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 journalArticle

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

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alpha-Fetoproteins
Residual Neoplasm
Drug Therapy
Induction Chemotherapy
Extracorporeal Circulation
Germ Cell and Embryonal Neoplasms
Bleomycin
Etoposide
Positron-Emission Tomography
Cisplatin
Neoplasms
Nonseminomatous germ cell tumor

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Successful resection of a giant mediastinal non-seminomatous germ cell tumor showing fluorodeoxyglucose accumulation after neoadjuvant chemotherapy : report of a case. / Takada, Kazuki; Morodomi, Yosuke; Okamoto, Tatsuro; Suzuki, Yuzo; Fujishita, Takatoshi; Kitahara, Hirokazu; Shimamatsu, Shinichiro; Kohno, Mikihiro; Kawano, Daigo; Hidaka, Noriko; Nakanishi, Yoichi; Maehara, Yoshihiko.

In: Fukuoka igaku zasshi = Hukuoka acta medica, Vol. 105, No. 5, 05.2014, p. 117-123.

Research output: Contribution to journalArticle

Takada, K, Morodomi, Y, Okamoto, T, Suzuki, Y, Fujishita, T, Kitahara, H, Shimamatsu, S, Kohno, M, Kawano, D, Hidaka, N, Nakanishi, Y & Maehara, Y 2014, 'Successful resection of a giant mediastinal non-seminomatous germ cell tumor showing fluorodeoxyglucose accumulation after neoadjuvant chemotherapy: report of a case.', Fukuoka igaku zasshi = Hukuoka acta medica, vol. 105, no. 5, pp. 117-123.
Takada, Kazuki ; Morodomi, Yosuke ; Okamoto, Tatsuro ; Suzuki, Yuzo ; Fujishita, Takatoshi ; Kitahara, Hirokazu ; Shimamatsu, Shinichiro ; Kohno, Mikihiro ; Kawano, Daigo ; Hidaka, Noriko ; Nakanishi, Yoichi ; Maehara, Yoshihiko. / Successful resection of a giant mediastinal non-seminomatous germ cell tumor showing fluorodeoxyglucose accumulation after neoadjuvant chemotherapy : report of a case. In: Fukuoka igaku zasshi = Hukuoka acta medica. 2014 ; Vol. 105, No. 5. pp. 117-123.
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