A case of acute megakaryocytic leukemia associated with a nonseminomatous primary mediastinal germ cell tumor diagnosed through elevation of serum lactate dehydrogenase

Emi Noguchi,Tsuneo Sasaki,Yasushi Omuro,Yoshiharu Maeda

doi:10.5348/ijcri-2015117-cr-10578

Emi Noguchi, Tsuneo Sasaki + Show 2 more

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https://doi.org/10.5348/ijcri-2015117-cr-10578

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Abstract

Introduction: Hematologic malignancies are seen in a small percentage of patients with primary mediastinal germ cell tumors (PMGct). case report: A 29-year-old male patient with a nonseminomatous primary mediastinal germ cell tumor was diagnosed with acute megakaryocytic leukemia. serum lactate dehydrogenase (LDH) elevation was a diagnostic clue. We discussed our case with a review of literature. conclusion: Oncologists should be aware of the association of PMGct with hematologic malignancies and consider this phenomenon as a differential diagnosis when LDH elevation is present in patients with PMGct.

Highlights

Hematologic malignancies are seen in a small percentage of patients with primary mediastinal germ cell tumors (PMGCT)
Case Report: A 29-year-old male patient with a nonseminomatous primary mediastinal germ cell tumor was diagnosed with acute megakaryocytic leukemia
Oncologists should be aware of the association of PMGCT with hematologic malignancies and consider this phenomenon as a differential diagnosis when lactate dehydrogenase (LDH) elevation is present in patients with PMGCT

Summary

INTRODUCTION

The association of germ cell tumors (GCT) with hematologic malignancies is rare and has been described mostly in case reports and case series for more than 30 years [1,2,3,4,5,6] It has a separate etiology from treatmentrelated leukemia. We report a case of acute megakaryocytic leukemia associated with a nonseminomatous primary mediastinal germ cell tumor whose diagnosis was challenging. Based on the tumor location (predominant midline distribution), relatively young age of the patient, male sex, and elevated serum β-hCG, AFP, and LDH levels, we diagnosed this condition as a primary mediastinal germ cell tumor; T1N0M0S2, Stage IIIB. The chromosome 12 abnormality was detected in repeated bone marrow test

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CONCLUSION