Mediastinal germ cell tumor in an adolescent: a case report

OBJECTIVE: To evaluate the effectiveness of comprehensive treatment of mediastinal germ cell tumor in a child with emphasis on the role of neoadjuvant chemotherapy and total resection. MATERIAL AND METHODS: The authors present a boy with primary mediastinal germ cell tumor. RESULTS: Treatment of a 17-year-old patient with stage IVA anterior mediastinal choriocarcinoma was followed by complete clinical and laboratory remission. Intensive induction polychemotherapy according to the MAKEI 2005 protocol led to significant tumor shrinkage (~85.5%) for subsequent en bloc resection of tumor and adjacent tissues. Postoperative period and final course of chemotherapy were uneventful; follow-up examinations showed normalization of tumor markers, favorable clinical status and no signs of recurrence. CONCLUSION: This case demonstrates that comprehensive treatment, including induction chemotherapy and subsequent total resection, enables complete remission even in aggressive and advanced forms of mediastinal germ cell tumors in adolescents. This confirms high effectiveness of modern therapeutic approaches.