Development of angiosarcoma in a mediastinal non‐seminomatous germ cell tumor that exhibited growing teratoma syndrome during chemotherapy

Abstract

Herein, we report a case of an angiosarcoma in a mediastinal non‐seminomatous germ cell tumor that exhibited growing teratoma syndrome during chemotherapy. A 26‐year‐old man presented with a giant anterior mediastinal mass, which was diagnosed as a non‐seminomatous germ cell tumor. The patient was administered three cycles of chemotherapy (bleomycin, etoposide, and cisplatin), but the mass grew despite normalization of tumor markers. Massive bleeding during thoracic surgery resulted in incomplete resection, and the mass was clinically and pathologically diagnosed as growing teratoma syndrome (only mature teratoma). The residual mass continued to grow, and complete resection was subsequently achieved after a detailed analysis of its vascular anatomy using angiography. The final pathological findings revealed angiosarcoma, which indicated a rare somatic type of mediastinal non‐seminomatous germ cell tumor.

Vascular tumors of the mediastinum

“…The heart, great vessels, esophagus, and the thymus have all been documented as sites of origin ( 50 - 53 ). Angiosarcomas can arise secondarily within other tumors of the mediastinum, some examples including primary germ cell tumors ( 54 , 55 ) and schwannomas ( 56 ). Tumors are treated by resection, with or without chemotherapy ( 50 , 51 , 57 ).…”