Severe dyspnea caused by a large mediastinal germ cell tumor: A case report

Abstract

We report the case of a 19-year-old man referred to our hospital with a complaint of severe dyspnea. Computed tomography demonstrated an anterior mediastinal tumor, of 130×95 mm, causing tracheal and bilateral bronchial stenosis.

The imaging along with a high serum level of alpha-fetoprotein (AFP) (2,643 ng/mL) facilitated the diagnosis of a malignant germ cell tumor. Chemotherapy (bleomycin, etoposide, and cisplatin: 4 courses) was administered immediately, with a significant reduction of the tumor size and normalization of AFP levels. We performed a combined resection of the mediastinal tumor, right atrium, and superior vena cava with graft reconstructions.

The postoperative course was favorable and he could return to college on postoperative day 22. He is currently alive with no evidence of recurrence at four years after surgery.