ABSTRACT
RESUMEN Los tumores de células germinales no son tan frecuentes, dentro de ellos se encuentra el teratoma como el más usual en ubicación mediastinal, es más habitual en hombres jóvenes cuando es maligno (teratocarcinoma), con una relación por género de 13,5:1, y una edad promedio de 26 años. Se describe la evolución de un hombre de 19 años de edad con un tumor mediastinal, con metástasis pulmonares e infiltración intracardíaca, resecado satisfactoriamente, cuyos síntomas más frecuentes fueron: disnea, dolor retroesternal, fiebre, tos, pérdida de peso y síndrome de vena cava superior. El diagnóstico se realizó por radiografía de tórax y tomografía axial computarizada. Se logró realizar la excéresis total del tumor y las metástasis, así como la tumoración intracardíaca, con reparación de la válvula tricúspide. El paciente ha tenido una evolución satisfactoria durante el primer año de seguimiento.
ABSTRACT Germ cell tumors are not so frequent; among them, teratomas are most common in the mediastinal location. Teratomas in young men are usually malignant (teratocarcinoma), with a gender ratio of 13.5:1, and an average age of 26 years. We describe the evolution of a 19-year-old man with a mediastinal tumor, with pulmonary metastases and intracardiac infiltration, successfully removed; whose most frequent symptoms were: dyspnea, retrosternal pain, fever, cough, weight loss and superior vena cava syndrome. The diagnosis was made by chest x-ray and computed tomography. Total removal of the tumor and metastases was achieved, as well as the intracardiac tumor, with tricuspid valve repair. The patient had a satisfactory outcome during the first follow-up year.
Subject(s)
Mediastinal Neoplasms , Neoplasms, Gonadal Tissue , Neoplasms, Germ Cell and Embryonal , Germ CellsABSTRACT
Primary mediastinal seminomas are rare tumors. Morphologically, they can be associated with secondary changes in the form of thymic remnants, cystic change, epithelioid granulomas, abundant fibrosis, and syncytiotrophoblast like cells. Ours was an interesting case where a 17‑year‑old adolescent male presented with anterior mediastinal mass. Fine needle aspiration and trucut biopsy of the mass favored tuberculosis; however, he did not respond to antituberculosis treatment regime. He was subjected to video‑assisted thoracoscopic surgery and the histopathological examination along with supportive immunohistochemistry of the mass revealed scattered seminoma cells which were being masked by extensive granulomatous reaction. The aim of this article is to report a case of primary mediastinal thymic seminoma in a young male associated with extensive granulomatous reaction masking the neoplastic population of cells leading to erroneous diagnosis on small biopsy.
ABSTRACT
A 20-year-old man was admitted to our hospital with persistent cough and dyspnea. He had bilateral distention of the jugular veins, and swollen lymph nodes were palpable in the right subclavicular region. Plain X-ray and computed tomography (CT) of the chest showed a solid soft tissue mass in the upper mediastinum, with leftward displacement of the trachea and complete obstruction of the superior vena cava. Mediastinal radiotherapy (1.8 Gy/day) and methylprednisolone (100 mg/day) were started immediately. Biopsy of the right subclavicular lymph nodes revealed metastatic seminoma. The patient was referred for chemotherapy, which was performed with a combination of cisplatin, bleomycin and etoposide (BEP). A partial response was observed after completion of 3 cycles of chemotherapy, but there was no further tumor shrinkage after additional salvage chemotherapy. The patient is being followed up on an outpatient basis and has been free of recurrence for 32 months after intensive treatment.
ABSTRACT
A case of suprasellar germ cell tumor is described in a 6-year -old Airedale Terrier bitch that presented behavioral changes and abrupt onset of blindness. The neoplasm compressed the ventral surface of the cerebrum from the level of basal ganglia to the mesencephalon. Histologically the neoplasm consisted of nests and trabeculae of round to polygonal cells that occasionally surround tubules and cysts formed by columnar cells. Neoplastic cells are immunopositive for cytokeratin and alpha-fetoprotein. The diagnosis was based on location, histological appearance and on the immunohistochemical staining.
