Zhu Fang, Wang Lixia, Zhai Xiaoli
Department of Pathology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine (Jinhua Municipal Central Hospital) Jinhua, Zhejiang Province, China.
Int J Clin Exp Pathol. 2020 Nov 1;13(11):2772-2777. eCollection 2020.
Primary mediastinal yolk sac tumors (YSTs) are rare and have a high degree of malignancy. This article reports a 42-year-old man with a primary mediastinal YST. The patient presented with chest tightness and shortness of breath. Using a contrast-enhanced computer tomography (CT) scan, the mediastinal space was found to be occupied by a mass shadow, about 10 cm × 8 cm with a clear boundary and low density. Serum alpha-fetoprotein (AFP) was elevated to 7169.66 ng/ml. The 5th day after hospitalization, a percutaneous biopsy of the mediastinal mass was performed. Malignant tumor cells were found by cytologic examination. According to the pathological morphology and immunohistochemical results, the tumor was diagnosed as primary mediastinal YST. Subsequently, the patient underwent five cycles of adjuvant chemotherapy including bleomycin, etoposide, and cisplatin (BEP) and surgical tumor removal. One month after operation, AFP was elevated to 252.96 ng/ml. CT examination showed that the tumor recurred. As of September 12, 2020, the patient has undergone four cycles of VIP (etoposide, ifosfamide, cisplatin) chemotherapy after relapse, and the patient's condition is currently in partial remission.
原发性纵隔卵黄囊瘤（YSTs）较为罕见，恶性程度高。本文报道了一名42岁的原发性纵隔YST患者。患者表现为胸闷、气短。通过增强计算机断层扫描（CT）发现纵隔间隙被一个肿块阴影占据，大小约为10 cm×8 cm，边界清晰，密度较低。血清甲胎蛋白（AFP）升高至7169.66 ng/ml。住院第5天，对纵隔肿块进行了经皮活检。细胞学检查发现恶性肿瘤细胞。根据病理形态和免疫组化结果，肿瘤被诊断为原发性纵隔YST。随后，患者接受了包括博来霉素、依托泊苷和顺铂（BEP）的五个周期辅助化疗及肿瘤切除术。术后1个月，AFP升高至252.96 ng/ml。CT检查显示肿瘤复发。截至2020年9月12日，患者复发后接受了四个周期的VIP（依托泊苷、异环磷酰胺、顺铂）化疗，目前病情处于部分缓解状态。
