[Complete resection of an advanced mediastinal nonseminomatous germ cell tumor with multiple distant metastases after down-staging by chemotherapy].
A mediastinal nonseminomatous germ cell tumor was completely resected after down-staging by chemotherapy despite the presence of multiple distant metastases. A 22-year-old female was admitted for superior vena cava (SVC) syndrome. Her SVC was obstructed by a large anterior mediastinal tumor; she also exhibited distant metastases on a left rib, in the liver, and multiple in the lung. The blood alpha-fetoprotein (AFP) level was extremely elevated to 57,530 ng/ml. Four courses of BEP therapy [cisplatin (CDDP), bleomycin (BLM), etoposide (VP-16)] and a high dose chemotherapy followed by a peripheral blood stem cell transplantation made the tumor become smaller and effected its down-staging. Residual mediastinal tumor with an intravascular tumor in SVC was completely resected. The SVC was reconstructed by an artificial vessel graft. A mediastinal nonseminomatous germ cell tumor, even though it has multiple distant metastases, can achieve down-staging and complete resection by a chemotherapy based on scientific evidence.
Usuda
K
K
Department of Thoracic Surgery, Kanazawa Medical University, Ishikawa, Japan.
Sagawa
M
M
Aikawa
H
H
Ueno
M
M
Tanaka
M
M
Machida
Y
Y
Tsuchihara
K
K
Masaki
Y
Y
Kinoshita
E
E
Sakuma
T
T
D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008479:Mediastinal Neoplasms / Q000188:drug therapy / Q000601:surgery*; D009362:Neoplasm Metastasis; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy / Q000601:surgery*; D055815:Young Adult