after a Primary Mediastinal Germ Cell Tumor in Korea

• Published in: Journal of Korean medical science Vol. 26; no. 8; pp. 1099 - 1102
• Main Authors: Yu, Nae, Kim, Hye Ryoun, Cha, Young-Joo, Park, Eun Kyung, Kim, Jeong Wook
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Medical Sciences 01.08.2011; 대한의학회
• Subjects: Adult; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Bleomycin - administration & dosage; Bone Marrow - pathology; Case Report; Chromosomes, Human, Pair 12; Cisplatin - administration & dosage; Etoposide - administration & dosage; Humans; Isochromosomes; Karyotyping; Leukemia, Megakaryoblastic, Acute - drug therapy; Leukemia, Megakaryoblastic, Acute - etiology; Leukemia, Megakaryoblastic, Acute - genetics; Male; Mediastinal Neoplasms - diagnosis; Mediastinal Neoplasms - drug therapy; Mediastinal Neoplasms - surgery; Neoplasms, Germ Cell and Embryonal - diagnosis; Neoplasms, Germ Cell and Embryonal - drug therapy; Neoplasms, Germ Cell and Embryonal - surgery; Neoplasms, Second Primary - drug therapy; Neoplasms, Second Primary - etiology; Neoplasms, Second Primary - genetics; Republic of Korea; Shock, Septic - pathology; 의학일반; Republic of Korea; Mediastinal Germ Cell Tumor; Acute Megakaryoblastic Leukemia; Isochromosome (12p)
• ISSN: 1011-8934; 1598-6357; 1598-6357
• DOI: 10.3346/jkms.2011.26.8.1099

The association of hematological malignancies with a mediastinal germ cell tumor (GCT) is very rare. We report one case of a young adult male with primary mediastinal GCT who subsequently developed acute megakaryoblastic leukemia involving isochromosome (12p). A 25-yr-old man had been diagnosed with a mediastinal GCT and underwent surgical resection and adjuvant chemotherapy. At 1 week after the last cycle of chemotherapy, his peripheral blood showed leukocytosis with blasts. A bone marrow study confirmed the acute megakaryoblastic leukemia. A cytogenetic study revealed a complex karyotype with i(12p). Although additional chemotherapy was administered, the patient could not attain remission and died of septic shock. This case was definitely distinct from therapy-related secondary leukemia in terms of clinical, morphologic, and cytogenetic features. To our knowledge, this is the first case report of a patient with mediastinal GCT subsequently developing acute megakaryoblastic leukemia involving i(12p) in Korea.