1
|
El Jarroudi M, Rezzoug F, El Ouardani S, Al Jarroudi O, Brahmi SA, Afqir S. Primary Mediastinal Dysgerminoma: A Case Report and Literature Review. Cureus 2024; 16:e57504. [PMID: 38707071 PMCID: PMC11066817 DOI: 10.7759/cureus.57504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2024] [Indexed: 05/07/2024] Open
Abstract
Germ cell tumors are malignant tumors that mostly develop in the gonads. Extragonadal localization is rare and may affect the mediastinal and sacrococcygeal regions. Mediastinal seminoma is a malignant germ cell tumor of the mediastinum. The tumor typically occurs in the anterosuperior mediastinum in males and often has a very slow growth pattern and limited potential for metastasis. And symptoms are not very characteristic, with many patients being asymptomatic and the tumor being discovered incidentally. In this paper, we report the case of a 26-year-old patient admitted for the management of a large anterosuperior mediastinal tumor encasing the vital structures of the mediastinum.
Collapse
Affiliation(s)
- Meryem El Jarroudi
- Medical Oncology, University Hospital Center Mohammed VI, Oujda, MAR
- Faculty of Medicine And Pharmacy, Mohammed First University, Oujda, MAR
| | - Fatima Rezzoug
- Medical Oncology, University Hospital Center Mohammed VI, Oujda, MAR
- Faculty of Medicine And Pharmacy, Mohammed First University, Oujda, MAR
| | - Soufia El Ouardani
- Medical Oncology, University Hospital Center Mohammed VI, Oujda, MAR
- Faculty of Medicine And Pharmacy, Mohammed First University, Oujda, MAR
| | - Ouissam Al Jarroudi
- Medical Oncology, University Hospital Center Mohammed VI, Oujda, MAR
- Faculty of Medicine And Pharmacy, Mohammed First University, Oujda, MAR
| | - Sami Aziz Brahmi
- Medical Oncology, University Hospital Center Mohammed VI, Oujda, MAR
- Faculty of Medicine And Pharmacy, Mohammed First University, Oujda, MAR
| | - Said Afqir
- Medical Oncology, University Hospital Center Mohammed VI, Oujda, MAR
- Faculty of Medicine And Pharmacy, Mohammed First University, Oujda, MAR
| |
Collapse
|
2
|
Dabsha A, Elkharbotly IAMH, Yaghmour M, Badr A, Badie F, Khairallah S, Esmail YM, Hossny M, Rizk A, El-Demiry A, Ghaly G, Al-Thani S, Demetres M, Mohamed A, Villena-Vargas J, Kamal M, Rahouma M. Survival difference among adult and pediatric mediastinal yolk sac tumors cases: A meta-analysis of case reports. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2024; 50:108019. [PMID: 38359725 DOI: 10.1016/j.ejso.2024.108019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 01/29/2024] [Accepted: 02/10/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Mediastinal Yolk sac tumors (YST) are rare and highly malignant extragonadal germ cell tumors with rapid growth and early metastases. We sought to conduct a meta-analysis of published case reports/case series to compare differences in survival, demographics, and treatment modalities between adult and pediatric patients with YST. METHODS Ovid Embase, Cochrane, and Ovid Medline databases were searched for primary mediastinal pure YST cases. The primary outcome was overall survival (OS). Log-rank and Cox regression were used. This study is registered on PROSPERO (CRD42022367586). RESULTS Among 846 studies, 87 met our inclusion criteria including 130 patients (Adults: 90 and Pediatrics: 40). About 41.5% of the patients were from the United States. The median age was 23.0 (Q1-Q3: 17.0-30.0), 88.5% were males, and (32.3%) were Asian. Stage II represented almost 40%. AFP was elevated in 96.9%. Respiratory distress was the presenting symptom in 65.4%. Chemotherapy, radiotherapy, and surgery were utilized in 84.6, 23.1, and 64.7% respectively. Median OS was 24 months (Adults: 23 months, Pediatrics: 25 months, P = 0.89). 3- and 5-year OS were 34.4% and 22.9% in adults and 41.5% and 41.5% in pediatrics, respectively. On multivariate analysis, anterior location of tumors, receipt of chemotherapy, and undergoing surgery were associated with better OS. CONCLUSION Primary mediastinal YSTs are rare, but lethal neoplasms. Our meta-analysis showed that mediastinal YSTs mimic other non-seminomatous mediastinal GCTs in terms of clinical characteristics and available treatment options. Early diagnosis, neoadjuvant chemotherapy, and surgical resection are the key points for effective management and improved outcomes.
