Concurrent development of testicular seminoma and choriocarcinoma of the superior mediastinum, presented as cervical mass: a case report and implications about pathogenesis of germ-cell tumours

Mountzios, Giannis; Pavlakis, George N.; Terpos, Evangelos; Sakorafas, George H.; Revelos, Kyriakos; Bamias, Aristotelis; Νικολάου, Νικόλαος; Papasavas, Pantelis; Soria, Jean‐Charles; Dimopoulos, Meletios Α.

doi:10.1186/1472-6890-6-8

Cited by 6 publications

(6 citation statements)

References 9 publications

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“…Since the first report of primary mediastinal choriocarcinoma by Arendt in 1931, there have been only 43 subsequent reports …”

Section: Discussionmentioning

confidence: 99%

“…All case reports of primary mediastinal choriocarcinoma published in English or providing an informative English abstract were included. The term “primary mediastinal choriocarcinoma” published in the British Medical journal summarized 20 cases of primary mediastinal choriocarcinoma reported from 1931 to 1969, 19 of which were in men; Fanger and MacAndrew reported the only female case; 25 and 23 cases from 1969 to 2014 were found and included,4–23,27,28 three of which were in women …”

Section: Discussionmentioning

confidence: 99%

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Primary choriocarcinoma in mediastinum with multiple lung metastases in a male patient: A case report and a review of the literature

et al. 2014

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Primary choriocarcinoma is a rare malignant tumor, particularly in men. The tumor, mostly found in the gastrointestinal system and mediastinum, often metastasizes early with poor therapeutic effects and prognosis. Herein, we present a male patient with primary mediastinum choriocarcinoma and widespread lung metastases. The disease progressed rapidly with little therapeutic effect from chemotherapy. The patient died of this disease 75 days after initial symptom presentations. Literature review found only 41 cases of primary choriocarcinoma reported in the mediastinum. This case highlights the importance of keeping primary choriocarcinoma in the differentials for mediastinum tumors in young men. Sex hormone testing is helpful to confirm diagnosis. Early biopsy should be performed to confirm pathologic diagnose, and early surgery and chemotherapy should be considered to improve the cure rate of this disease. Case reportA 20 year old male presented with paroxysmal cough, expectoration of phlegm, minor fresh red hemoptysis, fever, and chest distress and pain for two weeks on 25 May 2011. Contrast-enhanced computed tomography (CT) showed a huge borderless mass in the anterior mediastinum, with low density in the central and marked enhancement in the surrounding area; diffuse oval nodules with peripheral enhancement in bilateral lungs; and enlargement of multiple mediastinal lymph nodes (Fig 1).The patient was lassitude with mild cyanosis. No superficial lymph node enlargement was found. Clear harsh breath sounds were heard in both lungs, with mild moist rales in the right lower lung. No abnormal signs were observed in the heart, abdomen, genital system or neural system. Auxiliary examination results showed: Blood-Rt: white blood cell: 17.32 × 10 9 /L; neutrophil percentage: 75.8%; hemoglobin: 139g/L; Urine-Rt: red blood cell: 5.5/heterogeneous packet flows; protein: 1 + ; tumor markers: CA12-5 56.03 U/mL (normal value: 0-39 U/mL), CYFRA21-1 50.77 ng/mL (normal value: 1-3.3 ng/mL), NSE 19.93 ng/mL (normal value: 0-16.3 ng/mL) were all elevated significantly, and the carcinoembryonic antigen (CEA) level was normal; coagulation tests (5 items): D-dimer: 666 ug/L, FIB: 4.57g/L; and the biochemical test for liver function was normal. The abdominal ultrasound and CT scan were normal. The preliminary diagnosis was a mediastinal tumor with multiple lung metastases. B-ultrasound examination was performed to exclude the primary tumor from other sites, including bilateral testes, and all were negative. Ultrasound guided percutaneous needle biopsy of the mediastinal mass was performed and the cytologic examination showed few marked dyskaryotic cells, but only hemorrhagic necrosis tissue with some keratinized material was seen in histology (Figs 2, 3).The second ultrasound guided percutaneous needle biopsy from both the mediastinal mass and a metastatic lesion in the right lung was performed on 7 June 2011 and a clear pathological diagnosis was obtained as mediastinum chorionic epithelioma with lung metastasis. The immunoh...

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“…Since the first report of primary mediastinal choriocarcinoma by Arendt in 1931, there have been only 43 subsequent reports …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Primary choriocarcinoma in mediastinum with multiple lung metastases in a male patient: A case report and a review of the literature

et al. 2014

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“…The metastatic sites are the lungs, liver and brain. Skin metastasis is very rare but portends a grave prognosis 1 . Two cases of testicular choriocarcinoma with skin involvement are reported.…”

Section: Case Reportmentioning

confidence: 99%

“…Skin metastasis is very rare but portends a grave prognosis. 1 Two cases of testicular choriocarcinoma with skin involvement are reported. The case reports and literature review are presented to provide the pathologists and dermatologists the differential features from other metastatic carcinomas to the skin.…”

Section: Case Reportmentioning

confidence: 99%

Testicular choriocarcinoma metastatic to skin and multiple organs. Two case reports and review of literature

Chen

et al. 2010

J Cutan Pathol

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Two cases of males with subcutaneous masses as the first clinical sign of testicular choriocarcinoma are reported. The urine and serum human chorionic gonadotropin (hCG) test confirmed high level hCG from male choriocarcinoma. These cases, although very rare, can be a great diagnostic and therapeutic challenge and should be considered in the differential diagnosis of subcutaneous masses occurring in young males.

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“…Occasionally, a mediastinal mass can initially present as a cervical mass. [19][20][21] A mass originating from the superior mediastinum may extend superiorly into the thyroid space ( Figures 11 and 12), just as a thyroid mass such as a goiter may extend inferiorly through the thoracic inlet into the superior mediastinum. On sonography, differentiation of these two lesions can be difficult, therefore needing additional imaging studies such as CT or magnetic resonance imaging (MRI).…”

Section: Mediastinal Lesionsmentioning

confidence: 99%

Findings of Extrathyroid Lesions Encountered With Thyroid Sonography

Kwak

Kim

Park

et al. 2007

Journal of Ultrasound in Medicine

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Concurrent development of testicular seminoma and choriocarcinoma of the superior mediastinum, presented as cervical mass: a case report and implications about pathogenesis of germ-cell tumours

Cited by 6 publications

References 9 publications

Primary choriocarcinoma in mediastinum with multiple lung metastases in a male patient: A case report and a review of the literature

Primary choriocarcinoma in mediastinum with multiple lung metastases in a male patient: A case report and a review of the literature

Testicular choriocarcinoma metastatic to skin and multiple organs. Two case reports and review of literature

Findings of Extrathyroid Lesions Encountered With Thyroid Sonography

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