A case of mediastinal α-fetoprotein producing malignant germ cell tumor

Effect of preoperative administration of cis-platin-based combination chemotherapy

Abstract

A 25-year-old male patient with a primary mediastinal non-seminomatous germ cell tumor producing α-fetoprotein (AFP) is described. The patient initially experienced chest pain. A chest x-ray film and chest CT revealed a large tumor in the anterior mediastinum and left lung field. Preoperatively three courses of cis-platin-based combination chemotherapy were administered. The serum α-fetoprotein level decreased rapidly to a normal level, and the tumor was completely resected after the patient's serum α-fetoprotein level fell within the normal range. Five days were required for weaning of the patient from a respirator. Thereafter, his clinical course was normal. Postoperatively a single course of cis-platin-based combination chemotherapy was administered. As the observation time has been only two years, we not make definitive conclusion regarding the treatment modality. However, we feel that an adjuvant surgery should be performed after the normalization of serum AFP level by chemotherapy.
He continues to be active in society two years after the surgery and no recurrence of the tumor has been detected.