TY - JOUR
T1 - Hepatic angiosarcomatous transformation of a mediastinal germinal cell tumor
T2 - A care case report
AU - Corrias, Giuseppe
AU - Escalon, Joanna G
AU - Tang, Laura
AU - Monti, Serena
AU - Saba, Luca
AU - Mannelli, Lorenzo
N1 - Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.
PY - 2017/12
Y1 - 2017/12
N2 - RATIONALE: Mediastinal nonseminomatous germ cell tumor (NSGCT) is an uncommon entity. Metastatic hepatic sarcomatous transformation is rare.PATIENT CONCERNS: We report a 24-year-old man with no previous related medical history presented with chest pain and left arm numbness.DIAGNOSES: The x-ray showed an anterior mediastinal mass. The chest computed tomography (CT) confirmed the presence of a mildly enhancing mass in the same location, without invasion of any vascular structure. A CT-guided biopsy was performed, revealing a primary mediastinal nonseminomatous germ cell tumor (NSGCT), yolk sac histology, with areas of somatic transformation to malignant nerve sheath tumor. After surgery patient was followed-up with imaging. Two years later a CT scan showed a new hepatic hyper vascular lesion, confirmed by a subsequent magnetic resonance imaging (MRI) and positron emission tomography (PET) scan. A CT-guided biopsy revealed a hepatic metastatic transformation to angiosarcoma of the primitive NSGCT.INTERVENTIONS: The patient went on to received palliative chemotherapy.OUTCOMES: The patient is being followed-up regularly at the outpatient department.LESSONS: Because of the potential of metastatic sarcoma arising from germ cell tumors, these patients should undergo periodical follow-up, with periodical scans. PET\CT scan might have a role in the follow-up of these patients.
AB - RATIONALE: Mediastinal nonseminomatous germ cell tumor (NSGCT) is an uncommon entity. Metastatic hepatic sarcomatous transformation is rare.PATIENT CONCERNS: We report a 24-year-old man with no previous related medical history presented with chest pain and left arm numbness.DIAGNOSES: The x-ray showed an anterior mediastinal mass. The chest computed tomography (CT) confirmed the presence of a mildly enhancing mass in the same location, without invasion of any vascular structure. A CT-guided biopsy was performed, revealing a primary mediastinal nonseminomatous germ cell tumor (NSGCT), yolk sac histology, with areas of somatic transformation to malignant nerve sheath tumor. After surgery patient was followed-up with imaging. Two years later a CT scan showed a new hepatic hyper vascular lesion, confirmed by a subsequent magnetic resonance imaging (MRI) and positron emission tomography (PET) scan. A CT-guided biopsy revealed a hepatic metastatic transformation to angiosarcoma of the primitive NSGCT.INTERVENTIONS: The patient went on to received palliative chemotherapy.OUTCOMES: The patient is being followed-up regularly at the outpatient department.LESSONS: Because of the potential of metastatic sarcoma arising from germ cell tumors, these patients should undergo periodical follow-up, with periodical scans. PET\CT scan might have a role in the follow-up of these patients.
KW - Cell Transformation, Neoplastic
KW - Diagnostic Imaging
KW - Hemangiosarcoma/diagnostic imaging
KW - Humans
KW - Liver Neoplasms/diagnostic imaging
KW - Male
KW - Mediastinal Neoplasms/diagnostic imaging
KW - Neoplasms, Germ Cell and Embryonal/diagnostic imaging
KW - Young Adult
U2 - 10.1097/MD.0000000000009152
DO - 10.1097/MD.0000000000009152
M3 - Article
C2 - 29390446
SN - 0025-7974
VL - 96
SP - e9152
JO - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries
JF - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries
IS - 51
ER -