Development of angiosarcoma in a mediastinal non‐seminomatous germ cell tumor that exhibited growing teratoma syndrome during chemotherapy

• Published in: Thoracic cancer 2019-01, Vol.10 (1), p.111-115
• Main Authors: Matsuoka, Shunichiro, Koyama, Tsutomu, Takeda, Tetsu, Yamada, Kyoko, Hyogotani, Akira, Hamanaka, Kazutoshi, Sekiguchi, Nodoka, Koizumi, Tomonobu
• Format: Article
• Language: English
• Subjects: Adult; Anemia; BEP chemotherapy; Biomarkers; Biomarkers, Tumor; Bleomycin - administration & dosage; Bleomycin - adverse effects; Case Report; Case Reports; Chemotherapy; Cisplatin - administration & dosage; Cisplatin - adverse effects; Drug-Related Side Effects and Adverse Reactions - pathology; Drug-Related Side Effects and Adverse Reactions - surgery; Etoposide - administration & dosage; Etoposide - adverse effects; germ cell tumor; Hemangiosarcoma - chemically induced; Hemangiosarcoma - diagnosis; Hemangiosarcoma - pathology; Hemangiosarcoma - surgery; Hemorrhage - etiology; Hemorrhage - pathology; Humans; Male; Mediastinal Neoplasms - complications; Mediastinal Neoplasms - drug therapy; Mediastinal Neoplasms - pathology; Mediastinal Neoplasms - surgery; Medical imaging; Medical prognosis; Neoplasms, Germ Cell and Embryonal - complications; Neoplasms, Germ Cell and Embryonal - drug therapy; Neoplasms, Germ Cell and Embryonal - pathology; Neoplasms, Germ Cell and Embryonal - surgery; NMR; Nuclear magnetic resonance; Patients; Pulmonary arteries; Sarcoma; somatic type; Surgery; Teratoma - chemically induced; Teratoma - diagnosis; Teratoma - pathology; Teratoma - surgery; Testicular Neoplasms - complications; Testicular Neoplasms - drug therapy; Testicular Neoplasms - pathology; Testicular Neoplasms - surgery; Thoracic surgery; Thoracic Surgical Procedures - adverse effects; Tomography, X-Ray Computed; Tumors; Veins & arteries
• ISSN: 1759-7706; 1759-7714
• DOI: 10.1111/1759-7714.12901

Herein, we report a case of an angiosarcoma in a mediastinal non‐seminomatous germ cell tumor that exhibited growing teratoma syndrome during chemotherapy. A 26‐year‐old man presented with a giant anterior mediastinal mass, which was diagnosed as a non‐seminomatous germ cell tumor. The patient was administered three cycles of chemotherapy (bleomycin, etoposide, and cisplatin), but the mass grew despite normalization of tumor markers. Massive bleeding during thoracic surgery resulted in incomplete resection, and the mass was clinically and pathologically diagnosed as growing teratoma syndrome (only mature teratoma). The residual mass continued to grow, and complete resection was subsequently achieved after a detailed analysis of its vascular anatomy using angiography. The final pathological findings revealed angiosarcoma, which indicated a rare somatic type of mediastinal non‐seminomatous germ cell tumor.