Abstract
A 29-year-old man had chest pain and was found to have an anterior mediastinal tumor. A needle biopsy using computed tomographic imaging revealed a germ cell tumor composed of embryonal carcinoma and teratoma. The serum concentration of alpha-fetoprotein (AFP) was elevated at 9600 ng/ml, but all other tumor markers including beta-human chorionic gonadotropin were in the normal ranges. On December 16, 2000, combined chemotherapy (PEB regimen: cisplatin+etoposide+bleomycin) was administered twice, and high-dose chemotherapy (ICE regimen: carboplatin+etoposide+ifosfamide) followed by peripheral blood stem cell transplantation was also performed twice. After chemotherapy, the serum concentration of AFP decreased to 44.3 ng/ml, but was still high. Surgical resection followed by chemotherapy (PE regimen: cisplatin+etoposide) was performed, and the serum concentration of AFP decreased to a normal level 28 days after surgery. Histological examination of resected specimen revealed an immature teratoma. At present six months after surgery, the serum concentration of AFP is at a normal level and there are no signs of recurrence.
