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Vandaele T, Van Slambrouck J, Schöffski P, Dumez H, Weynand B, Sciot R, Barbarossa A, Provoost AL, Van de Voorde K, Debaveye Y, Bouneb S, Nafteux P, Ceulemans LJ. Extensive surgical resections for rare pleural neoplasms: a single-center experience with a yolk sac tumor and synovial sarcoma. World J Surg Oncol 2024; 22:96. [PMID: 38622623 PMCID: PMC11021014 DOI: 10.1186/s12957-024-03367-9] [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: 12/12/2023] [Accepted: 03/28/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Pleural neoplasms are rare and can be subdivided into pleural metastasis and primary pleural neoplasms. Non-mesothelioma primary pleural neoplasms are a diverse group of extremely rare pathologies. CASE PRESENTATION In this case series, we describe the presentation and management of two rare primary pleural neoplasms. A first case describes a primary pleural yolk sac tumor treated with neoadjuvant chemotherapy, extended pleurectomy decortication, and hyperthermic intrathoracic chemotherapy. In a second case we describe the management of a primary pleural synovial sarcoma by neoadjuvant chemotherapy and extrapleural pneumonectomy. A complete resection was obtained in both cases and the post-operative course was uncomplicated. No signs of tumor recurrence were noted during follow-up in the first patient. In the second patient a local recurrence was diagnosed 6 months after surgery. CONCLUSION Neo-adjuvant chemotherapy followed by extensive thoracic surgery, including hyperthermic intrathoracic chemotherapy, is a feasible treatment strategy for non-mesothelioma primary pleural neoplasms, but careful follow-up is required.
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Affiliation(s)
- Tom Vandaele
- Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium.
- Department of Chronic Diseases and Metabolism, Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium.
| | - Jan Van Slambrouck
- Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Chronic Diseases and Metabolism, Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium
| | - Patrick Schöffski
- Department of Oncology, University Hospitals Leuven, Leuven, Belgium
- Department of Oncology, Laboratory of experimental Oncology, KU Leuven, Leuven, Belgium
| | - Herlinde Dumez
- Department of Oncology, University Hospitals Leuven, Leuven, Belgium
- Department of Oncology, Laboratory of experimental Oncology, KU Leuven, Leuven, Belgium
| | - Birgit Weynand
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
- Department of Imaging and Pathology, Laboratory of translational cell and tissue research, KU Leuven, Leuven, Belgium
| | - Raf Sciot
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
- Department of Imaging and Pathology, Laboratory of translational cell and tissue research, KU Leuven, Leuven, Belgium
| | - Annalisa Barbarossa
- Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Chronic Diseases and Metabolism, Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium
| | - An-Lies Provoost
- Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Chronic Diseases and Metabolism, Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium
| | | | - Yves Debaveye
- Department of Intensive care, University Hospitals Leuven, Leuven, Belgium
- Department of cellular and molecular medicine, Laboratory of Intensive care, KU Leuven, Leuven, Belgium
| | - Sofian Bouneb
- Department of Anesthesiology, University Hospitals Leuven, Leuven, Belgium
- Department of cardiovascular science, Laboratory of anesthesiology and algology, KU Leuven, Leuven, Belgium
| | - Philippe Nafteux
- Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Chronic Diseases and Metabolism, Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium
| | - Laurens J Ceulemans
- Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Chronic Diseases and Metabolism, Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium
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2
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Wu D, Zhang K, Zhang X. Primary mediastinal yolk sac tumor: A case report and literature review. Clin Case Rep 2023; 11:e7781. [PMID: 37564606 PMCID: PMC10410121 DOI: 10.1002/ccr3.7781] [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] [Received: 03/24/2023] [Revised: 06/29/2023] [Accepted: 07/16/2023] [Indexed: 08/12/2023] Open
Abstract
Key Clinical Message There are limited published cases of primary mediastinal yolk sac tumor (PMYST), with no consensus on the best treatment alternative. By far, the surgery oriented comprehensive therapies are the main treatment methods. The surgical strategy should be individualized and aimed at radical resection, considering all the possibilities, including the use of cardiopulmonary bypass and prosthetic materials. Abstract A 15-year-old boy was diagnosed as PMYST. The tumor, with a size about 13 × 12 × 8 cm, was located in the right upper mediastinum, closely adhering to ascending aorta, superior vena cava, right atrium, and the right hilum. After 6 cycles chemotherapy of bleomycin, etoposide, and cisplatin (BEP), no significant change was found in the size of tumor. Subsequently, an extended tumor excision including partial resection of the right lung, the pericardium, the diaphragm and the right phrenic nerve, was performed successfully with cardiopulmonary bypass on standby. During 6 months of follow-up, there was no tumor recurrence. Meanwhile, in PubMed, we searched the English case reports and case series of PMYST during the past decade. A total of 73 articles were retrieved, in which 22 articles on the therapy and prognosis of PMYST were extracted and reviewed, included 16 case reports and 6 case series with a total of 52 patients. Due to the rarity of PMYST, it is difficult to provide a specific treatment regimen. The surgery-oriented comprehensive therapies are still the main treatment methods. The surgical strategy should be individualized and aim at radical resection, considering all the possibilities, including the use of cardiopulmonary bypass and prosthetic materials.
