Malignant mediastinal germ cell tumors: Clinical findings and diagnostic and therapeutic problems

Abstract

This study aimed to confirm the clinical issues associated with malignant mediastinal germ cell tumors (MGCT). The records of eight patients with MGCT [seminoma (3), yolk sac tumor (1), embryonal carcinoma (1), adenocarcinoma with teratoma (1), others (2)] treated at Showa University group hospitals between 1993 and 2006 were reviewed. All patients were male. The median age was 30 years (range: 21-69). Six of the 8 tumors were located in the anterior, and two were in the middle mediastinum. Four of the 8 patients showed elevated tumor markers prior to the therapy. Two patients showed an elevation of AFP only, and one an elevation of HCG only. One patient exhibited an elevation of both markers. Biopsy was performed in 6 of the 8 cases: CT- guided needle biopsy in 4, mediastinoscopic biopsy in 1, and open biopsy in 1. One of the 6 patients who underwent biopsy received a diagnosis contradicting the final pathological finding of the resected specimen. Chemotherapy should be carried out initially when there is a high serum tumor marker level in cases of MGCT, which may occur in the middle mediastinum.