Extragonadal germinogenic tumor of the mediastinum. A clinical case

Relevance.

Extragonadal germinogenic tumors are rare, are actually of a casuistic nature and account for 3% to 10% of all germinogenic tumors of gonadal localization. This fact causes the lack of a clear algorithm for the treatment and monitoring of patients with a similar disease. In the case of an extrahonadal germinogenic tumor in the mediastinum, the disease is asymptomatic for a long time and is diagnosed either accidentally during preventive measures, or with the development of pronounced complications in the form of mediasthenal hypertension with the development of pericardial and pleural effusions, pulmonary hypoplasia and heart failure. All of the above, combined with the lack of unified approaches to treatment, determines the high relevance of the problem of curation of patients with this disease.

Description of the clinical case.

The above publication presents a clinical case of a 35-year-old male patient with a mediastinal extragonadal germinogenic tumor, which was first detected on fluorography during a preventive examination. We used clinical, morphological, immunohistochemical and radiological research methods in order to determine the localization, prevalence and histological structure of the tumor as clearly as possible, to select individual treatment tactics for the patient. The features of the presented case were the mixed nature of the tumor according to histological examination data, as well as the significant size and asymptomatic course of the disease. The patient showed a multiple excess of levels of alpha-fetoprotein and human chorionic gonadotropin. As the first stage of treatment, the patient underwent polychotherapy according to the BEP scheme, against which a positive response was achieved in the form of a significant decrease in tumor volume. Subsequently, radical surgical treatment was performed. According to the results of morphological examination of the removed tissues, it was noted that complete pathomorphosis of the tumor was achieved against the background of chemotherapy.

Conclusion.

An extra-gonadal germinogenic tumor in the form of a mediastinal seminoma is a rare tumor, and the tactics of examination, treatment and further observation of patients of which are determined individually by a collegial decision of a multiprofile commission. It is this approach that allows us to achieve high results in the treatment of this pathology.