1994 Volume 8 Issue 5 Pages 629-637
A 39-year-old woman presented with dyspnea and chest pain. A chest roentgenogram and CT scan showed a large mass extending from the mediastinum to the left thoracic cavity. Needle biopsy of the tumor showed “mature teratoma, no malignancy”, but we suspected a malignant component because the serum levels of AFP, CA19-9 and CAl2-5 were high. One course of preoperative chemotherapy (cisplatin, etoposide, bleomycin) was administered, but the serum tumor markers increased and the tumor did not shrink. An operation was performed through median sternotomy and 4th. intercostal space anterolateral thoracotomy. The tumor, which involved the left upper lobe but not the great vessels, was completely removed along with the entire left upper lobe. The serum levels of tumor markers returned to normal by one month after surgery. The pathological diagnosis was immature teratoma. Immunohistochemical studies of the tumor showed AFP, CA19-9 and CAl2-5 in the immature tissue. The patient is alive and well 14 months after surgery, and the serum levels of tumor markers have remained normal.
