Primary Mediastinal Seminoma

Abstract

The records and histopathology of 4 patients with primary mediastinal seminoma were reviewed. All of them were male and at presentation had one or more poor prognostic factors, namely superior vena cava obstruction, hilar lymphadenopathy, bulky tumor, and raised Α-fetoprotein titers. Their treatment consisted partly or entirely of chemotherapy. Three of them survived free of disease 2–5 years off treatment, 1 of them died of pulmonary fibrosis with no tumor found at postmortem examination. The prognostic factors and treatment of this tumor and the risk of combined radiotherapy and chemotherapy containing bleomycin are discussed.

Mediastinal Tumors: Diagnosis and Treatment

“…Mediastinal seminomas occur usually in men in their third decade [27]. Most patients are symptomatic, with pain, cough, or dyspnea.…”

“…Seminomas are highly radiosensitive. In the past moderate-size tumors were treated with radiation alone, with cure rates reported from 50% to almost 100% [27]. Advanced tumors are treated with cisplatinbased chemotherapy with excellent results.…”

Surgical Management of Mediastinal Tumors and Fibrosis

“…Mediastinal seminomas occur usually in men in their third decade. 18 Most patients are symptomatic with pain, cough, or dyspnea. Serum tumor markers (β-hCG and AFP) should be measured to rule out an occult nonseminomatous component in the tu mor.…”

“…the past, moderate-size tumors were treated with ra diation therapy alone, with cure rates reported from 50 to almost 100%. 18 Advanced tumors are treated with cisplatin-based chemotherapy with excellent re sults. Controversy currently exists about treatment of less-advanced tumors with chemotherapy rather than radiotherapy.…”