Extragonadal germ cell tumor of the mediastinum: local spread estimated by direct injection of a contrast agent into the pericardial cavity

Abstract

Purpose of the study: to study the possibilities of computed tomographic pericardiography in assessing the invasion of a mediastinal tumor into the myocardium.Materials and methods. Traditional computed tomography with intravenous contrasting and direct contrasting of the pericardial cavity (computed tomographic pericardiography) were compared in a 19-year-old patient with mediastinal germ cell tumor.Results. Due to the introduction of a contrast agent under manual pressure into the pericardial cavity, it became possible to exclude tumor invasion into the myocardium at the level of the atria. This made it possible to assess the technical feasibility of tumor removal at the preoperative stage.Conclusion. Extragonadal germ cell tumors of the mediastinum often have an asymptomatic course, which leads to the detection of tumors that are already large in size, with signs of spread to neighboring organs and structures. Traditional computed tomography with intravenous contrast does not always allow to exclude invasion of the myocardium, pericardium and large vessels. This article demonstrates a clinical case of performing direct contrasting of the pericardial cavity (computed tomographic pericardography) in a 19-year-old patient with a germ cell tumor of the mediastinum, which made it possible to exclude myocardial invasion and subsequently successfully operate the patient.