Adenocarcinoma Arising from Anterior Mediastinal Teratoma Controlled with Concurrent Chemoradiothreapy

Abstract

Teratomas with malignant transformation and adenocarcinoma arising from anterior mediastinal teratoma are rare diseases. We report a 37-year-old woman presented with right facial swelling and dyspnea on exertion for one month before admission. Chest computed tomography scan revealed a 5.5-cm anterior mediastinal heterogeneous tumor with calcification and a fat nodule. The tumor had metastasized to mediastinal lymph nodes and compressed superior vena cava. All the tumor markers checked were within normal limits. The pathology report of tumor biopsy showed teratoma with malignant transformation to adenocarcinoma. The tumor cells did not harbor epidermal growth factor receptor (EGFR) mutations. We gave the patient chemotherapy with BEP (bleomycin, etoposide, cisplatin) as first-line therapy. Because of disease progression, we used radiotherapy plus chemotherapy with cisplatin and 5-FU. After the concurrent chemoradiotherapy, the patient achieved a stable disease with reduction of pericardial effusion and dyspnea. Because mediastinal teratoma with adenocarcinoma transformation is rare, there is no well-established guideline for the patient management. We report here that concurrent radiotherapy plus chemotherapy with 5-FU and cisplatin produced good disease control.