Giant Mediastinal Germ Cell Tumour: An Enigma of Surgical Consideration

We present a case of 16-year-old male, who was referred from private centre for dyspnoea, fatigue, and orthopnea. The chest radiograph revealed complete opacification of left chest which was confirmed by computed tomography as a large left mediastinal mass measuring 14 × 15 × 18 cm. The diagnostic n...

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Main Authors: Firdaus Hayati, Nurayub Mohd Ali, Levin Kesu Belani, Nornazirah Azizan, Andee Dzulkarnaen Zakaria, Mohd Ramzisham Abdul Rahman
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:Case Reports in Surgery
Online Access:http://dx.doi.org/10.1155/2016/7615029
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author Firdaus Hayati
Nurayub Mohd Ali
Levin Kesu Belani
Nornazirah Azizan
Andee Dzulkarnaen Zakaria
Mohd Ramzisham Abdul Rahman
author_facet Firdaus Hayati
Nurayub Mohd Ali
Levin Kesu Belani
Nornazirah Azizan
Andee Dzulkarnaen Zakaria
Mohd Ramzisham Abdul Rahman
author_sort Firdaus Hayati
collection DOAJ
description We present a case of 16-year-old male, who was referred from private centre for dyspnoea, fatigue, and orthopnea. The chest radiograph revealed complete opacification of left chest which was confirmed by computed tomography as a large left mediastinal mass measuring 14 × 15 × 18 cm. The diagnostic needle core biopsy revealed mixed germ cell tumour with possible combination of embryonal carcinoma, yolk sac, and teratoma. After 4 cycles of neoadjuvant BEP regime, there was initial response of tumour markers but not tumour bulk. Instead of classic median sternotomy or clamshell incision, posterolateral approach with piecemeal manner was chosen. Histology confirmed mixed germ cell tumour with residual teratomatous component without yolk sac or embryonal carcinoma component. Weighing 3.5 kg, it is one of the largest mediastinal germ cell tumours ever reported. We describe this rare and gigantic intrathoracic tumour and discuss the spectrum of surgical approach and treatment of this exceptional tumour.
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publishDate 2016-01-01
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series Case Reports in Surgery
spelling doaj-art-12e5d6f83f684d2ea35d8b8d9ced8e6f2025-08-20T02:02:10ZengWileyCase Reports in Surgery2090-69002090-69192016-01-01201610.1155/2016/76150297615029Giant Mediastinal Germ Cell Tumour: An Enigma of Surgical ConsiderationFirdaus Hayati0Nurayub Mohd Ali1Levin Kesu Belani2Nornazirah Azizan3Andee Dzulkarnaen Zakaria4Mohd Ramzisham Abdul Rahman5Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, MalaysiaDepartment of Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MalaysiaDepartment of Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MalaysiaDepartment of Pathobiology and Medical Diagnostic, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, MalaysiaDepartment of Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, MalaysiaDepartment of Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MalaysiaWe present a case of 16-year-old male, who was referred from private centre for dyspnoea, fatigue, and orthopnea. The chest radiograph revealed complete opacification of left chest which was confirmed by computed tomography as a large left mediastinal mass measuring 14 × 15 × 18 cm. The diagnostic needle core biopsy revealed mixed germ cell tumour with possible combination of embryonal carcinoma, yolk sac, and teratoma. After 4 cycles of neoadjuvant BEP regime, there was initial response of tumour markers but not tumour bulk. Instead of classic median sternotomy or clamshell incision, posterolateral approach with piecemeal manner was chosen. Histology confirmed mixed germ cell tumour with residual teratomatous component without yolk sac or embryonal carcinoma component. Weighing 3.5 kg, it is one of the largest mediastinal germ cell tumours ever reported. We describe this rare and gigantic intrathoracic tumour and discuss the spectrum of surgical approach and treatment of this exceptional tumour.http://dx.doi.org/10.1155/2016/7615029
spellingShingle Firdaus Hayati
Nurayub Mohd Ali
Levin Kesu Belani
Nornazirah Azizan
Andee Dzulkarnaen Zakaria
Mohd Ramzisham Abdul Rahman
Giant Mediastinal Germ Cell Tumour: An Enigma of Surgical Consideration
Case Reports in Surgery
title Giant Mediastinal Germ Cell Tumour: An Enigma of Surgical Consideration
title_full Giant Mediastinal Germ Cell Tumour: An Enigma of Surgical Consideration
title_fullStr Giant Mediastinal Germ Cell Tumour: An Enigma of Surgical Consideration
title_full_unstemmed Giant Mediastinal Germ Cell Tumour: An Enigma of Surgical Consideration
title_short Giant Mediastinal Germ Cell Tumour: An Enigma of Surgical Consideration
title_sort giant mediastinal germ cell tumour an enigma of surgical consideration
url http://dx.doi.org/10.1155/2016/7615029
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