Wu Diqing, Zhang Kun, Zhang Xueqin
Department of Cardiac and Macrovascular Surgery Suzhou Hospital of Anhui Medical University Suzhou China.
Department of Oncology Suzhou Hospital of Anhui Medical University Suzhou China.
Clin Case Rep. 2023 Aug 8;11(8):e7781. doi: 10.1002/ccr3.7781. eCollection 2023 Aug.
There are limited published cases of primary mediastinal yolk sac tumor (PMYST), with no consensus on the best treatment alternative. By far, the surgery oriented comprehensive therapies are the main treatment methods. The surgical strategy should be individualized and aimed at radical resection, considering all the possibilities, including the use of cardiopulmonary bypass and prosthetic materials.
A 15-year-old boy was diagnosed as PMYST. The tumor, with a size about 13 × 12 × 8 cm, was located in the right upper mediastinum, closely adhering to ascending aorta, superior vena cava, right atrium, and the right hilum. After 6 cycles chemotherapy of bleomycin, etoposide, and cisplatin (BEP), no significant change was found in the size of tumor. Subsequently, an extended tumor excision including partial resection of the right lung, the pericardium, the diaphragm and the right phrenic nerve, was performed successfully with cardiopulmonary bypass on standby. During 6 months of follow-up, there was no tumor recurrence. Meanwhile, in PubMed, we searched the English case reports and case series of PMYST during the past decade. A total of 73 articles were retrieved, in which 22 articles on the therapy and prognosis of PMYST were extracted and reviewed, included 16 case reports and 6 case series with a total of 52 patients. Due to the rarity of PMYST, it is difficult to provide a specific treatment regimen. The surgery-oriented comprehensive therapies are still the main treatment methods. The surgical strategy should be individualized and aim at radical resection, considering all the possibilities, including the use of cardiopulmonary bypass and prosthetic materials.
原发性纵隔卵黄囊瘤（PMYST）的已发表病例有限，对于最佳治疗方案尚无共识。迄今为止，以手术为主的综合治疗是主要治疗方法。手术策略应个体化，旨在根治性切除，需考虑所有可能性，包括使用体外循环和人工材料。
一名15岁男孩被诊断为PMYST。肿瘤大小约为13×12×8cm，位于右上纵隔，紧密附着于升主动脉、上腔静脉、右心房和右肺门。在接受博来霉素、依托泊苷和顺铂（BEP）的6周期化疗后，肿瘤大小无明显变化。随后，在体外循环备用的情况下，成功进行了扩大的肿瘤切除术，包括部分切除右肺、心包、膈肌和右膈神经。在6个月的随访中，无肿瘤复发。同时，我们在PubMed上搜索了过去十年中PMYST的英文病例报告和病例系列。共检索到73篇文章，其中提取并复习了22篇关于PMYST治疗和预后的文章，包括16篇病例报告和6篇病例系列，共52例患者。由于PMYST罕见，难以提供具体的治疗方案。以手术为主的综合治疗仍然是主要治疗方法。手术策略应个体化，旨在根治性切除，需考虑所有可能性，包括使用体外循环和人工材料。
