title: High-dose chemotherapy followed by autologous peripheral blood stem cell transplantation for recurrent primary mediastinal malignant germ cell tumor: a case report.
abstract: A 15-yr-old boy presented with an anterior mediastinal mass, multiple lung metastases and obstruction of the left brachiocephalic vein, the superior vena cava and the subclavian vein. Tumor biopsy by CT guidance confirmed a diagnosis of GCT. Five courses of BEP therapy were performed, and CT of the chest revealed reduction in the anterior mediastinal mass and disappearance of the multiple lung metastases. We performed the anterior mediastinal mass extraction followed by adjuvant chemotherapy consisting of ICE and TIP. However, the AFP levels became elevated soon after. Abnormal accumulation was observed in the right upper lung by DW-MRI. After the operation, two courses of TI chemotherapy and two courses of HDCT followed by auto-PBSCT were performed. He was complicated with auditory disorder and renal dysfunction. Although HDCT followed by auto-PBSCT was effective for the relapsed primary mediastinal GCT, a treatment strategy avoiding late complications is warranted.
authors.affiliation: Department of Pediatrics, St. Marianna University School of Medicine Hospital, Kanagawa, Japan.
authors.forename: Dai
authors.initials: D
authors.lastname: Keino
authors.forename: Kensuke
authors.initials: K
authors.lastname: Kondoh
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Murata
authors.forename: Ryo
authors.initials: R
authors.lastname: Ohyama
authors.forename: Mizuho
authors.initials: M
authors.lastname: Morimoto
authors.forename: Shinji
authors.initials: S
authors.lastname: Muto
authors.forename: Miho
authors.initials: M
authors.lastname: Fukuda
authors.forename: Munechika
authors.initials: M
authors.lastname: Wakisaka
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kitagawa
authors.forename: Akitoshi
authors.initials: A
authors.lastname: Kinoshita
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000737:chemistry / Q000627:therapeutic use*; D001706:Biopsy; D016121:Brachiocephalic Veins / Q000473:pathology; D038524:Diffusion Magnetic Resonance Imaging; D019788:Fluorodeoxyglucose F18 / Q000737:chemistry; D006801:Humans; D008175:Lung Neoplasms / Q000276:immunology / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D009362:Neoplasm Metastasis; D009373:Neoplasms, Germ Cell and Embryonal / Q000276:immunology / Q000628:therapy*; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods*; D049268:Positron-Emission Tomography; D011379:Prognosis; D012008:Recurrence; D013350:Subclavian Vein / Q000473:pathology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014683:Vena Cava, Superior / Q000473:pathology
chemical_list: D000970:Antineoplastic Agents; D019788:Fluorodeoxyglucose F18
keywords: autologous peripheral stem cell transplantation; high-dose chemotherapy; lung metastasis; primary mediastinal germ cell tumor