Lim C H, Mohamed-Haflah N H, Abdullah-Sani M H, Loh C K, Abdul-Rahman M R
Department of Orthopaedic and Traumatology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Department of Paediatrics, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Malays Orthop J. 2023 Mar;17(1):188-192. doi: 10.5704/MOJ.2303.023.
Mediastinal germ cell tumours are a rare group of extragonadal germ cell tumours with less than 5% prevalence of all germ cell tumours. Primary mediastinal germ cell tumours themselves account for 16-36% of the extragonadal germ cell tumours. Along the spectrum of osteosarcoma, parosteal osteosarcoma is a well-differentiated surface osteosarcoma with a prevalence of 4% of all osteosarcoma. As such synchronous primary parosteal osteosarcoma and primary mediastinal germ cell tumour are exceedingly rare. This leads to complexity in determining the most appropriate chemotherapy for two different types of tumours and its potential side effects of reduced immunity leading to potential secondary infection. Here we report a case of a 16-year-old boy who presented with synchronous primary osteosarcoma and primary mediastinal germ cell tumour, complicated with atypical mycobacterial infection post-operatively. Additionally, we discuss our choice of chemotherapy and the management of the atypical mycobacterial infection.
纵隔生殖细胞肿瘤是一组罕见的性腺外生殖细胞肿瘤，在所有生殖细胞肿瘤中的患病率不到5%。原发性纵隔生殖细胞肿瘤本身占性腺外生殖细胞肿瘤的16% - 36%。在骨肉瘤谱系中，骨旁骨肉瘤是一种分化良好的表面骨肉瘤，占所有骨肉瘤的4%。因此，同步发生的原发性骨旁骨肉瘤和原发性纵隔生殖细胞肿瘤极为罕见。这导致在确定针对两种不同类型肿瘤的最合适化疗方案及其免疫降低导致潜在继发感染的潜在副作用方面存在复杂性。在此，我们报告一例16岁男孩，其患有同步原发性骨肉瘤和原发性纵隔生殖细胞肿瘤，术后并发非典型分枝杆菌感染。此外，我们讨论了我们对化疗的选择以及非典型分枝杆菌感染的管理。
