Successful resection of a giant mediastinal non-seminomatous germ cell tumor showing fluorodeoxyglucose accumulation after neoadjuvant chemotherapy: report of a case.

Kazuki Takada, Yosuke Morodomi, Tatsuro Okamoto, Yuzo Suzuki, Takatoshi Fujishita, Hirokazu Kitahara, Shinichiro Shimamatsu, Mikihiro Kohno, Daigo Kawano, Noriko Hidaka, Yoichi Nakanishi, Yoshihiko Maehara

Research output: Contribution to journalArticlepeer-review

Abstract

A 32-year-old man presented with a mediastinal non-seminomatous germ cell tumor showing fluorodeoxyglucose (FDG) accumulation (maximum standardized uptake value = 22.21) and extremely elevated blood alpha-fetoprotein (AFP) level (9203.0 ng/ml). The patient underwent 4 cycles of neoadjuvant chemotherapy (cisplatin, bleomycin, and etoposide), which normalized the AFP level and reduced the tumor size, allowing complete resection without a support of extracorporeal circulation. Despite preoperative positron emission tomography revealing increased FDG uptake in the residual tumor (maximum standardized uptake value = 3.59), the pathologic evaluation revealed that no viable germ cell tumor cells remained. We believe FDG uptake should not be used as a criterion for surgical resection after neoadjuvant chemotherapy. It is appropriate to resect the residual tumor regardless of FDG uptake after induction chemotherapy if a tumor is resectable and the AFP level normalizes.

Original languageEnglish
Pages (from-to)117-123
Number of pages7
JournalFukuoka igaku zasshi = Hukuoka acta medica
Volume105
Issue number5
Publication statusPublished - May 2014

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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