É descrito um caso de tumor de células germinativas supra-selar em numa cadela Airedale Terrier de seis anos de idade, que apresentou transtornos do comportamento e aparecimento abrupto de cegueira. O neoplasma comprimia a superfície ventral do cérebro desde a altura dos núcleos basais até o mesencéfalo. Histologicamente, o neoplasma consistia de ninhos e trabéculas de células redondas ou poligonais que ocasionalmente arranjavam-se ao redor de túbulos e cistos formados por células colunares. As células neoplásicas foram positivas na imunoistoquímica para citoqueratina e a-fetoproteína. O diagnóstico foi feito com base na localização do tumor, no seu aspecto histológico e nos resultados da marcação imunoistoquímica.
Subject(s)
Animals , Female , Dogs , Central Nervous System , Neoplasms, Germ Cell and Embryonal/diagnosis , Neoplasms, Germ Cell and Embryonal/veterinary , Nervous System Neoplasms/veterinaryABSTRACT
Los tumores germinales extragonadales representan entre el 1 y 2.5% de los tumores de células germinales (TCG), siendo el mediastino la segunda localización en frecuencia luego de las gónadas. Se presenta el caso de un paciente masculino de 29 años de edad que consulta por tos irritativa de cinco meses de evolución. Se realizaron radiografía, tomografía computada (TC) y resonancia magnética (RM) de tórax y ecografía testicular. Los hallazgos por imágenes, sumados a la presencia de marcadores tumorales elevados (alfa-fetoproteína y gonadotrofina coriónica humana), confirmaron el diagnóstico de TCG extragonadal, avalado posteriormente por la cirugía y la anatomía patológica.
The prevalence of extragonadal germ cell tumors is only 1- 2.5% of all germ cell tumors. The mediastinum is the second most common site affected. We present the case of a 29 years old male pacient, with a persistent cough dating back to five months. We performed chest X-R, thorax CT and MRI and testicular US. The findings of this images besides the presence of elevated levels of alpha-fetoprotein and beta-human gonadotropin confirm the diagnosis of extragonadal germ cell tumor.
ABSTRACT
Retroperitoneal tumors are relatively rare, accounting for 0.2% of all cancers; many different histologic types are present, and primitive retroperitoneal germ cell tumors constitute a small miniority of about 3%. Most primary extragonadal germ cell tumors (EGCTs) arise from the mediastinum of retroperitoneum in young males. The authors experienced a case of primary extragonadal mixed germ cell tumor with a 43-year-old woman complaining left lower abdominal pain. With the case report, a brief review was made.
Subject(s)
Adult , Female , Humans , Male , Abdominal Pain , Germ Cells , Mediastinum , Neoplasms, Germ Cell and EmbryonalABSTRACT
We experienced one case of extragonadal germ cell tumor of retroperitoneal origin. The patient had orchiopexy of left cryptorchidism twenty years ago. The left testis was atrophied and the right testis was normal on palpation. Retroperitoneal exploratory surgery and complete excision of the mass were performed. The pathologic report identified seminoma. There was no evidence of metastasis computed tomography and bone scan. Then left orchiectomy and right testicular biopsy were performed. The left testis demonstrated hyalinization of seminiferous tubules and right testis demonstrated normal finding, but both specimens showed no malignancy or carcinoma in situ. The patient was treated with BEP(bleomycin, etoposide, cisplatin) combination chemotherapy. With a follow-up of 24 months the patient remains disease free.
Subject(s)
Humans , Male , Biopsy , Carcinoma in Situ , Cryptorchidism , Drug Therapy, Combination , Etoposide , Follow-Up Studies , Germ Cells , Hyalin , Neoplasm Metastasis , Neoplasms, Germ Cell and Embryonal , Orchiectomy , Orchiopexy , Palpation , Seminiferous Tubules , Seminoma , TestisABSTRACT
Extragonadal germ cell tumors are rare. accounting for approximately 38 of all germ cell tumors. Debate continues over whether these lesions originate from extragonadal site or are metastatic disease from an undetected testis primary tumor. Recently. we experienced a case of extragonadal mixed germ cell tumor in a 26-year-old male who showed complete response by combination chemotherapy with cisplatin. etoposide. and bleomycin(PVpB) and have remained disease tree for about 14 months since diagnosis. Herein we report the case with brief review of the literature.