title: [Multiple hepatic metastases due to germ cell tumor on initial clinical presentation].
abstract: A 31-year-old man presented with abdominal pain. Abdominal computed tomography (CT) demonstrated heterogeneously enhanced liver masses and chest CT revealed an anterior abnormal mass. He was admitted for further examination and treatment. The patient's serum beta-HCG level was markedly elevated (2,300ng/ml) and liver biopsy revealed the presence of choriocarcinoma and positive immunostaining for HCG. The patient was suspected to have combined germ cell tumor in the mediastinum with multiple liver metastases. He was treated with 8 cycles of BEP therapy (cisplatin. etoposide, bleomycin) and the beta-HCG level was normalized. We report a case of germ cell tumor with multiple and diffuse hypervascular masses in the liver as the initial clinical manifestation.
authors.affiliation: The First Department of Internal Medicine, Shinshu University School of Medicine.
authors.forename: Souichiro
authors.initials: S
authors.lastname: Ebisawa
authors.forename: Seiichi
authors.initials: S
authors.lastname: Yamazaki
authors.forename: Masanori
authors.initials: M
authors.lastname: Yasuo
authors.forename: Kazuyasu
authors.initials: K
authors.lastname: Urushihata
authors.forename: Kenji
authors.initials: K
authors.lastname: Tsushima
authors.forename: Masayuki
authors.initials: M
authors.lastname: Hanaoka
authors.forename: Tomonobu
authors.initials: T
authors.lastname: Koizumi
authors.forename: Keisaku
authors.initials: K
authors.lastname: Fujimoto
authors.forename: Keishi
authors.initials: K
authors.lastname: Kubo
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage; D031954:Choriocarcinoma, Non-gestational / Q000188:drug therapy / Q000556:secondary*; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D002945:Cisplatin / Q000008:administration & dosage; D004333:Drug Administration Routes; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary*; D008297:Male; D008479:Mediastinal Neoplasms / Q000188:drug therapy / Q000473:pathology*; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy / Q000556:secondary*
chemical_list: D018997:Chorionic Gonadotropin, beta Subunit, Human; D001761:Bleomycin; D005047:Etoposide; D002945:Cisplatin