Abstract
An asymptomatic 26-year-old man received an annual medical check-up, and chest X-ray showed a protrusion of the aortopulmonary window. Chest computed tomography (CT) revealed an anterior mediastinal tumor and cysts with thin wall and septum enhancement. The preoperative diagnosis was cystic thymoma or malignant lymphoma. We performed total resection of the tumor through a median sternotomy. The pathological findings revealed seminoma, positive for c-kit stain, and multilocular thymic cysts. Cysts were lined by normal squamous epithelium and no seminoma cells were located on their surface. So, cysts were probably secondary changes caused by seminoma cells themselves or inflammatory stimulations. No invasion to adjacent structures was seen. After the surgery, testicular ultrasound imaging and abdominal, pelvic, and cerebral CT showed no apparent tumor or enlarged lymph nodes; however, an abnormal uptake in the right mesenteric lymph node was pointed out by 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET) scan. The patient received four courses of bleomycin, etoposide, and cisplatin (BEP) as adjuvant chemotherapy. Follow-up PET scan revealed no uptake in the right mesenteric lymph node. To date, no recurrence or metastasis has been identified for 16 months.
Highlights
Prominent cystic change of mediastinal seminomas in patients is uncommon and rarely reported, and those cases that are reported show only unilocular cystic changes
We present a patient with a mediastinal seminoma with multilocular thymic cysts
It is probable that primary seminoma caused the cyst formation of the thymus
Summary
Background Prominent cystic change of mediastinal seminomas in patients is uncommon and rarely reported, and those cases that are reported show only unilocular cystic changes. We present a patient with a mediastinal seminoma with multilocular thymic cysts. It is probable that primary seminoma caused the cyst formation of the thymus. Chest CT revealed a thin-walled multilocular cystic tumor, 9.0 cm in diameter, in the anterior mediastinum. The septum of the tumor was enhanced by contrast medicine (Fig. 2a).
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