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Affiliation(s)
- Diqing Wu
- Department of Cardiac and Macrovascular SurgerySuzhou Hospital of Anhui Medical UniversitySuzhouChina
| | - Kun Zhang
- Department of OncologySuzhou Hospital of Anhui Medical UniversitySuzhouChina
| | - Xueqin Zhang
- Department of Cardiac and Macrovascular SurgerySuzhou Hospital of Anhui Medical UniversitySuzhouChina
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3
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Qin L, Zhu M, Wang T, Wang H, Pan Q, He D. The clinical features and prognostic outcomes of primary mediastinal yolk sac tumors: A retrospective analysis of 15 rare cases from multiple centers. Medicine (Baltimore) 2021; 100:e26480. [PMID: 34398004 PMCID: PMC8294869 DOI: 10.1097/md.0000000000026480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 05/28/2021] [Indexed: 01/04/2023] Open
Abstract
Primary mediastinal yolk sac tumors (PMYSTs) are a rare occurrence. As such, the clinicopathological features, treatment, and prognosis, of this disease still remain unclear. In this study, we aimed to provide further information relating to this rare malignancy in order to facilitate the creation of more specific clinical guidelines for the diagnosis and treatment of patients with PMYSTs.In this retrospective study, we recruited 15 patients who had been diagnosed with PMYST from four medical institutions to create a population-based cohort. We then used Kaplan-Meier analysis and the log-rank test to investigate and compare overall survival (OS) and progression-free survival (PFS).A total of 15 cases were identified. The mean age was 27.3 years (range: 19-34 years). The estimated 1- and 2-year PFS rates were 66.7% and 60.0%, respectively. The 1- and 2-year OS rates were both 73.3%. Computer tomography scans revealed tumors were located in the anterior middle mediastinum (5 cases), the anterior superior mediastinum (1 case), the left anterior mediastinum (3 cases), and the right anterior mediastinum (6 cases). Of the 15 patients receiving extended resections, the majority (40.0%) underwent tumor resection, partial pericardiotomy, pulmonary wedge resection, and mediastinal lymphadenectomy. R0 resections were achieved in eleven patients. Four patients underwent R2 resection and experienced postoperative complications, including pneumonia (2 cases), atelectasis (1 case), and bronchopleural fistula (1 case). Four patients developed postoperative lung metastasis. Three patients died due to progressive diseases. Disease recurred in all patients at a median of 8.0 months (range: 6.0-11.0 months).PMYST is a rare but highly malignant tumor with a poor prognosis. Tumor resection, with optimal extended surgical management, may provide patients with the best chance of a cure although postoperative complications relating to the pulmonary systems should be treated with caution.
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Affiliation(s)
- Li Qin
- Department of Obstetrics and Gynecology, The Central Hospital of Enshi Autonomous Prefecture, Enshi, China
| | - Menglin Zhu
- Department of Oncology, The Central Hospital of Enshi Autonomous Prefecture, Enshi, China
| | - Tiejun Wang
- Department of Oncology, Hubei Cancer Hospital, Wuhan, China
| | - Hongli Wang
- Department of Pathology, Minda Hospital of Hubei Minzu University, Enshi, China
| | - Qin Pan
- Department of Obstetrics and Gynecology, Jingzhou Central Hospital, The Second Clinical Medical College of Yangtze University, Jingzhou, China
| | - Du He
- Department of Oncology, The Central Hospital of Enshi Autonomous Prefecture, Enshi, China
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4
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Noor M, Leal BL, Patel D. A Rare Case of Primary Mediastinal Endodermal Sinus Tumor Presenting with Hemoptysis. Cureus 2020; 12:e9517. [PMID: 32884873 PMCID: PMC7462652 DOI: 10.7759/cureus.9517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Mediastinal non-seminomatous germ cell tumors (NSGCTs) are very rare, with an approximate annual incidence of 500 in the United States. Here, we present a case of a 22-year-old male presenting with hemoptysis who was found to have primary mediastinal NSGCT, endodermal sinus tumor type (or yolk sac type). We review the imaging findings, pathology, and treatment of primary mediastinal endodermal sinus tumors.
