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| 篇名 |
Primary Nonseminomatous Germ Cell Tumors of the Mediastinum |
| 作者 |
Jin-Shing Chen, Yih-Leong Chang, Chung-Chieh Huang, Jang-Ming Lee, Shi-Ping Luh, Yung-Chie Lee. |
| 卷期/出版年月 |
31卷5期 (1998/10) |
| 頁次 |
301-307 |
| 摘要 |
Between 1987 and 1996, five male patients ranging from 9 to 39 years old
(median, 23 years), were treated for nonseminomatous germ cell tumors that
appeared to arise in the anterior mediastinum without clinical involvement of the testes. The most common presenting symptom was chest pain, and the mean
diameter of the tumor was 13.7 cm (range: 10.5 to 18 cm). Tumor markers were
measured in four patients and all had a raised alpha-fetoprotein (AFP) level
(range: 453.5 ug/L to 16469 ug/L). Echo-guided needle biopsies were performed in
all five patients and only two of them had definite diagnosis. The diagnosis of the other three patients could only be obtained through exploratory sternotomy.
Among these five patients, one was treated with primary surgical intervention
followed by chemotherapy. He died of complications of chemotherapy one month
later. Another patient who received only an operation died of surgical complications eight days after the operation. The other three patients underwent
cisplatin-based chemotherapy after the diagnosis of nonseminomatous germ cell
tumors was made. One of them received furher radiotherapy for the residual
mass on chest x-ray film after normalization of the tumor markers. He died of
liver metastasis 7 months after the operation. Those two patients who received
surgical excision of the residual mass after completion of chemotherapy and
normalization of the tumor markers were still alive at 9 years and 12 months after the operation. The modern multimodality treatment, including cisplatin-based chemotherapy coupled with adjunctive surgery if necessary, does provide a better chance of survival in our patients of primary nonseminomatous germ cell tumors of the mediastinum. |
| 關鍵詞 |
nonseminomatous germ cell tumors, mediastinum, cisplatin-based chemotherapy. |
| 分類 |
Original Articles |
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