Primary malignant mediastinal germ cell tumors: A study of eleven cases and a review of the literature

Primary malignant mediastinal germ cell tumours: improved prognosis with platinum-based chemotherapy and surgery

“…Studies reported since 1985 show a range of overall survival from 21% to 63% (Horwich & Peckham, 1986;McLeod et al, 1988;Kiffer & Sandeman, 1989;Logothetis et al, 1986;Giaccone et al, 1991;Kersh et al, 1987;Parker et al, 1986;Nichols et al, 1990a;Toner et al, 1991) (Table V). Previous reports were even more gloomy (Fuen et al, 1980;Israel et al, 1985).…”

“…It has been suggested that there is an association between mediastinal germ cell tumour and haematological neoplasia (Nichols et al, 1990b) (Table IV) an overall survival in excess of 80% can be expected with the use of chemotherapy with or without radiotherapy (Horwich & Peckham, 1986;McLeod et al, 1988;Kiffer & Sandeman, 1989;Logothetis et al, 1985;Giaccone et al, 1991;Kersh et al, 1987). Based on this study and a recent report on the treatment for metastatic seminoma it appears that single agent carboplatin may be an appropriate first line treatment for patients with primary mediastinal seminoma, though excellent results are found with cisplatinbased combination chemotherapy, and for smaller tumours radiotherapy alone is effective (Table IV).…”

A young male with shortness of breath

“…The primary mediastinal seminoma has an estimated incidence of 25% of that of primary mediastinal germ cell tumors and is usually located in the anterior mediastinum,[45] with the majority of cases occurring in males in their third decade.A MEDLINE search showed that only two cases of primary seminoma originating from the middle mediastinum[67] and two cases from the posterior mediastinum[89] have been reported in the literature. Our patient was 32 years old and the tumor was located in the anterior superior mediastinum.…”

Mediastinal Germ Cell Tumors

“…They usually occur in the anterior mediastinum [23,51]. The vast majority of mediastinal seminomas are identified in men; only rare cases have been reported in women [6,26,29,69,71,72]. The reported age ranges between 11 and 79 years with a mean age of 46.5 years in one study [51]; other studies report that the tumor most commonly occurs in the third decade followed by the fourth and second decade [6].…”

“…The clinical presentation of patients with mediastinal GCT depends largely on tumor size. Symptoms such as cough, chest pain, hemoptysis, dyspnea, postobstructive pneumonia, and/or superior vena cava (SVC) syndrome occur in general due to compression of adjacent organs including large airways, great vessels, the heart, and phrenic nerve [25][26][27][28]. SVC syndrome, for instance, was described in approximately 10-25 % of anterior mediastinal seminomas [7,15,[29][30][31].…”