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遠隔転移のある縦隔非セミノーマ胚細胞性腫瘍に対する集学的治療
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JPY
Abstract
A mediastinal nonseminomatous germ cell tumor was completely resected after down-staging by chemotherapy despite the presence of multiple distant metastases. A 22-year-old female was admitted for superior vena cava (SVC) syndrome. Her SVC was obstructed by a large anterior mediastinal tumor;she also exhibited distant metastases on a left rib, in the liver, and multiple in the lung. The blood α-fetoprotein(AFP)level was extremely elevated to 57,530 ng/ml. Four courses of BEP therapy[ cisplatin( CDDP), bleomycin( BLM), etoposide( VP-16)]and a high dose chemotherapy followed by a peripheral blood stem cell transplantation made the tumor become smaller and effected its down-staging. Residual mediastinal tumor with an intravascular tumor in SVC was completely resected. The SVC was reconstructed by an artificial vessel graft. A mediastinal nonseminomatous germ cell tumor, even though it has multiple distant metastases, can achieve down-staging and complete resection by a chemotherapy based on scientific evidence.
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