Abstract
A 16-year-old man was admitted to the hospital because of an abnormal shadow on a chest X-ray. A chest CT demonstrated an anterior mediastinal tumor. Serum AFP was high, serum hCG was within normal limit, and sex item showed Klinefelter's syndrome (XXY). No abnormality was revealed in the gonad and retroperitoneum, and the tumor was thought to arise in the mediastinum. Atelectasis of the right middle lobe was noted, but there was no invasion into the surrounding organs nor metastasis to the lung on preoperative imagings. So an operation was precedently performed. Operative procedures included an extirpation of the tumor with lymph node dissection according to extended total thymectomy. After the operation the patient was added two courses of chemotherapy with CBDCA, etoposide and bleomycin, by mesuring serum AFP as an index. There has been no sign of recurrence, as of five years after the operation.
We think that a mediastinal tumor with either high serum AFP or serum hCG can be definitely diagnosed as NSGCT and we should employ chemotherapy as the treatment of first choice.
However, there are some cases in which a resection of the tumor is permitted to precede chemotherapy like this case.
