title: A rare case of bilateral massive hemothorax from spontaneous rupture of a primary mediastinal mixed germ cell tumor.
abstract: Spontaneous rupture of a mediastinal germ cell tumor, while rare, is always accompanied by bleeding. In this report, we describe a case of a primary mediastinal mixed germ cell tumor that presented with bilateral massive hemothorax and hemorrhagic shock. An urgent thoracotomy, which was performed to control bleeding, confirmed bilateral hemothorax secondary to a ruptured mediastinal tumor. Pathologic diagnosis revealed the mediastinal tumor to be mixed choriocarcinoma and immature teratoma, with lung metastatic choriocarcinoma. The patient recovered well from the operation and received salvage chemotherapy. Two years after diagnosis, the patient remains in remission with no evidence of disease.
authors.affiliation: Department of Thoracic Surgery, The Affiliated First People's Hospital, Shanghai Jiao Tong University, Shanghai, China. ruanzheng@csco.org.cn
authors.forename: Zheng
authors.initials: Z
authors.lastname: Ruan
authors.forename: Shaohua
authors.initials: S
authors.lastname: Wang
authors.forename: Zheng
authors.initials: Z
authors.lastname: Wang
authors.forename: Yubiao
authors.initials: Y
authors.lastname: Jing
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood; D001803:Blood Transfusion; D017024:Chemotherapy, Adjuvant; D031954:Choriocarcinoma, Non-gestational / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000378:metabolism / Q000556:secondary / Q000601:surgery; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D003131:Combined Modality Therapy; D003951:Diagnostic Errors; D005440:Fluid Therapy; D006488:Hemostasis, Surgical / Q000379:methods*; D006491:Hemothorax / Q000209:etiology*; D006801:Humans; D007713:Klinefelter Syndrome / Q000150:complications / Q000175:diagnosis; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary / Q000601:surgery; D008297:Male; D008479:Mediastinal Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery; D018365:Neoplasm, Residual; D011013:Pneumonectomy / Q000379:methods; D012074:Remission Induction; D012422:Rupture, Spontaneous; D012771:Shock, Hemorrhagic / Q000209:etiology* / Q000601:surgery / Q000628:therapy; D013724:Teratoma / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary / Q000601:surgery; D013972:Thyrotropin / Q000378:metabolism; D014057:Tomography, X-Ray Computed
chemical_list: D014408:Biomarkers, Tumor; D018997:Chorionic Gonadotropin, beta Subunit, Human; D013972:Thyrotropin