Abstract
A case of AFP producing malignant teratoma of the anterior mediastinum which rapidly enlarged is reported. A 30-year-old man was found having an anterior mediastinal tumor on a chest X-ray film on a regular check-up. AFP level that had increased preoperatively to 2221.0ng/ml was normalized postoperatively. Histologically, the tumor was diagnosed as malignant teratoma with yolk sac carcinomatous area, with metastasis to mediastinal lymph nodes. Immunohistochemical staining for AFP was positive in tumor cells. The tumor seemed to have originated from the thymus. The patient postoperatively received two courses of combination chemotherapy with cisplatinum and ectoposide. Fourteen months later, pleural dissemination occurred despite a normal AFP level. After another four courses of combination chemotherapy with cisplatinum, bleomycin and vinblastine, the pleural nodules were reduced in size and number. In a review of the Japanese literature, 18 cases of malignant teratoma with yolk sac tumor were compared with 62 cases of pure yolk sac tumor for AFP level and prognosis.
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