Bouabid Meriem, Moukhlissi Mohamed, Bensghir Ahmed, Samba Soumya, Berhili Soufiane, Mezouar Loubna
Department of Radiotherapy, Faculty of Medicine Oujda, Hassan II Oncology Center, Mohammed VI Hospital Center of Oujda, Mohammed 1st University Oujda, Morocco.
Radiol Case Rep. 2023 Aug 1;18(10):3565-3571. doi: 10.1016/j.radcr.2023.07.036. eCollection 2023 Oct.
Mediastinal Seminoma is one of the malignant germ cell tumors of the mediastinum. It is a rare tumor that represents only 1%-4% of mediastinal tumors. We report the case of a patient treated at the Oncology Center of Oujda for a pure primitive seminoma of the mediastinum, with a review of the literature to assess the epidemiological, clinical, therapeutic, and prognostic characteristics of this pathology. This is a 25-year-old man whose aunt is being treated for breast cancer and who complained of persistent dry cough with asthenia without any other associated signs. The initial imaging revealed a voluminous locally advanced tumor process in the anterior and middle mediastinum. Tumor markers Alpha-fetoprotein (AFP) and beta-subunit of chorionic gonadotrophic hormone (BHCG) were normal, as well as testicular ultrasound. The CT- guided transthoracic biopsy with anatomopathological study and immunohistochemistry was in favor of a pure seminoma. The treatment consisted of primary chemotherapy with BEP protocol. The response was favorable with a significant reduction in tumor size estimated at 90%. The residual tumor was inoperable due to its intimate contact with the vascular structures and was treated with external radiotherapy at a total dose of 36 Gy. The evolution at 20 months after treatment was in favor of a good clinical and radiological evolution.
纵隔精原细胞瘤是纵隔恶性生殖细胞肿瘤之一。它是一种罕见的肿瘤，仅占纵隔肿瘤的1%-4%。我们报告了一名在乌季达肿瘤中心接受治疗的纵隔纯原发性精原细胞瘤患者的病例，并回顾了文献以评估该病理的流行病学、临床、治疗和预后特征。这是一名25岁的男性，其姑姑正在接受乳腺癌治疗，他主诉持续干咳伴乏力，无任何其他相关体征。初始影像学检查显示在前纵隔和中纵隔有一个巨大的局部晚期肿瘤病变。肿瘤标志物甲胎蛋白（AFP）和绒毛膜促性腺激素β亚单位（BHCG）正常，睾丸超声检查也正常。经CT引导的经胸活检及解剖病理学研究和免疫组化检查支持为纯精原细胞瘤。治疗采用BEP方案进行原发性化疗。反应良好，肿瘤大小估计显著缩小了90%。由于残留肿瘤与血管结构紧密相连，无法手术切除，遂接受了总剂量为36 Gy的外照射放疗。治疗后20个月的病情进展显示临床和影像学方面均有良好进展。
