title: Large mixed germ cell tumor in a young patient presenting as an intrapulmonary mass.
abstract: We present the case of a 26-year-old man with a bland medical history, who presented to the general practitioner because of severe cough and dyspnea. The chest X-ray revealed a massive organ-displacing tumor in the right chest not delineable from the mediastinum. The subsequent needle core biopsy was diagnostic for a mixed germ cell tumor comprising immature teratoma and seminoma. After an initially good response to chemotherapy, tumor markers and tumor size were progressive. The right-sided pneumonectomy revealed an intrapulmonary tumor with cystic and solid components, hemorrhage, and necrosis with a tumor diameter of 18cm. Histology confirmed a teratoma with mature and immature components accompanied by residual seminomatous tumor cells. Despite maximal intensive care, the patient died four weeks after surgery from acute respiratory distress syndrome. We describe this exceptional large intrapulmonary germ cell tumor and discuss the spectrum of such rare tumors.
authors.affiliation: Institute of Surgical Pathology, Department Pathology, University Hospital Zurich, Zurich, Switzerland. florian.fritzsche@usz.ch
authors.forename: Florian R
authors.initials: FR
authors.lastname: Fritzsche
authors.forename: Glen
authors.initials: G
authors.lastname: Kristiansen
authors.forename: Thomas
authors.initials: T
authors.lastname: Frauenfelder
authors.forename: Isabelle
authors.initials: I
authors.lastname: Opitz
authors.forename: Peter
authors.initials: P
authors.lastname: Bode
authors.forename: Holger
authors.initials: H
authors.lastname: Moch
authors.forename: Matteo
authors.initials: M
authors.lastname: Montani
mesh_terms: D000328:Adult; D014408:Biomarkers, Tumor / Q000378:metabolism; D003131:Combined Modality Therapy; D018450:Disease Progression; D017809:Fatal Outcome; D006801:Humans; D008175:Lung Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D008297:Male; D013902:Radiography, Thoracic; D018239:Seminoma / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D013724:Teratoma / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D014057:Tomography, X-Ray Computed
chemical_list: D014408:Biomarkers, Tumor