[Combined treatment with resection, intraoperative hypotonic and post-operative systemic chemotherapy using cis-platinum for a mediastinal yolk sac tumor: a case report].

Generally yolk sac tumor in the mediastinum is a rare and highly malignant neoplasm. We report a case of yolk sac tumor, which was treated with resection, and then intraoperative hypotonic and postoperative systemic chemotherapy. A 33-year-old man was diagnosed as a mediastinal tumor with chest X-ray and chest CT findings. At operation he had mediastinal tumor which invaded to the part of the right upper lobe and pericardium, disseminated on the right diaphragm. A large tumor was removed with partial pericardiectomy and wedge resection of the right upper lobe. After resection hypotonic chemotherapy with cis-platinum was performed. This tumor had endodermal sinus structure, Schiller-Duval body, and eosinophilic hyaline globolus which were histological characteristics of yolk sac tumor, and the value of serum alpha-fetoprotein (AFP) was high. After operation with this diagnosis systemic chemotherapy consisted of cis-platinum, etoposide were performed. Patient was discharged uneventfully 8 months later.