Abstract
Objectives Primary mediastinal germ cell tumors (PMGCTs) are rare, which often makes them difficult to treat. Herein, we examined patients with PMGCTs who underwent multimodal treatment. Methods We examined 6 patients (median age: 25 years, range: 19–27 years) with PMGCTs who underwent multimodal treatment between April 2001 and March 2015. Three patients had seminomas, 2 patients had yolk sac tumors, and 1 patient had choriocarcinoma. The median observation period was 32.5 months (range: 8–84 months). Results Three of the 6 patients received initial operation followed by 3-4 courses of chemotherapy (bleomycin, etoposide, and cisplatin (BEP) or etoposide and cisplatin (EP)). One patient developed multiple lung metastases 17 months after surgery; received salvage chemotherapy with vinblastine, ifosfamide, and cisplatin; and achieved complete remission. The remaining 3 patients received initial BEP and EP chemotherapy. Multiple lung metastases and supraclavicular lymph node metastases were detected in 2 of these patients at the initial diagnosis. The patients underwent resections to remove residual tumor after treatment, and no viable tumor cells were found. Conclusions Reliable diagnosis and immediate multimodal treatments are necessary for patients with PMGCTs. The 6 patients treated in our hospital have never experienced recurrence after the multimodal treatment.
Highlights
Primary mediastinal germ cell tumor (PMGCT) is a rare cancer that accounts for less than 5% of germ cell malignancies and only 1–4% of all mediastinal tumors [1, 2]
Chemotherapy for PMGCT has already become a standard practice since the introduction of cisplatin-based combination chemotherapy
With standard chemotherapy consisting of 4 courses of bleomycin, etoposide, and cisplatin (BEP), men with nonseminoma mediastinal tumors have experienced better prognoses, not better than patients with mediastinal seminomas or primary tumors of the testis [5]
Summary
Primary mediastinal germ cell tumor (PMGCT) is a rare cancer that accounts for less than 5% of germ cell malignancies and only 1–4% of all mediastinal tumors [1, 2]. The histopathological characteristics of PMGCTs are similar to those of gonadal germ cell tumors (GCTs). They have different biological behaviors, clinical characteristics, and overall prognoses [3]. With standard chemotherapy consisting of 4 courses of bleomycin, etoposide, and cisplatin (BEP), men with nonseminoma mediastinal tumors have experienced better prognoses, not better than patients with mediastinal seminomas or primary tumors of the testis [5]
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