Comprehensive Treatment of a Rare Primary Mediastinal Yolk SAC Tumour with Immature Teratoma
Year: 2025
Type: article
Study design: Case Report
Abstract: Primary anterior mediastinal yolk SAC tumours are rare but fatal, and primary mediastinal endodermal sinus tumours with immature teratomas are even rarer.This article reports a 31-year man with a yolk SAC tumour with an immature teratoma who was admitted to the hospital for repeated chest pain for more than 3 months.The patient was admitted with a serum alpha-fetoprotein (AFP) level of 3000 ng/mL (reference value: 0-9 ng/mL).Computed tomography (CT) of the chest revealed a solid mass in the left anterior mediastinal area, left lung inflammation, and a small amount of effusion in the left pleural cavity.CT-guided biopsy for diagnosis indicated endodermal sinus tumour.On September 12, 2018, the tumour was resected by a median anterior thoracotomy under general anaesthesia.Left upper lobectomy, partial pericardial resection, pericardial repair, and bilateral closed chest drainage were performed.Postoperative pathological results revealed germ cell-derived malignant tumour, consisting of 70% endodermal sinus tumour, and 30% immature teratoma.Next-generation sequencing of tissue specimens after surgery revealed DDR2, exon 5, c.286T> G, p.F96V, and a mutation abundance of 49.58%; PDL1 testing of tissue specimens showed a low expression level (<1%).The patient was treated with carboplatin plus docetaxel for four cycles.A re-examination on February 26, 2019, of the chest CT revealed a new anterior mediastinal mass, suggesting recurrence of the tumour after surgery and metastasis to the left posterior pleura.The patient died of recurrence and metastasis in August 2019.
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4413034412