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Affiliation(s)
| | | | - Dhruv Patel
- Radiology, Osceola Regional Medical Center, Kissimmee, USA
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Geng R, Zheng Z, Lin Y, Li Y, Ge G, Zhang J, Wang C, Dai X, Ye Q, Zhen J, Zhang Y, Fu C, Li Y. Clinical characteristics and prognostic factors of male yolk sac tumor: a Surveillance, Epidemiology, and End Results program study. World J Urol 2020; 39:1211-1217. [PMID: 32562046 DOI: 10.1007/s00345-020-03311-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 06/11/2020] [Indexed: 10/24/2022] Open
Abstract
INTRODUCTION Yolk sac tumor (YST) is a rare malignant germ cell tumor, which usually affects young males. Because of the low incidence, few studies on YST have been published. In our study, we aim to investigate the clinical characteristics, survival and risk factors of male YST patients based on the Surveillance, Epidemiology, and End Results (SEER) program. METHODS We identified 569 male YST patients from the SEER-18 database with additional treatment fields. Clinical characteristics, survival and prognostic factors were described in the study. Chi-square tests were applied to analyze categorical and continuous variables between different groups. Univariate and multivariate Cox proportional hazard model were performed to assess the relative impacts of risk factors on cancer-specific survival (CSS) in YST patients. Kaplan-Meier method and the log-rank test were used to analyze differences in survival that were significant. RESULTS The major primary sites of YST were testis (74.69%), mediastinum (15.47%), retroperitoneum (2.64%) and central nervous system (1.24%). The 3-year and 5-year CSS was 70.0%, 56.5% vs. 97.2%, 96.0% for the mediastinal and testicular YST patients, respectively (p < 0.001). Primary site of mediastinum, distant SEER Summary stage were independent factors of poor prognosis (hazard ratio (HR) = 2.010 (1.094-3.695), p = 0.025; HR = 6.501 (2.294-18.424), p < 0.001, respectively). Receiving surgery was a good prognosis factor for all patients (HR = 0.495 (0.260-0.940), p = 0.032) and for the mediastinal group (p = 0.0019). Being treated with chemotherapy indicated poor outcome in all patients (HR = 3.624 (1.050-12.507), p = 0.042) and in the localized testicular YST patients (p = 0.0077). CONCLUSION For the first time, our study revealed the primary site distribution of male YST, and summarized the clinical characteristics, survival and prognostic factors based on the SEER database, which provided important epidemiological evidence for clinical practice.
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Affiliation(s)
- Ruixuan Geng
- Department of International Medical Services, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China
| | - Zhibo Zheng
- Department of International Medical Services, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China
| | - Yuxiao Lin
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yaguang Li
- Department of International Medical Services, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China.,Department of Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Guannan Ge
- Department of International Medical Services, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China.,Department of Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Jieshi Zhang
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Chenyu Wang
- Department of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaoyan Dai
- Department of International Medical Services, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China
| | - Qiuyue Ye
- Department of International Medical Services, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China
| | - Junfeng Zhen
- Department of International Medical Services, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China
| | - Ying Zhang
- Department of International Medical Services, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China
| | - Chenwei Fu
- Department of International Medical Services, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China.
| | - Yongning Li
- Department of International Medical Services, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China.
