Montresor E, Nifosì F, Lupi A, Gorla A, Iacono C, Modena S, Di Guida V, Puchetti V
Istituto di Patologia Chirurgica, Università degli Studi, Verona.
Chir Ital. 1994;46(3):46-52.
9 patients (8 males 1 female, middle age 24.3 years, range 20-41) affected by primary mediastinal germ cell tumor were surgically treated in our department. They were 4 seminomas, 2 embryonal carcinomas, 1 malignant teratoma and 2 benign teratomas. Three patients were asymptomatic; cough, dyspnea and chest pain were the most frequently observed symptoms. The staging work-up did not show signs of metastatic disease in the malignant types. Benign teratomas underwent complete excision. In one patient suffering from seminoma radiotherapy and chemotherapy caused complete remission of the disease. In the others cases remission of the neoplasm was obtained by resection and adjuvant therapy in 3 cases, by neoadjuvant treatment and excision of the residual mass in 3 cases. Among the patients suffering from seminoma, 2 are dead at 60 months since initial treatment and 2 are alive at 132 and 120 months respectively. Among the patients with malignant nonseminomatous tumours, 2 are alive at 60 and 36 months and 1 patient is dead at 13 months. Two patients with benign teratoma are alive at 189 and 168 months respectively. At present a multimodality treatment including surgery, radiotherapy and cisplatin-based combination chemotherapy, give the most satisfactory results in the treatment of malignant mediastinal germ cell tumours.
9例原发性纵隔生殖细胞肿瘤患者（8例男性，1例女性，中年，平均年龄24.3岁，范围20 - 41岁）在我科接受了手术治疗。其中4例为精原细胞瘤，2例为胚胎癌，1例为恶性畸胎瘤，2例为良性畸胎瘤。3例患者无症状；咳嗽、呼吸困难和胸痛是最常见的症状。分期检查未发现恶性类型有转移疾病的迹象。良性畸胎瘤均行完整切除。1例精原细胞瘤患者经放疗和化疗后疾病完全缓解。其他病例中，3例通过手术切除及辅助治疗使肿瘤缓解，3例通过新辅助治疗及残留肿块切除使肿瘤缓解。在精原细胞瘤患者中，2例在初始治疗后60个月死亡，2例分别在132个月和120个月时存活。在恶性非精原细胞瘤患者中，2例分别在60个月和36个月时存活，1例在13个月时死亡。2例良性畸胎瘤患者分别在189个月和168个月时存活。目前，包括手术、放疗和以顺铂为基础的联合化疗在内的多模式治疗，在恶性纵隔生殖细胞肿瘤的治疗中取得了最满意的效果。
