Chen L T, Chen C L, Hwang W S
Department of Internal Medicine, Kaohsiung Medical College Hospital, Taiwan, Republic of China.
Chest. 1990 Jul;98(1):231-3. doi: 10.1378/chest.98.1.231.
A 21-year-old man presenting with a mediastinal mass was diagnosed as having primary mediastinal mixed nonseminomatous GCT by incisional biopsy and elevated serum concentrations of AFP and beta-HCG. After four courses of PVB chemotherapy followed by 4,000 rads of radiotherapy, the AFP level declined markedly, but the mediastinal mass further enlarged and underwent cystic change. Pathologic examination of the resected tumor only showed immature teratoma. The serum AFP level returned to normal and remained so three months after the operation. This experience suggests that in patients with nonseminomatous GCT treated with combination chemotherapy, measurements of tumor volume alone do not provide information regarding the tumor's response. Early recognition of the "growing teratoma syndrome" will allow for surgical salvage.
一名21岁男性因纵隔肿块就诊，经切开活检及血清甲胎蛋白（AFP）和β人绒毛膜促性腺激素（β-HCG）水平升高，被诊断为原发性纵隔混合性非精原细胞瘤性生殖细胞肿瘤（GCT）。在接受四个疗程的顺铂、长春新碱和博来霉素（PVB）化疗并随后接受4000拉德放射治疗后，AFP水平显著下降，但纵隔肿块进一步增大并出现囊性变。切除肿瘤的病理检查仅显示为未成熟畸胎瘤。术后血清AFP水平恢复正常并在术后三个月保持正常。该经验表明，在接受联合化疗的非精原细胞瘤性GCT患者中，仅测量肿瘤体积并不能提供有关肿瘤反应的信息。早期识别“生长中的畸胎瘤综合征”将有助于手术挽救。
