Mediastinal Seminoma with an Elevated Level of Serum Angiotensin-converting Enzyme

Ishii, Hiroshi; Igata, Fumiyasu; Nabeshima, Kazuki; Kushima, Hisako; Watanabe, Kentaro

doi:10.2169/internalmedicine.54.3953

Cited by 3 publications

(4 citation statements)

References 15 publications

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“…14,15 Several seminoma cases with coexisting sarcoidosis and paraneoplastic sarcoid-like reaction have also been reported. [16][17][18] Adequate pathological examination is necessary in order to confirm the absence of malignant metastasis.…”

Section: Discussionmentioning

confidence: 99%

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Testicular seminoma with a progressing pulmonary nodule and mediastinal lymphadenopathy without retroperitoneal metastasis

et al. 2020

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Introduction Testicular germ cell cancer has a relatively good prognosis even if visceral and/or lymph node metastases are present thanks to chemotherapy. Yet chemotherapy can lead to various adverse events. Therefore, it is crucial to distinguish whether a suspected metastatic disease is metastasis or not. Case presentation A 33‐year‐old male visited our hospital to receive subsequent therapy for suspected recurrent seminoma with a progressing pulmonary nodule and mediastinal lymphadenopathy after orchiectomy. The pathological diagnosis of needle aspiration and resected specimen of the several lesions was consistent with epithelioid cell granuloma without caseous necrosis. Based on these findings, the lung and mediastinal lymph node lesions were diagnosed as sarcoidosis. Conclusion In cases where the simultaneous occurrence of other benign or malignant diseases is suspected, pathological confirmation is necessary for appropriate decision‐making.

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Section: Discussionmentioning

confidence: 99%

“…1d-f) tended to increase in size over two months of observation. 18 F-FDG-PET/CT also revealed several enlarged and hypermetabolic mediastinal nodes (Fig. 1g,h).…”

Section: Case Presentationmentioning

confidence: 91%

Testicular seminoma with a progressing pulmonary nodule and mediastinal lymphadenopathy without retroperitoneal metastasis

et al. 2020

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“…Our case resulted in a diagnostic dilemma following microscopic examination, as there were no neoplastic cells that were masked by inflammatory cells, along with a florid granulomatous reaction. Only a few mediastinal seminomas with chronic granulomatous inflammation have been reported previously (7)(8)(9). There was a case in which only a mediastinal seminoma and chronic granulomatous inflammation were pathologically accompanied, and they were also mistaken from a small biopsy to be TB, and the diagnosis was delayed (8).…”

Section: E F C B Amentioning

confidence: 99%

Granulomatous reaction of primary mediastinal seminoma leading to diagnostic delay: a case report

Lee¹,

Lim²,

Lee³

et al. 2018

J. Thorac. Dis.

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Primary mediastinal seminoma (PMS) is a rare tumor. PMS can be morphologically related to secondary changes in the form of thymic remnants, cystic degeneration, epithelioid granulomas, fibrotic change, and syncytiotrophoblast-like cells. Ours was an interesting case where a 26-year-old male presented with an incidentally-found anterior mediastinal mass. Even though he had no pulmonary symptoms, the transthoracic co-axial needle biopsy of the mass suggested tuberculosis (TB). However, on follow-up computed tomography (CT) and magnetic resonance image (MRI) in 2 months, the mass slightly increased in size, and a small part of low density or signal intensity appeared, despite the regular anti-TB treatment regimen. Surgical resection was performed, and the resected specimens revealed scattered and irregular-shaped seminoma cells with an intervening chronic granulomatous reaction. The aim of this article is to report a case of PMS in a young male patient who had a granulomatous reaction that mimicked a neoplastic population of cells leading to an erroneous diagnosis of the small biopsy. Therefore, awareness of the secondary changes that can mimic a primary lesion can help with an early correction of this misdiagnosis.

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“…Hypercalciuria and hypercalcemia usually respond to corticosteroids within a few days. Hydroxychloroquine and ketoconazole have also proved to be useful to lower calcitriol and calcium levels in patients with sarcoidosis [45]. Long-term effects of other therapies on the granuloma burden also helps limiting hypercalcemic complications of sarcoidosis.…”

Section: Treatmentmentioning

confidence: 99%

Urologic and Urinary Manifestations of Sarcoidosis

Vanderhulst¹

2017

Med Surg Urol

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Sarcoidosis is a chronic granulomatous disease than most commonly affects the lungs, but concomitant -or exceptionally isolated-extrapulmonary involvement is frequent. Urologic symptoms may occur in a patient known with sarcoidosis or may reveal the disease.The present review illustrates the protean nature of the disease, which can manifest with any of the common urologic symptoms and can be mistaken for other conditions such as infection and cancer. An insight into diagnostic and therapeutic management is also proposed.We hope to increase awareness about urologic manifestations of sarcoidosis in order to help the clinicians avoiding misdiagnosis, which could expose the patients to unnecessary medications or surgical procedures, progressive disease, recurrence and long-term sequelae.

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Mediastinal Seminoma with an Elevated Level of Serum Angiotensin-converting Enzyme

Cited by 3 publications

References 15 publications

Testicular seminoma with a progressing pulmonary nodule and mediastinal lymphadenopathy without retroperitoneal metastasis

Testicular seminoma with a progressing pulmonary nodule and mediastinal lymphadenopathy without retroperitoneal metastasis

Granulomatous reaction of primary mediastinal seminoma leading to diagnostic delay: a case report

Urologic and Urinary Manifestations of Sarcoidosis

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