Chaudhry Ikram Ulhaq, Rahhal Mohammed, Khurshid Imtiaz, Mutairi Hadi
Department of Chest Surgery, King Fahad Specialist Hospital, Dammam, Saudi Arabia.
Department of Adult Oncology, King Fahad Specialist Hospital, Dammam, Saudi Arabia.
BMJ Case Rep. 2014 Jun 17;2014:bcr2014204662. doi: 10.1136/bcr-2014-204662.
Primary non-seminomatous germ cell tumours of anterior mediastinum are uncommon. Endodermal sinus tumour of the anterior mediastinum (yolk sac) is a rare but lethal neoplasm. We present a case of an 18-year-old man who presented with chest pain, cough and haemosputum with markedly raised serum α-fetoprotein (AFP) levels above 112,000 ng/mL. Chest roentgenogram and CT showed a giant anterior mediastinal mass. CT guided biopsy revealed a diagnosis of endodermal sinus tumour. After the completion of chemotherapy, extensive surgical resection was carried out along with the right lung metastastectomy. Five years postresection follow-up the patient is disease free with normal serum tumour markers. This is the longest survival ever reported of such tumours with highest AFP level (>112,000 ng/mL) and lung metastasis.
前纵隔原发性非精原细胞瘤性生殖细胞肿瘤并不常见。前纵隔内胚窦瘤（卵黄囊瘤）是一种罕见但致命的肿瘤。我们报告一例18岁男性，其表现为胸痛、咳嗽和咯血，血清甲胎蛋白（AFP）水平显著升高，超过112,000 ng/mL。胸部X线片和CT显示前纵隔有巨大肿块。CT引导下活检确诊为内胚窦瘤。化疗结束后，进行了广泛的手术切除并同时切除了右肺转移灶。切除术后五年随访，患者无疾病复发，血清肿瘤标志物正常。这是此类肿瘤中AFP水平最高（>112,000 ng/mL）且伴有肺转移的病例所报道的最长生存期。
