Acharya Sudeep, Pokima Ngowari, Yetiskul Ekrem, Achkar Michel, Grabie Yisroel Y, Khanijo Sameer, Villa Sanchez Manuel, Chalhoub Michel
Pulmonary and Critical Care Medicine, Staten Island University Hospital, Staten Island, USA.
Internal Medicine, Staten Island University Hospital, Staten Isand, USA.
Cureus. 2024 Jun 17;16(6):e62555. doi: 10.7759/cureus.62555. eCollection 2024 Jun.
We describe a rare and remarkable transformation of an immature mediastinal teratoma into high-grade angiosarcoma in a 21-year-old male. Mediastinal teratomas, particularly immature ones, are exceedingly rare, representing a small fraction of germ cell tumors (GCTs). Our case describes the clinical journey of the patient, who initially presented with acute chest pain and was subsequently diagnosed with an immature teratoma following imaging studies and elevated tumor markers. Despite an initial positive response to cisplatin-based chemotherapy, surveillance imaging revealed liver masses, which a biopsy confirmed as angiosarcoma. This transformation underscores the aggressive nature of immature teratomas and the propensity for sarcomatous differentiation, particularly in the mediastinum. The case contributes valuable insight into the management and surveillance of mediastinal non-seminoma germ cell tumors (MNGCT), a subset of GCTs with limited literature. We believe this case is the first in the literature to describe a transformation from an immature teratoma in the mediastinum to a high-grade angiosarcoma.
我们描述了一名21岁男性中罕见且显著的未成熟纵隔畸胎瘤转变为高级别血管肉瘤的病例。纵隔畸胎瘤，尤其是未成熟型，极为罕见，仅占生殖细胞肿瘤（GCTs）的一小部分。我们的病例描述了该患者的临床病程，患者最初表现为急性胸痛，随后经影像学检查及肿瘤标志物升高被诊断为未成熟畸胎瘤。尽管最初对基于顺铂的化疗有阳性反应，但监测影像学显示肝脏有肿块，活检证实为血管肉瘤。这种转变突显了未成熟畸胎瘤的侵袭性本质以及肉瘤样分化的倾向，尤其是在纵隔部位。该病例为纵隔非精原细胞生殖细胞肿瘤（MNGCT）的管理和监测提供了有价值的见解，MNGCT是GCTs的一个子集，相关文献有限。我们认为该病例是文献中首例描述纵隔未成熟畸胎瘤转变为高级别血管肉瘤的病例。
