Multimodality treatment of primary mediastinal germ cell tumor with growing teratoma syndrome: a case report

Germ cell tumors arise from errors occurring during the migration of embryonic stem cells to the gonads. They constitute 10-15% of malignant mediastinal tumors. Thirty-nine years old male patient was admitted with shortness of breath and gynecomastia. Positron emission tomography / Computed tomography (PET/CT) showed hypermetabolic mediastinal mass in the anterior mediastinum. Serum tumor markers were elevated. Mixed germ cell tumor was diagnosed via transthoracic tru-cut biopsy. After three cycles of systemic cisplatin, etoposide and bleomycin treatment, PET/CT showed a decreased metabolic activity but an increase in the size of mass. "Growing teratoma syndrome" was diagnosed. The excision of the mass was performed via a median sternotomy. Then autologous stem cell transplantation was performed. Patients was presented as a successful example of a multimodality treatment of a primary mediastinal germ cell tumor with GTS.