title: Radical surgical resection for giant primary mediastinal endodermal sinus tumour with pulmonary metastasis after chemotherapy: can be curative.
abstract: Primary non-seminomatous germ cell tumours of anterior mediastinum are uncommon. Endodermal sinus tumour of the anterior mediastinum (yolk sac) is a rare but lethal neoplasm. We present a case of an 18-year-old man who presented with chest pain, cough and haemosputum with markedly raised serum α-fetoprotein (AFP) levels above 112,000 ng/mL. Chest roentgenogram and CT showed a giant anterior mediastinal mass. CT guided biopsy revealed a diagnosis of endodermal sinus tumour. After the completion of chemotherapy, extensive surgical resection was carried out along with the right lung metastastectomy. Five years postresection follow-up the patient is disease free with normal serum tumour markers. This is the longest survival ever reported of such tumours with highest AFP level (>112,000 ng/mL) and lung metastasis.
authors.affiliation: Department of Chest Surgery, King Fahad Specialist Hospital, Dammam, Saudi Arabia.
authors.forename: Ikram Ulhaq
authors.initials: IU
authors.lastname: Chaudhry
authors.affiliation: Department of Adult Oncology, King Fahad Specialist Hospital, Dammam, Saudi Arabia.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Rahhal
authors.affiliation: Department of Adult Oncology, King Fahad Specialist Hospital, Dammam, Saudi Arabia.
authors.forename: Imtiaz
authors.initials: I
authors.lastname: Khurshid
authors.affiliation: Department of Chest Surgery, King Fahad Specialist Hospital, Dammam, Saudi Arabia.
authors.forename: Hadi
authors.initials: H
authors.lastname: Mutairi
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000627:therapeutic use; D018240:Endodermal Sinus Tumor / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary* / Q000601:surgery; D008297:Male; D008479:Mediastinal Neoplasms / Q000188:drug therapy / Q000601:surgery*; D056346:Sternotomy / Q000379:methods; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents