Abstract
A 14-year-old boy was referred to our hospital with complaints of a high fever and cough. Computed tomography demonstrated two mediastinal tumors with the radiographic characteristics of mature teratoma, measuring 11 and 4.5 cm in diameter. With a high serum level of alpha fetoprotein, the lesions were diagnosed as mixed germ cell tumors including a non-seminomatous malignant component. As a large part of the tumors seemed to be a resectable mature teratoma, and infection in the tumor was suspected to be the origin of the high fever, we performed surgical resection. The resected specimen contained two mature teratomas which were the predominant component, a yolk-sac tumor of 2 cm in diameter, and seminoma in the thymic gland. Postoperatively, a tumor of 1 cm in diameter was detected in the right testis, which was suspected of being a seminoma. High inguinal orchiectomy was performed. Histological examination revealed a testicular epidermoid cyst. Two courses of postoperative chemotherapy with cisplatin and etoposide were performed. In the treatment of a malignant mediastinal germ cell tumor, surgical resection followed by chemotherapy might be a reasonable and effective treatment if the lesion seems to be resectable and infectious.
