title: Seminomatous extragonadal germ cell tumor with complete obstruction of the superior vena cava responding to intensive chemotherapy.
abstract: A 20-year-old man was admitted to our hospital with persistent cough and dyspnea. He had bilateral distention of the jugular veins, and swollen lymph nodes were palpable in the right subclavicular region. Plain X-ray and computed tomography (CT) of the chest showed a solid soft tissue mass in the upper mediastinum, with leftward displacement of the trachea and complete obstruction of the superior vena cava. Mediastinal radiotherapy (1.8 Gy/day) and methylprednisolone (100 mg/day) were started immediately. Biopsy of the right subclavicular lymph nodes revealed metastatic seminoma. The patient was referred for chemotherapy, which was performed with a combination of cisplatin, bleomycin and etoposide (BEP). A partial response was observed after completion of 3 cycles of chemotherapy, but there was no further tumor shrinkage after additional salvage chemotherapy. The patient is being followed up on an outpatient basis and has been free of recurrence for 32 months after intensive treatment.
authors: Department of Urology, J.A. Aichi Anjo Kosei Hospital, Japan.
authors: Yoshinobu
authors: Y
authors: Moritoki
authors: Department of Urology, J.A. Aichi Anjo Kosei Hospital, Japan.
authors: Toshiki
authors: T
authors: Kato
authors: Department of Urology, J.A. Aichi Anjo Kosei Hospital, Japan.
authors: Hidenori
authors: H
authors: Nishio
authors: Department of Urology, J.A. Aichi Anjo Kosei Hospital, Japan.
authors: Hideyuki
authors: H
authors: Kamisawa
authors: Department of Urology, J.A. Aichi Anjo Kosei Hospital, Japan.
authors: Yasuhiko
authors: Y
authors: Hirose
authors: Department of Urology, J.A. Aichi Anjo Kosei Hospital, Japan.
authors: Ryosuke
authors: R
authors: Ando
authors: Department of Urology, J.A. Aichi Anjo Kosei Hospital, Japan.
authors: Hidetoshi
authors: H
authors: Akita
authors: Department of Urology, J.A. Aichi Anjo Kosei Hospital, Japan.
authors: Takehiko
authors: T
authors: Okamura
keywords: Extragonadal germ cell tumor; intensive chemotherapy; superior vena cava obstruction
references: J Clin Oncol. 1997 Feb;15(2):594-603
references: 9053482
references: Ann Thorac Surg. 2008 Feb;85(2):379-84
references: 18222229
references: Ann Thorac Surg. 2008 Feb;85(2):371-8
references: 18222228
references: J Clin Oncol. 2002 Apr 1;20(7):1864-73
references: 11919246
references: Cancer. 2001 Apr 1;91(7):1394-401
references: 11283942
references: Cancer. 1975 Sep;36(3):1162-8
references: 1237349
references: Ann Oncol. 2004 Sep;15(9):1377-99
references: 15319245