Collapse
Affiliation(s)
- Anas Dabsha
- Cardiothoracic Surgery Department, Weill Cornell Medicine, New York, NY, USA; Surgical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Ismail A M H Elkharbotly
- Surgical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt; General Surgery Department, Newham University Hospital, London, UK
| | - Mohammad Yaghmour
- Cardiothoracic Surgery Department, Weill Cornell Medicine, New York, NY, USA
| | - Amr Badr
- El Ruwaisat Family Medical Center, Sharm Elsheikh, Egypt
| | - Fady Badie
- General Surgery Department, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - Sherif Khairallah
- Cardiothoracic Surgery Department, Weill Cornell Medicine, New York, NY, USA; Surgical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Yomna M Esmail
- Cardiothoracic Surgery Department, Weill Cornell Medicine, New York, NY, USA
| | - Mohamed Hossny
- Cardiothoracic Surgery Department, Weill Cornell Medicine, New York, NY, USA
| | - Amr Rizk
- Cardiothoracic Surgery Department, Weill Cornell Medicine, New York, NY, USA; Surgical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Amr El-Demiry
- Surgical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Galal Ghaly
- Surgical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Shaikha Al-Thani
- Cardiothoracic Surgery Department, Weill Cornell Medicine, New York, NY, USA
| | - Michelle Demetres
- Cardiothoracic Surgery Department, Weill Cornell Medicine, New York, NY, USA
| | - Abdelrahman Mohamed
- Surgical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | | | - Mona Kamal
- Symptom Research Department, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Mohamed Rahouma
- Cardiothoracic Surgery Department, Weill Cornell Medicine, New York, NY, USA; Surgical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt.
| |
Collapse
|
3
|
Fichtner A, Marx A, Ströbel P, Bremmer F. Primary germ cell tumours of the mediastinum: A review with emphasis on diagnostic challenges. Histopathology 2024; 84:216-237. [PMID: 37994540 DOI: 10.1111/his.15090] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/12/2023] [Accepted: 10/20/2023] [Indexed: 11/24/2023]
Abstract
This article will review current aspects of the histopathological, immunohistochemical and molecular analysis of primary mediastinal germ cell tumours (PMGCTs) as well as their aetiological, epidemiological, clinical and therapeutic features. PMGCTs represent an important differential diagnosis in the spectrum of mediastinal tumours, and their diagnosis is usually made on small tissue samples from core needle biopsies in combination with diagnostic imaging and serum tumour markers. As in lymphomas, a small biopsy is often the only viable tumour sample available from these patients, as they receive chemotherapy prior to eventual surgical resection. Pathologists therefore need to apply an efficient combination of immunohistochemical markers to confirm the diagnosis of a PMGCT and to exclude morphological mimics.
Collapse
Affiliation(s)
- Alexander Fichtner
- Institute of Pathology, University Medical Center Göttingen, Göttingen, Germany
| | - Alexander Marx
- Institute of Pathology, University Medical Center Göttingen, Göttingen, Germany
| | - Philipp Ströbel
- Institute of Pathology, University Medical Center Göttingen, Göttingen, Germany
| | - Felix Bremmer
- Institute of Pathology, University Medical Center Göttingen, Göttingen, Germany
| |
Collapse
|
5
|
Ahuja J, Strange CD, Agrawal R, Erasmus LT, Truong MT. Approach to Imaging of Mediastinal Masses. Diagnostics (Basel) 2023; 13:3171. [PMID: 37891992 PMCID: PMC10606219 DOI: 10.3390/diagnostics13203171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/04/2023] [Accepted: 10/07/2023] [Indexed: 10/29/2023] Open
Abstract
Mediastinal masses present a diagnostic challenge due to their diverse etiologies. Accurate localization and internal characteristics of the mass are the two most important factors to narrow the differential diagnosis or provide a specific diagnosis. The International Thymic Malignancy Interest Group (ITMIG) classification is the standard classification system used to localize mediastinal masses. Computed tomography (CT) and magnetic resonance imaging (MRI) are the two most commonly used imaging modalities for characterization of the mediastinal masses.