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马 义, 刘 敬, 齐 康, 张 继, 林 钢, 刘 海, 商 学, 李 简. [Diagnosis and treatment of seven primary mediastinal yolk sac tumors]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2019; 51:1091-1095. [PMID: 31848510 PMCID: PMC7433596 DOI: 10.19723/j.issn.1671-167x.2019.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Primary mediastinal yolk sac tumor, which is also known as endodermal sinus tumor, is a rare but lethal neoplasm and its prognosis is very dismal. The current treatment for this tumor is controversial, and chemotherapy combined with resection of residual lesions is adopted sometimes. We summarized the experience of seven primary mediastinal yolk sac tumors treated with platinum-based chemotherapy and extended resection in Peking University First Hospital. METHODS Clinicopathological data of the patients with primary mediastinal yolk sac tumor who received operation in Peking University First Hospital between August 2014 and August 2018 were collected and analyzed retrospectively. RESULTS We experienced seven primary mediastinal yolk sac tumors during this period. Computed tomography scan revealed an anterior mediastinal tumor in all the patients and all of them had markedly raised alphafetoprotein (AFP) and normal β-human chorion gonadotropin (β-HCG). Five patients underwent needle core biopsy before treatment, which showed a mediastinal yolk sac tumor. All of these patients received preoperative platinum-based chemotherapy and they all presented partial response according to computed tomography. Two other patients did not receive preoperative biopsy, so they directly underwent extended resection. All of the seven patients underwent operation successfully and two of them experienced postoperative complications, including one with pneumonia and the other with atelectasis. R0 resection was achieved in six patients and R1 resection was achieved in the other patient. According to postoperative pathology, there were one microcyst subtype, one adenoid subtye, one giant capsule subtype and two hybrid subtypes. Surprisingly, there were no yolk sac tumor tissue in the other two patients after preoperative chemotherapy. All the patients received postoperative chemotherapy, excluded one patient who was unable to tolerate chemotherapy after operation. Three patients experienced postoperative pulmonary metastases within one year and two of them died soon. The other patient received chemotherapy and immunotherapy after recurrence and he was alive at the time of writing. Four other patients were alive without recurrence and metastasis. CONCLUSION Primary mediastinal yolk sac tumor is rare and its prognosis is poor. A multimodality approach including adjuvant chemotherapy and resection of residual lesions is the optimal treatment and it may lead to long-term survival.
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Affiliation(s)
- 义祥 马
- 北京大学第一医院 胸外科,北京 100034Department of Thoracic Surgery, Peking University First Hospital, Beijing 100034, China
| | - 敬伟 刘
- 北京大学第一医院 胸外科,北京 100034Department of Thoracic Surgery, Peking University First Hospital, Beijing 100034, China
| | - 康 齐
- 北京大学第一医院 胸外科,北京 100034Department of Thoracic Surgery, Peking University First Hospital, Beijing 100034, China
| | - 继新 张
- 北京大学第一医院 病理科,北京 100034Department of Pathology, Peking University First Hospital, Beijing 100034, China
| | - 钢 林
- 北京大学第一医院 胸外科,北京 100034Department of Thoracic Surgery, Peking University First Hospital, Beijing 100034, China
| | - 海波 刘
- 北京大学第一医院 胸外科,北京 100034Department of Thoracic Surgery, Peking University First Hospital, Beijing 100034, China
| | - 学谦 商
- 北京大学第一医院 胸外科,北京 100034Department of Thoracic Surgery, Peking University First Hospital, Beijing 100034, China
| | - 简 李
- 北京大学第一医院 胸外科,北京 100034Department of Thoracic Surgery, Peking University First Hospital, Beijing 100034, China
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Liu B, Lin G, Liu J, Liu H, Shang X, Li J. Primary mediastinal yolk sac tumor treated with platinum-based chemotherapy and extended resection: Report of seven cases. Thorac Cancer 2018; 9:491-494. [PMID: 29318787 PMCID: PMC5879052 DOI: 10.1111/1759-7714.12591] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 12/09/2017] [Accepted: 12/09/2017] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Primary mediastinal yolk sac tumor, which is also known as endodermal sinus tumor, is a rare but lethal neoplasm, and it is a kind of mediastinal non-seminomatous germ cell tumor. The current standard treatment in mediastinal non-seminomatous germ cell tumors is chemotherapy combined with postchemotherapy residual mass resection. We report on seven cases of primary mediastinal yolk sac tumor treated with platinum-based chemotherapy and extended resection. METHODS We experienced seven cases of primary mediastinal yolk sac tumor between August 2014 and August 2017. All cases had markedly raised α-fetoprotein and normal β-human chorion gonadotropin. Computed tomography scan revealed an anterior mediastinal tumor in all cases. Five patients underwent needle core biopsy, which showed a mediastinal yolk sac tumor. They received preoperative platinum-based chemotherapy and then underwent extended resection, and four of them received postoperative platinum-based chemotherapy. Two other patients did not receive preoperative biopsy, and they underwent surgical extended resection and then received postoperative platinum-based chemotherapy. RESULTS Two patients (29%) experienced a postoperative complication, including one pneumonia and one atelectasis. There were no operative deaths. R0 resection was achieved in six patients (86%), and R2 resection was achieved in the other patient. Three patients experienced pulmonary metastases within one year, and two of them soon died. Four other patients were alive without recurrence at the time of writing. CONCLUSION Primary mediastinal yolk sac tumor is rare, and the prognosis is poor. A multimodality aggressive approach including adjuvant chemotherapy followed by surgical resection is the optimal treatment and may lead to long-term survival.
