title: Anterior mediastinal nonseminomatous germ cell tumor with malignant transformation: a case report.
abstract: OBJECTIVE
  We report a case of a 21-year-old man who presented with the unusual symptoms of heart failure and was found to have an anterior mediastinal yolk sac tumor.
  
  
  METHODS
  A review of the literature using the Ovid search engine was performed.
  
  
  RESULTS
  The patient was treated with the current standard of neoadjuvant chemotherapy: bleomycin, etoposide, and cisplatin (BEP) with marked reduction in tumor size, followed by en bloc surgical resection. The final pathology revealed teratoma with malignant change: chondrosarcoma, adenocarcinoma, and poorly differentiated sarcoma.
  
  
  CONCLUSIONS
  This is a rare initial presentation of an anterior mediastinal germ-cell tumor with treatment consisting of neoadjuvant therapy and surgical resection. In addition, we present the adverse and extremely rare malignant degeneration of this tumor.
authors.affiliation: Division of Cardiothoracic Surgery, Keesler Medical Center, Keesler Air Force Base, Biloxi, MS 39534, USA. michael.michel@keesler.af.mil
authors.forename: Michael
authors.initials: M
authors.lastname: Michel
authors.forename: Jerry W
authors.initials: JW
authors.lastname: Pratt
mesh_terms: D000328:Adult; D002471:Cell Transformation, Neoplastic / Q000473:pathology; D018240:Endodermal Sinus Tumor / Q000150:complications / Q000473:pathology* / Q000628:therapy; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D008297:Male; D008479:Mediastinal Neoplasms / Q000150:complications / Q000473:pathology* / Q000628:therapy; D008482:Mediastinum / Q000473:pathology; D009362:Neoplasm Metastasis; D013724:Teratoma / Q000473:pathology