Collapse
Affiliation(s)
- Jitesh Ahuja
- Department of Thoracic Imaging, The University of Texas MD Andeson Cancer Center, Houston, TX 77030, USA; (C.D.S.); (R.A.); (M.T.T.)
| | - Chad D. Strange
- Department of Thoracic Imaging, The University of Texas MD Andeson Cancer Center, Houston, TX 77030, USA; (C.D.S.); (R.A.); (M.T.T.)
| | - Rishi Agrawal
- Department of Thoracic Imaging, The University of Texas MD Andeson Cancer Center, Houston, TX 77030, USA; (C.D.S.); (R.A.); (M.T.T.)
| | - Lauren T. Erasmus
- Department of Anatomy and Cell Biology, Faculty of Sciences, McGill University, Montreal, QC H3A 0G4, Canada;
| | - Mylene T. Truong
- Department of Thoracic Imaging, The University of Texas MD Andeson Cancer Center, Houston, TX 77030, USA; (C.D.S.); (R.A.); (M.T.T.)
| |
Collapse
|
6
|
Bouabid M, Moukhlissi M, Bensghir A, Samba S, Berhili S, Mezouar L. Pure mediastinal seminoma about a case report. Radiol Case Rep 2023; 18:3565-3571. [PMID: 37577076 PMCID: PMC10412719 DOI: 10.1016/j.radcr.2023.07.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/15/2023] [Accepted: 07/18/2023] [Indexed: 08/15/2023] Open
Abstract
Mediastinal Seminoma is one of the malignant germ cell tumors of the mediastinum. It is a rare tumor that represents only 1%-4% of mediastinal tumors. We report the case of a patient treated at the Oncology Center of Oujda for a pure primitive seminoma of the mediastinum, with a review of the literature to assess the epidemiological, clinical, therapeutic, and prognostic characteristics of this pathology. This is a 25-year-old man whose aunt is being treated for breast cancer and who complained of persistent dry cough with asthenia without any other associated signs. The initial imaging revealed a voluminous locally advanced tumor process in the anterior and middle mediastinum. Tumor markers Alpha-fetoprotein (AFP) and beta-subunit of chorionic gonadotrophic hormone (BHCG) were normal, as well as testicular ultrasound. The CT- guided transthoracic biopsy with anatomopathological study and immunohistochemistry was in favor of a pure seminoma. The treatment consisted of primary chemotherapy with BEP protocol. The response was favorable with a significant reduction in tumor size estimated at 90%. The residual tumor was inoperable due to its intimate contact with the vascular structures and was treated with external radiotherapy at a total dose of 36 Gy. The evolution at 20 months after treatment was in favor of a good clinical and radiological evolution.
Collapse
Affiliation(s)
- Meriem Bouabid
- Department of Radiotherapy, Faculty of Medicine Oujda, Hassan II Oncology Center, Mohammed VI Hospital Center of Oujda, Mohammed 1st University Oujda, Morocco
| | - Mohamed Moukhlissi
- Department of Radiotherapy, Faculty of Medicine Oujda, Hassan II Oncology Center, Mohammed VI Hospital Center of Oujda, Mohammed 1st University Oujda, Morocco
| | - Ahmed Bensghir
- Department of Radiotherapy, Faculty of Medicine Oujda, Hassan II Oncology Center, Mohammed VI Hospital Center of Oujda, Mohammed 1st University Oujda, Morocco
| | - Soumya Samba
- Department of Radiotherapy, Faculty of Medicine Oujda, Hassan II Oncology Center, Mohammed VI Hospital Center of Oujda, Mohammed 1st University Oujda, Morocco
| | - Soufiane Berhili
- Department of Radiotherapy, Faculty of Medicine Oujda, Hassan II Oncology Center, Mohammed VI Hospital Center of Oujda, Mohammed 1st University Oujda, Morocco
| | - Loubna Mezouar
- Department of Radiotherapy, Faculty of Medicine Oujda, Hassan II Oncology Center, Mohammed VI Hospital Center of Oujda, Mohammed 1st University Oujda, Morocco
| |
Collapse
|