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Affiliation(s)
- Bing Liu
- Department of Thoracic Surgery, Peking University First Hospital, Peking University, Peking, China
| | - Gang Lin
- Department of Thoracic Surgery, Peking University First Hospital, Peking University, Peking, China
| | - Jingwei Liu
- Department of Thoracic Surgery, Peking University First Hospital, Peking University, Peking, China
| | - Haibo Liu
- Department of Thoracic Surgery, Peking University First Hospital, Peking University, Peking, China
| | - Xueqian Shang
- Department of Thoracic Surgery, Peking University First Hospital, Peking University, Peking, China
| | - Jian Li
- Department of Thoracic Surgery, Peking University First Hospital, Peking University, Peking, China
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Silva LLCD, Vergilio FS, Yamaguti DCC, Cruz IAND, Queen JAG. Yolk sac primary tumor of mediastino: a rare case in a young adult. ACTA ACUST UNITED AC 2017; 15:496-499. [PMID: 28954036 PMCID: PMC5875168 DOI: 10.1590/s1679-45082017rc4008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 05/04/2017] [Indexed: 11/23/2022]
Abstract
Germ cell tumors are rare neoplasms that mostly occur in the gonads, although they can also affect other body sites, especially the anterior mediastinum (50 to 70% of all extragonadal germ cell tumors). We report a case of a primary mediastinal yolk sac tumor, a rare and aggressive germ cell tumors subtype. This was a 38-year-old man who was admitted to Hospital do Servidor Público Estadual “Francisco Morato de Oliveira”, complaining about dyspnea and dry cough for 1 year. The computed tomography scan of his chest revealed a large mass in the anterior mediastinum with heterogeneous enhancement to the contrast associated with pleural effusion. There were also high serum levels of alpha-fetoprotein. After neoadjuvant chemotherapy, the patient underwent surgical resection of the mass, followed by pathological examination, which confirmed a primary mediastinal yolk sac tumor, a nonseminomatous subtype of germ cell tumors. Primary mediastinal yolk sac tumors have poor prognosis, despite advances in therapy with surgical resection and cisplatin-based chemotherapy. This poor prognosis is due to the degree of invasion and unresectability in most patients by the time of the diagnosis.
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Affiliation(s)
- Lorena Luryann Cartaxo da Silva
- Instituto de Assistência Médica ao Servidor Público Estadual, Hospital do Servidor Público Estadual "Francisco Morato de Oliveira", São Paulo, SP, Brazil
| | - Fernanda Sasaki Vergilio
- Instituto de Assistência Médica ao Servidor Público Estadual, Hospital do Servidor Público Estadual "Francisco Morato de Oliveira", São Paulo, SP, Brazil
| | - Diva Carvalho Collarile Yamaguti
- Instituto de Assistência Médica ao Servidor Público Estadual, Hospital do Servidor Público Estadual "Francisco Morato de Oliveira", São Paulo, SP, Brazil
| | - Isabela Azevedo Nicodemos da Cruz
- Instituto de Assistência Médica ao Servidor Público Estadual, Hospital do Servidor Público Estadual "Francisco Morato de Oliveira", São Paulo, SP, Brazil
| | - Joana Angrisani Granato Queen
- Instituto de Assistência Médica ao Servidor Público Estadual, Hospital do Servidor Público Estadual "Francisco Morato de Oliveira", São Paulo, SP, Brazil
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Occult Mediastinal Yolk Sac Tumor Producing α-Fetoprotein Detected by 18F-FDG PET/CT. Clin Nucl Med 2016; 41:585-6. [DOI: 10.1097/rlu.0000000000001238] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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